Linguistic justice is about institutions distributing material and symbolic resources fairly when they are faced with linguistic diversity. However, no theory of linguistic justice has developed a systematic and comprehensive account of the moral dilemmas that take place in interpersonal linguistic relationships, in particular the power dynamics leading to (linguistic) domination. The aim of this article is to start building a general theory of linguistic domination, one that offers new conceptual tools for both empirical and normative analyses of (...) linguistically diverse societies. Using the republican tradition of thought, I argue that there is linguistic domination whenever someone is subject to the uncontrolled capacity for interference over their linguistic uses, ideology and acquisition by another agent. This article tests under what conditions this phenomenon takes place and the parties involved in it (both in terms of individuals and political institutions). (shrink)

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some (...) members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC. (shrink)

A strong tradition in philosophy denies the possibility of moral dilemmas. Recently, several philosophers reversed this tradition. In this dissertation, I clarify some fundamental issues in this debate, argue for the possibility of moral dilemmas, and determine some implications of this possibility. ;In chapter I, I define moral dilemmas roughly as situations where an agent morally ought to adopt each of two alternatives but cannot adopt both. Moral dilemmas are resolvable if and (...) only if one of the moral oughts overrides the other. ;In chapter II, I criticize several opponents of moral dilemmas, including utilitarians, Kant, Aquinas, and Ross. My main criticism is that no opponent of moral dilemmas can adequately justify moral residue . ;Chapters III and IV concern the two main arguments against the possibility of moral dilemmas. First, the argument for 'ought' implies 'can' runs as follows. If the agent cannot adopt both, then it is not the case that the agent ought to adopt both. But the agent ought to adopt both, since the agent ought to adopt each . Thus, the defining judgements of a moral dilemma seem to imply a contradiction. In response, I argue that the relation between 'ought' and 'can' is not a logical implication but a conversational implicature. ;Chapter IV concerns the argument from 'ought' implies 'permitted': If the agent ought to adopt one alternative, then the agent is permitted to adopt that alternative, which means that it is not the case that the agent ought not to adopt that alternative. But the agent ought not to adopt that alternative, since the agent ought to adopt the other alternative and cannot adopt both. I respond that 'ought' does not logically imply but conversationally implicates 'permitted'. ;In chapter V, I argue that, despite recent claims, both moral realism and anti-realism are compatible with the possibility of moral dilemmas. Thus, there are several reasons to accept and no reasons to deny the possibility of moral dilemmas. (shrink)

Moral Dilemmas is the second volume of collected essays by the eminent moral philosopher Philippa Foot, gathering the best of her work from the late 1970s to the 1990s. It fills the gap between her famous 1978 collection Virtues and Vice (now reissued) and her acclaimed monograph Natural Goodness, published in 2001. In this new collection, Professor Foot develops further her critique of the dominant ethical theories of the last fifty years, and discusses such topics as the (...) nature of moral judgement, practical rationality, and the conflict of virtue with desire and self-interest. Moral Dilemmas, alongside her other two books, completes the summation of her distinctive and lasting contribution to twentieth-century moral philosophy. (shrink)

The essays in this volume illuminate a central topic in ethical theory: moral dilemmas. Some contemporary philosophers dispute the traditional view that a true moral dilemma -- a situation in which a person has two irreconcilable moral duties -- cannot exist. This collection provides the historical background to the ongoing debate with selections from Kant, Mill, Bradley, and Ross. The best recent work on the question is represented in essays by Donagan, Foot, Hare, Marcus, Nagel, van (...) Fraassen, Williams, and others. (shrink)

The current chapter provides an overview of research on responses in moral dilemmas where maximization of outcomes for the greater good (utilitarianism) conflicts with adherence to moral norms (deontology). Expanding on a description of the traditional paradigm to study moral-dilemma judgments (i.e., the trolley problem), the chapter reviews the most prominent dual-process account of moral-dilemma judgments, normative conclusions that have been derived from this account, and criticisms raised against this line of work. The following sections (...) review advances in the development of alternative approaches that aim to address shortcomings of the traditional dilemma paradigm as well as the implications of this work for psychological theories of moral-dilemma judgments and philosophical inferences about the normative implications of moral-dilemma research. The chapter concludes with a review of research on the links between moral-dilemma judgments and social impressions. (shrink)

