30 results
12 - Prisoner's Dilemmas, intergenerational asymmetry, and climate change ethics
-
- By Douglas MacLean, University of North Carolina at Chapel Hill
- Edited by Martin Peterson, Texas A & M University
-
- Book:
- The Prisoner's Dilemma
- Published online:
- 05 July 2015
- Print publication:
- 02 July 2015, pp 219-242
-
- Chapter
- Export citation
-
Summary
12.1 Introduction
Climate change is happening, and human activity is the cause. What are we going to do about it? Bill McKibben calls this “the most important question that there ever was.” It is a practical question, but it also raises some philosophical issues. My goal in this chapter is to examine these philosophical issues. They include matters of self-interest and rational choice, and they include moral issues about the value of nature, the nature of human values, and difficult issues about international justice and intergenerational morality.
A number of writers have pointed out that climate change has remarkable spatial and temporal characteristics. It is a global problem and a paradigm of what game theorists call the Prisoner's Dilemma. The fundamental characteristic of a Prisoner's Dilemma is that if each agent successfully pursues its rational best interests, the result is collectively worse for each of them than some other possible result. I will discuss this issue in Section 12.3 below.
The temporal problem is an illustration of intergenerational asymmetry, or what some philosophers call the “tyranny of the present.” In each generation, people must decide whether they will collectively accept some costs in order to reduce greater harms and costs in the future or continue to pursue short-term gains and pass the problem on to the next generation. Because future people do not exist, they cannot bargain, reciprocate, compensate, reward, or punish us for what we do. I will discuss the implications of this asymmetry in intergenerational morality in Sections 12.4 and 12.5.
Both of these philosophical problems are familiar, and I will have little to add to the technical analysis of them. Once one understands and accepts the central facts about climate change, moreover, it is easy enough to formulate principles that tell us what we must do to avoid causing the worst harms and to mitigate the future harms we have already caused.
Contributors
-
- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
-
- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
-
- Chapter
- Export citation
Externality and Institutions, Andreas Papandreou. Clarendon Press, 1994, ix + 304 pages.
- Douglas MacLean
-
- Journal:
- Economics & Philosophy / Volume 14 / Issue 1 / April 1998
- Published online by Cambridge University Press:
- 16 October 2009, pp. 169-176
-
- Article
- Export citation
DIFFERENT PERSPECTIVES ON SAVING LIVES
- DOUGLAS MACLEAN
-
- Journal:
- Economics & Philosophy / Volume 23 / Issue 1 / March 2007
- Published online by Cambridge University Press:
- 01 March 2007, pp. 89-96
-
- Article
- Export citation
-
In “Weighing Lives”, John Broome defends a very weak consequentialist account of the value of saving lives. This paper challenges the commitments of this kind of account and describes some reasons for saving lives that would appeal to a non-consequentialist.
36 - Informed Consent and the Construction of Values
-
- By Douglas MacLean, Professor of Philosophy, University of North Carolina, Chapel Hill
- Edited by Sarah Lichtenstein, Paul Slovic
-
- Book:
- The Construction of Preference
- Published online:
- 05 June 2012
- Print publication:
- 28 August 2006, pp 668-681
-
- Chapter
- Export citation
-
Summary
Informed consent is a fundamental component of moral justification. It distinguishes love-making from rape, employment from servitude, and life-saving surgery from felonious assault with a deadly weapon, to mention just a few examples. At a more general level, consent distinguishes democratic from authoritarian governments, and it justifies a capitalist economic system. Efficiency is important, but freedom is what makes capitalism most appealing, as producers choose what to produce, and consumers choose what to buy. Consent is required to justify activities that impose a risk of harm or death on others. This is true of dramatic and newsworthy instances, such as trying to site a nuclear waste disposal facility, but it may also be true of activities as mundane as driving cars. When I drive a car in a city, I impose a risk of injury or death on innocent pedestrians. I also contribute to pollution and climate change, which imposes further risks on others. I do not know how the consent process works that permits me to engage in this kind of risk-imposing activity, but it seems reasonable to think that some sort of tacit consent must be at work to justify our using automobiles.
When disparities of power or the effects of new technologies threaten the effectiveness of consent, democratic governments intervene with regulations aimed at reinforcing the conditions of consent or establishing procedures for obtaining it.
2 - Some Morals of a Theory of Nonrational Choice
- Edited by Rajeev Gowda, Indian Institute of Management, Bangalore, Jeffrey C. Fox, Catawba College, North Carolina
-
- Book:
- Judgments, Decisions, and Public Policy
- Published online:
- 11 January 2010
- Print publication:
- 20 December 2001, pp 46-70
-
- Chapter
- Export citation
-
Summary
Individuals and organizations often have powerful incentives to shape our preferences, influence our judgments, and get us to make choices that serve their interests, whether or not they serve our own. We depend on our rational instincts, democratic institutions, and other rules and procedures to protect us from being exploited by these forces. To the ex-tent that our preferences are shaped in non-rational ways, however, and to the extent that others can find ways to bypass our rational faculties, we need to worry about our susceptibility to manipulation. If our nonrational tendencies are deep and pervasive, this worry may be justified, even when we have in place procedures and robust institutions aimed at steering us toward rational deliberation, and even when we want and try to act reasonably. This chapter is an examination of the grounds for this worry.
