Non-Intentional
Actions
The aim of the paper is to show that there
are actions which are non-intentional. An account is first given which links
intentional and unintentional action to acting for a reason, or appropriate
causation by an intention. Mannerisms and habitual actions are then presented as
examples of behavior which are actions, but which are not done in the course of
acting for a reason. This account has advantages over that of Hursthouse's
"arational actions," which are allegedly intentional actions done for
no reason at all. Finally, one consequence of neglecting non-intentional action
is discussed to illustrate its importance.
A
Not-So-Simple View of Intentional Action
The Simple View (SV) holds that for someone
to intentionally A, he must intend to A. Critics of SV point to
intentional actions which, due to belief-conditions or consistency constraints,
agents cannot intend. By recognizing species of intention which vary according
to the agent's confidence in acting, I argue that the stringency of consistency
constraints depends on the agent's confidence. A more sophisticated SV holds
that the species of intending is related to the degree of intentionality of the
action. Finally, I show that where agents do what they believe impossible,
without intending to do so, the action is not intentional.
The Doctor-Patient Relationship: A Survey of Attitudes and Practices of Doctors in Singapore
This article reports the results of a survey, by mailed questionnaire, of the attitudes, values and practices of doctors in Singapore with respect to the doctor-patient relationship. Questionnaires were sent to a random sample of 475 doctors (261 general practitioners and 214 medical specialists), out of which 249 (52.4%) valid responses were completed and returned. The survey is the first of its kind in Singapore. Questions were framed around issues of medical paternalism, consent and patient autonomy. As the doctors were exposed to Western ethical concepts in their training, we were not surprised to find that they would mostly allow patients some say in decision-making and keep patients reasonably informed. In respecting patient autonomy, they would usually seek to influence patient choice by persuasion. However, the residual "Asian-ness" of doctors in Singapore gives rise to some inconsistencies between values and practices. Many doctors still believe that a number of their patients are incapable of rational choice. There is some lack of openness in telling patients the whole truth. When patients choose to refuse treatment, many doctors are prepared to involve family members in making a consensus decision.
Doctors were also asked how they made ethical judgements in the face of dilemmas, and how they would like disputes with patients to be resolved. By and large, the doctors prefer to make their own judgements rather than to rely on rules. They also wish to keep the law courts out of disputes with patients, preferring less public ways of settling disputes.
Ethics,
Human Cloning, and Procreation
Interest and controversy surround the
possibility of cloning adult humans in the way that Dolly the sheep was cloned.
What I will do within the limitations of this paper is to point at the direction
I think an ethical debate about human cloning should take, and to identify some
of the considerations to be brought into the debate.
Reasons commonly cited for and against human
cloning appeal to the benefits and harms that may result. I argue that there can
be no conclusive argument against human cloning which rests on the harms
outweighing the benefits. Any attempt to do a cost-benefit analysis will be
hampered by too many incommensurables. But apart from that, for two reasons, the
predicted harms need not eventuate. Firstly, the fact that the harms are
predicted means that steps can be taken to avoid or minimize them. The harms are
not ones that will occur no matter what we do about it.
Secondly, the predictions are themselves
exaggerated, depending on a slippery slope argument: that the introduction of
the technology will lead inexorably to its abuse and logically extends to the
worst possible outcome. There are two flaws in the argument. Conditions for a
slide down the slippery slope may not be fulfilled. Secondly, the slippery slope
argument is premised on its not being possible to draw a clear and non-arbitrary
line between what is permitted and what is unacceptable. There are however many
points at which a line can be drawn to distinguish between cases of human
cloning.
I will introduce into the debate two further
questions which can help to shed light on the permissibility of human cloning.
Firstly, what is the nature and scope of procreative liberty, and does it
extend to a right to reproduce by cloning oneself? Even if it is thought that
procreative liberty extends to assisted forms of reproduction such as IVF,
cloning goes so far beyond what normally counts as reproduction that it is
unclear whether it serves that which we value about human reproduction. For
cloning exerts too much of an influence over the new individual. The meaning of
human reproduction is intrinsically tied to the bringing forth of new life in
which both parents have a share, not the exact duplication of an existing
individual.