Moral Dilemmas is the second volume of collected essays by the eminent moral philosopher Philippa Foot, gathering the best of her work from the late 1970s to the 1990s. It fills the gap between her famous 1978 collection Virtues and Vices and her acclaimed monograph Natural Goodness, published in 2001. In this new collection Professor Foot develops further her critique of the dominant ethical theories of the last fifty years, and discusses such topics as the nature of (...) moral judgement, practical rationality, and the conflict of virtue with desire and self-interest. Moral Dilemmas, alongside her other two books, completes the summation of her distinctive and lasting contribution to twentieth-century moral philosophy. (shrink)

Marcus argues that moral dilemmas are real, but that they are not the result of inconsistent moral principles. Moral principles are consistent just in case there is some world where all principles are 'obeyable.' They are inconsistent just in case there is no world where all are 'obeyable.' What this logical point is meant to show is that moral dilemmas do not make moral codes inconsistent. She also discusses guilt, and argues that guilt (...) is still appropriate even in cases of conflict, even when the agent thinks the right thing to do is clear. (shrink)

A moral dilemma is a situation in which an agent ought to do each of two actions, Both of which he cannot do. If there are genuine moral dilemmas, The ethical theorist is presented with a problem: he must reject several very plausible principles of standard deontic logic. The main reasons usually given to show that there are moral dilemmas are examined, And it is argued that they are not sufficient. Several positive arguments are then (...) presented, Arguments which try to show that an adequate moral theory must rule out the possibility of genuine dilemmas. (shrink)

This collection of previously unpublished essays addresses a number of issues arising out of philosophical controversies over the possibility of genuine moral dilemmas. Issues addressed include the form of a moral dilemma; the paradoxes a moral dilemma is said to entail; the question of whether a moral dilemma must exhibit inconsistency; the role of intractable circumstances in occasioning moral dilemmas; and the plausibility of supposing that there might be rational ways of addressing (...) class='Hi'>moral dilemmas in practice. The contributors, writing from a number of widely differing points of view, include Simon Blackburn, Ruth Barcan Marcus, Alan Donagan, Terrance McConnell, Walter Sinnott-Armstrong, Mary Mothersill, Norman Dahl, David Brink, Peter Railton, Thomas E. Hill, Jr., Christopher Gowans, and H.E. Mason. (shrink)

The author defines moral dilemmas as situations where there is a moral requirement for an agent to adopt each of two alternatives, And the agent cannot adopt both, But neither moral requirement overrides the other. The author then argues that moral dilemmas are possible because conflicting moral requirements can be either symmetrical or incomparable in a way that is limited enough to be plausible but still strong enough to yield moral dilemmas.

E j lemmon, B a o williams, Bas van fraassen, And ruth marcus have argued on behalf of the existence of moral dilemmas, I.E., Cases where an agent is subject to conflicting absolute moral obligations. The paper criticizes this support and contends that no moral dilemma is possible.

The aim of the consequentializing project is to show that, for every plausible ethical theory, there is a version of consequentialism that is extensionally equivalent to it. One challenge this project faces is that there are common-sense ethical theories that posit moral dilemmas. There has been some speculation about how the consequentializers should react to these theories, but so far there has not been a systematic treatment of the topic. In this article, I show that there are at (...) least five ways in which we can construct versions of consequentialism that are extensionally equivalent to the ethical theories that contain moral dilemmas. I argue that all these consequentializing strategies face a dilemma: either they must posit moral dilemmas in unintuitive cases or they must rely on unsupported assumptions about value, permissions, requirements, or options. I also consider this result's consequences for the consequentializing project. (shrink)

Lemmon argues that dilemmas occur between classes of 'oughts;' duties, obligations, and moral principles. He claims that there are not conflicts within each class, presumably because he is a utilitarian, and thinks that moral principles will always be univocal.