One of the central aims of behavioral decision theory is to discover and analyze the causal processes of preference formation. Behavioral decision theory is not a single theory but an amalgamation of findings, hypotheses, and research projects in different areas of the social sciences, which are united by their interest in discovering the empirical bases of judgment and choice. Some of the most interesting research in this area comes from psychologists who show how preferences are often determined in predictable but nonrational ways, with the implication that most of us can easily be led to make choices that we would also admit are not rationally justifiable.
7 - Forgoing life-sustaining food and water: Is it killing?
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 184-201
-
- Chapter
- Export citation
-
Summary
The moral permissibility of patients forgoing life-sustaining medical treatment has come to be widely accepted. The issue of forgoing life-sustaining food and water, however, has only very recently gained attention in public policy discussions. One source of resistance to extending this acceptance of a general right to forgo life-sustaining treatment to the case of food and water has explicitly philosophical origins: for a physician to withhold food and water might seem to be not merely to allow the patient to die, but to kill the patient, and therefore wrong. A closely related moral worry is that for physicians to withhold food and water would be to make them the direct cause of their patients' deaths, which also would be wrong. And finally, many worry that providing food and water is ordinary care, not extraordinary or “heroic,” and so must be obligatory.
In each case, a distinction is drawn – between killing and allowing to die, causing or not causing death, and withholding ordinary or extraordinary care – and in each case it is claimed that the former, though not the latter, is morally forbidden. I consider appeal to the intrinsic moral importance of these distinctions to be confused, both in general and as applied to food and water. In the hope of reducing the impact of these moral confusions in the policy debate about forgoing food and water, I will address here both the general meaning and the putative moral importance of these distinctions, as well as their specific application to the case of food and water.
Sources and acknowledgments
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp vii-x
-
- Chapter
- Export citation
PART II - LIFE-AND-DEATH DECISIONS IN THE CLINIC
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 93-94
-
- Chapter
- Export citation
PART III - LIFE-AND-DEATH DECISIONS IN HEALTH POLICY
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 233-234
-
- Chapter
- Export citation
13 - Justice, health care, and the elderly
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 388-407
-
- Chapter
- Export citation
-
Summary
A dominant theme in both public and policy-making discussions of health care in recent years has been the need to control relentlessly escalating health care costs. One widely perceived and important cause of this problem has been the “graying” of America – recent and anticipated increases in life expectancy and in the proportion of the population over age 65, and especially the even more rapid increase in the “old old” population. The increased numbers of elderly in turn make disproportionately large use of health care. In response to any proposals to limit the availability to the elderly of resources generally, and health care resources in particular, their advocates have added the charge of “ageism” to the more familiar charges of racism and sexism. From the other side and in the face of the daunting political power of the elderly wielded by such lobbying groups as the American Association of Retired Persons, the argument is increasingly heard that making Social Security or Medicare programs relatively immune from the budget cuts suffered by other domestic programs is creating intergenerational injustice – that the welfare of children and working-age Americans is being wrongly sacrificed for the benefit of the elderly. The intensifying policy debate over health care and other social support programs serving the elderly is forcing a rethinking of questions of intergenerational justice and the claims of the elderly on social resources.
4 - Moral rights and permissible killing
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 95-122
-
- Chapter
- Export citation
-
Summary
In what types of cases that arise in the practice of medicine is it morally permissible to kill human beings? My discussion of this question will largely involve working out some implications of a particular type of normative moral theory for the question of terminating human life in medical settings. However, the very substantial and often heated disagreement that arises over these issues amounts to more than simply disagreement over the implications of the kind of view I shall develop. Rather, it arises in large part because participants in the disputes hold general moral views of fundamentally different sorts. In the emotionally charged context in which these discussions often take place, and where the specifics of particular cases often occupy much of the attention, the deeper sources of the moral disagreement encountered are often obscured. I shall begin then with a brief attempt to illuminate some of those sources.
How one divides and distinguishes substantive moral theories is largely a matter of convenience, in the sense that it depends on the purpose of the inquiry at hand and the usefulness to that inquiry of carving up the geography of normative ethics in that particular way. No general distinctions between types of normative theories which delineate broad categories of such views are the correct distinctions or categories; any quite general distinctions will at the very least blur differences that are important in other contexts.
Frontmatter
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp i-iv
-
- Chapter
- Export citation
1 - Informed consent
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 21-54
-
- Chapter
- Export citation
-
Summary
The two central aims of the requirement that medical care cannot be given to competent patients without their informed consent are illustrated by the following two cases, in which that requirement is violated.
Case 1. Dr. Smith diagnoses his patient, Mrs. Jones, as having breast cancer. He informs her that a radical mastectomy should be performed as soon as possible, brushes aside her timid attempts to discuss the matter further, and with her silent and grudging acquiescence books her in the hospital for surgery.