The second question I want to introduce is:
In what way does the having of children contribute to human happiness,
and would cloning as a means of reproduction satisfy a desire to have children
in the way that natural reproduction does?
There are some infertile couples who desire
not just to have children to raise, but to have their own genetic offspring. It
is evident that they can be just as satisfied having a child through IVF as
through natural means. To determine whether cloning could serve them just as
well, we can compare IVF with cloning. In human cloning, there are more features
of natural reproduction absent. In particular, there is no
"conception" in the sense of the fusion between male and female
gametes which takes place when fertilization occurs. It is more appropriate to
picture cloning as artificial twinning, with the twins a generation apart. The
parent in this case is also the sibling.
If the aim of an infertile couple is to
produce an offspring from their union, cloning cannot substitute for natural
reproduction. Only one parent can be the genetic parent of the clone. The
meaning and significance of having one's own child through sexual relations is
not retained when a child is produced who possesses identical genes to oneself.
The complete identity in nuclear DNA between clone and "parent" marks
an important difference from natural reproduction and would arguably hinder the
satisfaction of the desire of an infertile couple to have their own child.
My suggestion here is that cloning is not
reproduction in the sense that makes natural reproduction desirable. What needs
to become meaningful is asexual reproduction as a way of satisfying a
person's desire to have his or her own child. This is a matter for social
negotiation. My discussion emphasises how very different human cloning is from
other forms of assisted reproduction. But I have left open the possibility that
human cloning, as a form of artificial twinning rather than reproduction, may be
permissible as a means to other human ends besides reproduction.
Intention
and Responsibility in Double Effect Cases
I argue that the moral distinction in double
effect cases rests on a difference not in intention as traditionally stated in
the Doctrine of Double Effect (DDE), but in desire. The traditional DDE has
difficulty ensuring that an agent intends the bad effect just in those cases
where what he does is morally objectionable. I show firstly that the mental
state of a rational agent who is certain that a side-effect will occur satisfies
Bratman's criteria for intending that effect. I then clarify the nature of the
moral distinction in double effect cases and how it can be used to evaluate the
moral blameworthiness of agents rather than the moral status of acts. The
agent's blameworthiness is reduced not by his lack of intention but by his
desire not to bring about the side-effect, and the 'counterfactual test' can be
used to determine whether he desires the effect in acting. In my version, the
DDE has its rationale in virtue ethics; it is not liable to abuse as the
traditional version is; and it makes more plausible distinctions when applied to
standard examples.
Desiring
and Intending to Do What One Tries to Do
In this paper, I argue that one can try to do
what one neither desires nor intends to do. I discuss first the relation between
desire and trying, and then the relation between intention and trying. My
position is that all that is required for trying is the desire and/or intention
to try. I also show that one can try to do what one believes it is impossible
for one to do. I conclude by explaining how the assumption that leads one to
hold the view that I reject is based on a mistake concerning the cognitive
nature of trying.
An extrinsic desire is defined as a desire
for something, not for its own sake, but for its supposed propensity to secure
something else that one desires. I argue that the notion of ‘extrinsic
desire’ is theoretically redundant. I begin by defining desire as a
propositional attitude with a desirability characterization. The roles of desire
and intention in practical reasoning are distinguished. I show that extrinsic
desire does not have its own motivational role. I also show that extrinsic
desire is not needed for other roles besides motivation to carry out the means,
and is not generated by reason. Finally, I argue that an account of extrinsic
motivation in terms of intention is preferable to an account in terms of
extrinsic desire. Because of the fundamental differences between extrinsic
desire and intrinsic desire, it is more advantageous to distinguish between them
as different kinds of mental states: intention and desire.