The history of moral dilemma theory often ignores the medieval period, overlooking the sophisticated theorizing by several thinkers who debated the existence of moral dilemmas from 1150 to 1450. In this book Michael V. Dougherty offers a rich and fascinating overview of the debates which were pursued by medieval philosophers, theologians and canon lawyers, illustrating his discussion with a diverse range of examples of the moral dilemmas which they considered. He shows that much of what (...) seems particular to twentieth-century moral theory was well-known long ago - especially the view of some medieval thinkers that some forms of wrongdoing are inescapable, and their emphasis on the principle 'choose the lesser of two evils'. His book will be valuable not only to advanced students and specialists of medieval thought, but also to those interested in the history of ethics. (shrink)

Recent work shows an important asymmetry in lay intuitions about moral dilemmas. Most people think it is permissible to divert a train so that it will kill one innocent person instead of five, but most people think that it is not permissible to push a stranger in front of a train to save five innocents. We argue that recent emotion-based explanations of this asymmetry have neglected the contribution that rules make to reasoning about moral dilemmas. In (...) two experiments, we find that participants show a parallel asymmetry about versions of the dilemmas that have minimized emotional force. In a third experiment, we find that people distinguish between whether an action violates a moral rule and whether it is, all things considered, wrong. We propose that judgments of whether an action is wrong, all things considered, implicates a complex set of psychological processes, including representations of rules, emotional responses, and assessments of costs and benefits. (shrink)

Moral Dilemmas is the second volume of collected essays by the eminent moral philosopher Philippa Foot, gathering the best of her work from the late 1970s to the 1990s. It fills the gap between her famous 1978 collection Virtues and Vices and her acclaimed monograph Natural Goodness, published in 2001. In this new collection Professor Foot develops further her critique of the dominant ethical theories of the last fifty years, and discusses such topics as the nature of (...) moral judgement, practical rationality, and the conflict of virtue with desire and self-interest. Moral Dilemmas, alongside her other two books, completes the summation of her distinctive and lasting contribution to twentieth-century moral philosophy. (shrink)

In this book, I consider whether the hypothesis of moral dilemmas undermines ethics' pretensions to objectivity. I argue against the view that moral dilemmas challenge the very possibility of ethical theory, as a practical and theoretical enterprise. By examining Kantian, Intuitionist and Utilitarian arguments about moral dilemmas, I show that no ethical theory is capable of avoiding them. I further argue that an adequate ethical theory should admit dilemmas. Dilemmas do not reveal (...) a logical or normative flaw in the theory that permits them to arise, nor are they necessarily generated by subjective mistakes. Rather, dilemmas are a sign of the deliberative capacity of an agent who operates in non-ideal conditions of rationality and cooperation. The inevitability of moral dilemmas shows that we should reconsider the bounds of deliberation, and the purposes of ethical theory. My argument for the philosophical significance of moral dilemmas rests on the claim that an adequate ethical theory should make sense of moral phenomenology, and that moral phenomenology should to be understood from the perspective of an agent who conceives of herself as an agent. The view of moral dilemmas I advocate does not invite skepticism about ethical theory, but suggests that we redefine its scope and its many practical aims. (shrink)

The demands of morality can seem straightforward. Be kind to others. Do not lie. Do not murder. But moral life is not so simple. We are often confronted with difficult situations in which someone is going to get hurt no matter what we do, in which we cannot meet all of our obligations, in which loyalties come into conflict, in which we cannot help everyone who needs it, or in which we must compromise on important values. It is natural (...) to describe such situations as moral dilemmas. This chapter is about the psychology of how we represent, process, and make decisions about what to do when moral life is difficult in this way. Our first aim is to provide some conceptual clarity on what exactly turns a choice situation into a moral dilemma. Here, we propose a normative account of moral dilemmas in terms of moral appropriate feelings of conflict in response to strongly conflicting reasons. Our second aim is to critically survey existing psychological work, providing an overview of some important findings, while raising questions for future research. (shrink)

Recent work shows an important asymmetry in lay intuitions about moral dilemmas. Most people think it is permissible to divert a train so that it will kill one innocent person instead of five, but most people think that it is not permissible to push a stranger in front of a train to save five innocents. We argue that recent emotion-based explanations of this asymmetry have neglected the contribution that rules make to reasoning about moral dilemmas. In (...) two experiments, we find that participants show a parallel asymmetry about versions of the dilemmas that have minimized emotional force. In a third experiment, we find that people distinguish between whether an action violates a moral rule and whether it is, all things considered, wrong. We propose that judgments of whether an action is wrong, all things considered, implicate a complex set of psychological processes, including representations of rules, emotional responses, and assessments of costs and benefits. q 2005 Published by Elsevier B.V. (shrink)