Case 2. Mr. Brown is suffering multiple complications and disability, principally from advanced diabetes and renal failure. He has had both legs amputated above the knee and is functionally blind. He is not considered a candidate for a kidney transplant and so faces the necessity of dialysis treatments for the rest of his life. He is mentally alert, has had his medical situation fully explained to him by his attending physicians, and seems to understand his situation well. Two weeks ago, he decided that he wanted no more painful dialysis treatments, knowing that their termination would quickly lead to his death, and he has remained steadfast in that decision since. Despite his decision, his physician refuses to stop the dialysis treatments, believing that to do so would be tantamount to killing his patient.
Index
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 417-435
-
- Chapter
- Export citation
Life and Death
- Philosophical Essays in Biomedical Ethics
- Dan W. Brock
- General editor Douglas MacLean
-
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993
-
How should modern medicine's dramatic new powers to sustain life be employed? How should limited resources be used to extend and improve the quality of life? In this collection, Dan Brock, a distinguished philosopher and bioethicist and co-author of Deciding for Others (Cambridge, 1989), explores the moral issues raised by new ideals of shared decision making between physicians and patients. The book develops an ethical framework for decisions about life-sustaining treatment and euthanasia, and examines how these life and death decisions are transformed in health policy when the focus shifts from what is best for a patient to what is just for all patients. Professor Brock combines acute philosophical analysis with a deep understanding of the realities of clinical health policy. This is a volume for philosophers concerned with medical ethics, health policy professionals, physicians interested in bioethics, and undergraduate courses in biomedical ethics.
PART I - PHYSICIANS AND PATIENTS MAKING TREATMENT DECISIONS
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 19-20
-
- Chapter
- Export citation
12 - Justice and the severely demented elderly
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 356-387
-
- Chapter
- Export citation
-
Summary
INTRODUCTION
This essay addresses a narrowly circumscribed aspect of justice and the elderly. What health care and expenditure of resources on health care are owed on grounds of justice to the severely demented elderly? This is not an entirely accurate specification of the group of patients with whom I am concerned in several respects. In the great majority of cases, the severely demented are among the elderly, understood here as the over age 65 population, but in a minority of cases dementia can progress to this stage in younger persons. In that respect, my argument here will apply to the claims to care of some non-elderly as well. The effects of dementia that are my special concern here are the erosion of memory and other cognitive functions that attack and, I shall argue, ultimately destroy personal identity and personhood in the patient. While senile dementia of the Alzheimer's type is probably the most common cause of cognitive disability of the specific form that erodes personal identity, it may have other causes as well. Thus, the implications of my argument here will extend to some other severely cognitively disabled patients besides the severely demented, though for convenience I shall generally refer simply to the severely demented.
6 - Death and dying
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 144-183
-
- Chapter
- Export citation
-
Summary
In recent decades medicine has gained dramatic new abilities to prolong life. Patients with kidney failure can be placed on renal dialysis; patients who have suffered cardiac arrest can sometimes be revived with advanced life-support measures including drugs, electric shock, airway intubation and closed or open heart massage; patients with pulmonary disease can be assisted by mechanical ventilation on respirators; and patients unable to eat or drink can receive nourishment and fluids intravenously or with tube feedings. These are only some of the most dramatic and well-known additions to medicine's armamentarium for staving off death in the gravely ill. While these and other life-sustaining treatments often provide very great benefits to individual patients by restoring or prolonging functioning lives, they also have the capacity to prolong patients' lives beyond the point at which they desire continued life support or are reasonably thought to be benefitted by it. Thus, where once nature took its course and pneumonia was the “old man's friend,” now increasingly someone must decide how long a life will be prolonged and when death will come. This chapter addresses some of the principal moral issues and arguments in current debates about life support. First, I address very briefly a related issue: the definition of death.
2 - The ideal of shared decision making between physicians and patients
- Dan W. Brock, Brown University, Rhode Island
- General editor Douglas MacLean
-
- Book:
- Life and Death
- Published online:
- 05 June 2012
- Print publication:
- 29 January 1993, pp 55-79
-
- Chapter
- Export citation
-
Summary
INTRODUCTION
Shared treatment decision making, with its division of labor between physician and patient, is a common ideal in medical ethics for the physician-patient relationship. Most simply put, the physician's role is to use his or her training, knowledge, and experience to provide the patient with facts about the diagnosis and about the prognoses without treatment and with alternative treatments. The patient's role in this division of labor is to provide the values – his or her own conception of the good – with which to evaluate these alternatives, and to select the one that is best for himself or herself. As a rough guide to practice, this is a reasonable conception; most of the time it is likely to produce sound treatment decisions. However, as an ideal it is too simplistic, and is subject to several challenges that I will explore in this essay.
Some challenges relate to the physician's role. This facts/values division of labor seems to assume that the physician can and should provide the facts about treatment alternatives in a value-neutral form. But some have questioned whether the sciences on which medicine is based are, or can be, value-free. Moreover, the concepts of health and disease, and of the normal and pathological, are held by many to be value-laden.