Moral dilemmas set a challenge for ethical theory. They are situations where agents seem to be under an obligation both to do, and to refrain from doing, a specific act. Are such situations possible? What is their exact nature? These are the questions that _Moral Dilemmas_ tries to answer. The book argues that moral theories should not allow for the possibility of irresolvable dilemmas, for situations in which no right answer exists. To this end, arguments seeking (...) to prove the existence of irresolvable dilemmas, especially the argument from the incommensurability of values, are discussed at length and refuted. The book shows that though on the normative level dilemmas are resolved, they typically involve a high moral cost for which there is no adequate compensation. This moral cost is the source of the regret and pain suffered by agents in moral dilemmas. Thus, moral dilemmas do not point to any inconsistency in our moral reasoning or theory, but to a problematic aspect of the human condition; at times (probably less often than is usually believed), human beings are justified, and even required, to dirty their hands by behaving in ways that in ordinary situations would be strictly forbidden and condemned. (shrink)

Ruth Marcus has offered an account of moral dilemmas in which the presence of dilemmas acts as a motivating force, pushing us to try to minimize predicaments of moral conflict. In this paper, I defend a Marcus-style account of dilemmas against two objections: first, that if dilemmas are real, we are forced to blame those who have done their best, and second, that in some cases, even a stripped down version of blame seems inappropriate. (...) My account highlights the importance of collective responsibility in understanding dilemmas, and I suggest that it sheds light on understanding moral progress. (shrink)

The moral dilemmas raised by modern medicine are no longer the concerns of doctors alone, but are the subject of intense public debate. Test-tube babies, the mechanical prolongation of life, the prescription of contraceptive pills to underage girls, the nontreatment of handicapped newborns--these issues generate widespread discussion throughout society. In this book, well-known experts address these concerns from philosophical, medical, and legal points of view. Clearly written and thought-provoking, these essays will contribute to the understanding of contemporary (...) class='Hi'>moral thinking and medical practice, and will inform public debate. (shrink)

A moral dilemma is a situation where an agent’s obligations conflict. Debate in this area focuses on the question of whether genuine moral dilemmas exist. This question involves considering not only the nature and significance of dilemmas, but also the connections between dilemmas, the logic of obligation and moral emotions.

Working as clinical ethicists in an academic hospital, we find that practitioners tend to take a principle‐based approach to moral dilemmas when it comes to (not) treating patients who feel like a burden, in which respect for autonomy tends to trump other principles. We argue that this approach insufficiently deals with the moral doubts of professionals with regard to feeling that you are a burden as a motive to decline or withdraw from treatment. Neither does it take (...) into adequately account the specific needs of the patient that might underlie their feeling of being a burden to others. We propose a care ethics approach as an alternative. It focuses on being attentive and responsive to the caring needs of those involved in the care process—which can be much more specific than either receiving or withdrawing from treatment. This approach considers these needs in the context of the patient's identity, biography and relationships, and regards autonomy as relational rather than as individual. We illustrate the difference between these two approaches by means of the case of Mrs K. Furthermore, we show that a care ethics approach is in line with interventions that are found to alleviate feeling a burden and maintain that facilitating moral case deliberation among practitioners can supports them in taking a care ethics approach to moral dilemmas in (not) treating patients who feel like a burden. (shrink)

Here the collected papers explore the whole question of the relation between the mythopoetic and the moral in the context of the Mahabharata. Here we have a story of extreme complexity, characters that are unforgettable, and a cosmic context in which gods and men alike grapple with destiny. The obligations of kinship and friendship jostle with each other. The women characters, as in everyday life, seem to bear a very heavy load of the burden of life and to stand (...) in a key position in almost every conflict. We are presented with predicaments at every turn. At times these predicaments seem to be aggravated by social structure. At other times they are cushioned by it. Philosophical tangles tied up with karma and dharma are interwoven with the mythopoetic material. Perhaps philosophical issues are pinpointed rather more than they are in Greek epic literature. The essays in this book treat the Mahabharata from an unusual angle, fastening on the moral dilemmas it presents. How universal are the dilemmas faced by the characters in the story, and are the dilemmas in fact resolved? In dealing with these questions, the discussions range over the meaning of the purusarthas, the institutions of marriage and the family, the concept of action in the Gita and the special predicaments faced by Draupadi, Arjuna and others. These studies invite the scholar to reflect afresh on the text and encourage the general reader to find in epic literature much that is relevant to life today. (shrink)

Earl Conee is a well known contemporary defender of the impossibility of moral dilemmas. In his 1982 paper "Against Moral Dilemmas" he argued that moral dilemmas are impossible because the existence of such a dilemma would entail that some obligatory action is forbidden, which is absurd. More recently, in "Why Moral Dilemmas are Impossible" he has defended the impossibility of moral dilemmas by claiming that the moral status of an (...) action depends in part on the moral status of its alternatives. I will here argue that this claim -- as he understands it -- is sufficiently controversial to undermine the force of his argument. (shrink)

This chapter contains sections titled: What are Genuine Moral Dilemmas? Applications.

Influential theories on moral judgments propose that they rely either on emotions or on innate moral principles. In contrast, the mental model theory postulates that moral judgments rely on reasoning, either intuition or deliberation. The theory allows for the possibility that intuitions lead to utilitarian judgments. This paper reports two experiments involving fifth-grade children, adolescents, and adults; the results revealed that children reason intuitively to resolve moral dilemmas in which action and inaction lead to different (...) outcomes. In particular, the results showed female children to be more utilitarian than female adults in resolving classical moral dilemmas: they preferred an action that achieved a good outcome for a greater number of people. Within the mental model theory’s framework there is no reason to expect that females and males differ in their ability to reason, but at the moment the results for females cannot be generalized to males who were not properly represented in the adults groups of the two experiments. The result revealing that (female) children are more utilitarian than (female) adults, which is hard to explain via many current theories, was predicted by the mental model theory. (shrink)

First published in 1994. Routledge is an imprint of Taylor & Francis, an informa company.

In this paper, I work within Ruth Marcus’s account of the source of moral dilemmas and articulate the implications of her theory for collective responsibility. As an extension to Marcus’s work, I explore what her account means for the moral emotions and responsibilities of those complicit in perpetuating unjust systems of a non-ideal world from which moral dilemmas arise. This move necessitates shifting away from the primacy of control. That one is born into unjust systems (...) one had no hand in establishing does not excuse one from responsibility to mend them. Similarly, even if one’s personal contribution in the perpetuation of unjust systems is negligible – the injustices would continue whether one participated or not, and one’s resistance would do little-to-nothing – one nevertheless retains responsibility. This expanded sense of responsibility necessitates a specialized sort of moral emotion – one that, like agent-regret or tragic-remorse, transcends the criterion of agentic control, but nevertheless can be classified neither as agent-regret nor tragic-remorse. (shrink)

Can there be genuine moral dilemmas? Some say no; it would be, or entail, a contradiction. Others say yes; such things are actual, therefore possible. I criticize standard lines of dilemmatic defense, but side with the defense against standard arguments well presented by David Brink. A leading analogy: moral dilemmas are no more logically offensive than checkmate (another case in which absolute obligations clash: always move out of check; never move into it.) I argue that Brink-style (...) arguments against dilemmas unwittingly and fallaciously stipulate away the possibility of bad behavior. (shrink)

From a philosophical standpoint, the work presented here is based on van Fraassen [26]. The bulk of that paper is organized around a series of arguments against the assumption, built into standard deontic logic, that moral dilemmas are impossible; and van Fraassen only briefly sketches his alternative approach. His paper ends with the conclusion that “the problem of possibly irresolvable moral conflict reveals serious flaws in the philosophical and semantic foundations of ‘orthodox’ deontic logic, but also suggests (...) a rich set of new problems and methods for such logic.” My goal has been to suggest that some of these methods might be found in current research on nonmonotonic reasoning, and that some of the problems may have been confronted there as well.I have shown that nonmonotonic logics provide a natural framework for reasoning about moral dilemmas, perhaps even more useful than the ordinary modal framework, and that the issues surrounding the treatment of exceptional information within these logics run parallel to some of the problems posed by conditional oughts. However, there is also another way in which deontic logic might benefit from a connection to nonmonotonic reasoning. A familiar criticism among ethicists of work in deontic logic is that it is too abstract, and too far removed from the kind of problems confronted by real agents in moral deliberation. It must be said that similar criticisms of abstraction and irrelevance are often lodged against work in nonmonotonic reasoning by more practically minded researchers in artificial intelligence; but here, at least, the criticisms are taken seriously. Nonmonotonic logic aims at a qualitative account of commonsense reasoning, which can be used to relate planning and action to defeasible goals and beliefs; and at least some of the theories developed in this area have been tested in realistic situations. By linking the subject of deontic logic to this research, it may be possible also to relate the idealized study of moral reasoning typical of the field to a more robust treatment of practical deliberation. (shrink)

In recent years, Alasdair MacIntyre and others have observed an increasing interest on the part of contemporary ethicists regarding the question of whetherinnocent agents ever find themselves in moral dilemmas. This present-day support for the existence of moral dilemmas for innocent agents has spawned a re-reading of canonical ethical texts in the history of philosophy. The point of departure for the present paper is one particularly contentious battleground of this ongoing historical retrieval, namely, the ethical writings (...) of Thomas Aquinas. I contend that Aquinas is not an ally of those who defend the existence of moral dilemmas for innocent agents. However, Aquinas does present what is in my view a valuable contribution to the discussion of moral dilemmas as such. I show that a close textual reading of one of Aquinas’s examples leads to some rather interesting consequences for his moral theory, and that, surprisingly, this example could be of interest to contemporary ethicists who argue for the existence of moral luck. (shrink)

Some philosophers have recently complained that moral theories almost always portray the distresses of ordinary people in moral predicaments as irrational. In the name of having a minimally realistic picture of ethical thought, these philosophers argue that accounts of morality must allow for strong moral dilemmas, choices involving mutually exclusive all-things-considered requirements or jointly exhaustive all-things-considered prohibitions. In this dissertation I clarify and reject several versions of this argument, which I call the argument from experience. ;In (...) chapters one and two I define strong moral dilemmas as essentially involving conflicts of moral reasons, and reject as premature attempts to reduce questions about strong dilemmas to questions about deontic logic. I accept the goal of representing ordinary experience faithfully, and ask whether a theory will necessarily distort that experience if it employs interpretations of 'ought' and 'prohibited' in ways guaranteeing a priori that there are no strong dilemmas. ;The argument from experience claims that people can have a justifiably high degree of confidence that they are in strong moral dilemmas, and in chapter three I question whether people ever have the needed sorts of confidence about the limits of their abilities, the precise location of their wrongdoing, or the futility of continued moral deliberation. ;In chapter four I reject specific arguments based on regret and guilt. The tendency to feel unavoidable agent-regret or guilt allegedly shows that the agent sees the choice as a strong dilemma, and the appropriateness of such distresses allegedly shows that the agent's way of seeing things is rational. I reply that someone can feel agent-regret without endorsing any moral judgment involving 'ought' or 'prohibited', and that guilt is never unavoidably appropriate. ;In chapter five I trace the failure of the argument from experience to the presence in ordinary thought of a notion of blame which is both conceptually guaranteed always to be avoidable and regarded as an infallible indicator of moral requirement and prohibition. I am led to wonder, finally, why this notion of blame should play a privileged role in philosophical pictures of morality. (shrink)

During the last two decades there has been an enormous development in treatment possibilities in the field of neonatology, particularly for (extremely) premature infants. Although there are cross-cultural differences in treatment strategy, an overview of the literature suggests that every country is confronted with moral dilemmas in this area. These concern decisions to initiate or withhold treatment directly at birth and, later on, decisions to withdraw treatment with the possible consequence that the child will die. Given that the (...) neonate cannot express his or her own will, who will decide? And on the basis of what information, values and norms? We explored some of these issues in daily practice by interviewing a small sample of health care practitioners in a Dutch university Neonatal Intensive Care Unit (NICU). It turned out that experiencing moral dilemmas is part of their daily functioning. Nurses underline the suffering of the newborn, whereas physicians stress uncertainty in treatment outcome. To make the best of it, nurses focus on their caring task, whereas physicians hope that future follow-up research will lead to more predictable outcomes. As for their own offspring, part of these professionals would hesitate to bring their own extremely premature newborn to a NICU. For the most oppressing dilemma reported – terminating an already initiated treatment – we propose the concept of ‘evidence shift’ to clarify the ambiguous position of uncertainty in decision making. (shrink)

: Autonomous driving systems promise important changes for future of transport, primarily through the reduction of road accidents. However, ethical concerns, in particular, two central issues, will be key to their successful development. First, situations of risk that involve inevitable harm to passengers and/or bystanders, in which some individuals must be sacrificed for the benefit of others. Secondly, and identification responsible parties and liabilities in the event of an accident. Our work addresses the first of these ethical problems. We are (...) interested in investigating how humans respond to critical situations and what reactions they consider to be morally right or at least preferable to others. Our experimental approach relies on the trolley dilemma and knowledge gained from previous research on this. More specifically, our main purpose was to test the difference between what human drivers actually decide to do in an emergency situations whilst driving a realistic simulator and the moral choices they make when they pause to consider what they would do in the same situation and to better understand why these choices may differs. Keywords: Self-driving Cars; Trolley Problem; Moral Choices; Moral Responsibility; Virtual Reality Dilemmi morali nelle automobili a guida autonoma Riassunto: I sistemi di guida autonomi promettono importanti cambiamenti per il futuro dei trasporti, principalmente attraverso la riduzione degli incidenti stradali. Tuttavia, vi sono preoccupazioni etiche, in particolare due questioni centrali, fondamentali per il loro sviluppo. In primo luogo, le situazioni di rischio che comportano inevitabili danni ai passeggeri e/o ai pedoni, ovvero situazioni in cui alcune persone devono essere sacrificate a beneficio di altri. In secondo luogo, l’identificazione delle parti responsabili in caso di incidente. Il nostro lavoro affronta il primo di questi problemi etici. Siamo interessati a studiare come gli umani rispondono a situazioni critiche e quali reazioni considerano moralmente giuste o almeno preferibili. Il nostro approccio sperimentale si basa sul trolley problem e sulle conoscenze acquisite da precedenti ricerche su questo ambito. Più specificamente, il nostro scopo principale è quello di testare la differenza tra ciò che i conducenti umani decidono effettivamente di fare in una situazione di emergenza, mentre guidano un simulatore realistico, e le scelte morali che compiono se posti nella stessa situazione e hanno la possibilità di decidere senza limiti di tempo. Lo scopo è inoltre comprendere come e perché queste scelte possono differire. Parole chiave: Automobili a guida autonoma; Trolley problem; Scelte morali; Responsabilità morale, Realtà virtuale. (shrink)

Asymmetric conflict is changing the way that we practise and think about war. Torture, rendition, assassination, blackmail, extortion, direct attacks on civilians, and chemical weapons are all finding their way to the battlefield despite longstanding international prohibitions. This book offers a practical guide for policy makers, military officers, students, and others who ask such questions as: do guerillas deserve respect or long jail sentences? Are there grounds to torture guerillas for information or assassinate them on the battlefield? Is there room (...) for nonlethal weapons to subdue militants and safeguard the lives of noncombatants? Who are noncombatants in asymmetric war? What is the status of civilians who shelter and aid guerillas? And, do guerillas have any right to attack civilians, particularly those who aid and shelter members of the stronger army? If one side can expand the scope of civilian vulnerability, then why can't the other? (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in (...) long-term care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Against theses of Bernard Williams and Bas C. van Fraassen, it is argued that there are no facts about moral dilemmas, characterizable independently of any moral theory. It is further argued that any adequate theory which denies that there are genuine moral dilemmas must provide a convincing account of how and why moral agents take themselves to be in dilemmatic situations. The ability of rationalist theories, which deny that genuine moral dilemmas occur, (...) to provide such account is examined. Aquinas's contribution receives particular attention. (shrink)

Although common sense and literature support the possibility of moral dilemmas, many traditional and contemporary philosophers deny this possibility because of several arguments. Probably the strongest argument against the possibility of moral dilemmas can be called the argument from ought and ought not. Various versions of this argument have been presented by McConnell, Hare, and Conee. Its basic form can be outlined as follows.If any agent is in any moral dilemma, then that agent ought to (...) adopt each of two alternatives but cannot adopt both.If any agent ought to adopt any alternative, but that agent cannot adopt that alternative together with another alternative, then that agent ought not not to adopt that other alternative.Therefore, if any agent is in any moral dilemma, then that agent both ought and ought not to adopt each alternative.It is not possible that any agent both ought and ought not to adopt any alternative.Therefore, it is not possible for any agent to be in any moral dilemma. (shrink)