Unintended Killing of Innocents in War
Civilians not engaged in the business of war are often killed in warfare. The moral distinction between the killing of combatants and noncombatants in war is controversial, but it is clearly criminal to kill civilians who are unarmed, engaged in peaceful activities, and bear no responsibility for war. But soldiers have been known, without prior planning, to slaughter civilians, with no further objectives to be achieved by means of the killings. Such killings appear to have resulted from chance encounters between soldiers and civilians. If our moral condemnation of the killings is based on the killer's intention, then soldiers may be excused on the grounds that their killings are not intended. I argue in this paper that the soldier's lack of a specific intention to kill the innocent can be morally blameworthy. For intentions originate from the agent's desires through a process of practical reasoning. Killing of civilians in chance encounters without intention is evidence that the soldiers are not sufficiently averse to killing innocent people. They are similar in this respect to soldiers who kill civilians intentionally.
Active
Voluntary Euthanasia and the Problem of Intending Death
In
this paper, I discuss an example from Buchanan of active voluntary euthanasia
(AVE). I first refute objections to
the intuitive permissibility of the killing described in the example.
After explaining why the killing is intentional, I evaluate Buchanan's
solution to the ‘problem of intending death’.
According to Buchanan, what justifies a physician in intentionally
bringing about a patient's death by AVE is a principle that embodies the values
of patient self-determination and well-being.
I argue that these two considerations are not sufficient for justifying
AVE. The motive of the physician matters, but it is his desire
rather than his intention that is relevant.
An ethical physician may bring about intentionally the death of his
patient if in forming his intention, he began with an appropriate desire to keep
the patient alive as well as a legitimate desire to prevent prolonged suffering,
with the latter outweighing the former. The
ethical physician also desires to respect the choice of his patient wherever
possible. On my account, the
physician should be guided by the virtues and goals of his profession rather
than by strict ‘all-or-nothing’ principles.
I defend my account by describing the advantages of my account, and
dismissing possible objections.
Genetic Information, Electronic Records, and the Threat to Medical Confidentiality
Genetic testing will enable the genes responsible for diseases to be detected prior to the onset of a disease. But the power and scope of genetic tests can pose very real dangers, and the principle of confidentiality in medicine has undeniable value, even in the genetic era. This paper focuses on the question of how genetic testing poses problems for medical confidentiality in conjunction with the use of electronic databanks. I will suggest that the use of information technology for the storage and transmission of patient records needs to be controlled to reduce the threat posed to medical confidentiality, especially with respect to information obtained from genetic testing.
A system where the patient records are stored in a common databank and are readily available to medical professionals from any institution has some clear advantages. In an emergency, a doctor will be able to retrieve without delay the records of a patient he has never treated before. A central databank will also facilitate disease control as the pattern of disease spread can be monitored. It will facilitate research, as researchers will not need to search for information from many different sources. With respect to genetic information, there is little benefit for the patient to keep the results of genetic tests in a centralized databank. The information is not the type that is going to make a difference in a medical emergency. The main use of genetic information stored in a databank is research. But such use provides a weak justification for breaching confidentiality, as the patient himself may not benefit from such research, and the future beneficiaries are not identifiable individuals. The patient should have the choice of keeping genetic information off the electronic record.
Given that the unauthorized disclosure of genetic information is a particularly damaging violation of privacy that could gravely harm its subject, and given that the use of electronic databanks cannot ensure the security of genetic information, it seems quite unwise to store such information. If the benefits of genetic information are to be reaped, then confidentiality must be assured.
Human Dignity and the Human Genome
The Universal Declaration on the Human Genome and Human Rights published by UNESCO in 1997 warns against research that is disrespectful of or contrary to human dignity. What is human dignity? Why is respect for human dignity of moral significance? What is the connection between genetic research and respect for human dignity? In what way can respect for human dignity be used as a condition for genetic research to be morally acceptable?
In this paper, I shall investigate the concept of human dignity, and examine its status as a moral concept. I reject a Kantian interpretation in terms of respect for persons. In its clearest sense, dignity is linked with identity, so that its application to the morality of genetic research is best understood in terms of a view of human nature as irreducible to genetic endowment. But this view is in need of philosophical analysis.
A Reappraisal of the
Doctrine of Doing and Allowing
Warren
Quinn and Philippa Foot have given versions of the Doctrine of Doing and
Allowing justifying a moral distinction between doing something to bring about
harm, and doing nothing to prevent harm. They
argue that it is justified to allow one person to die so that one can save a
larger number of people, but not to kill one person to achieve the same purpose.
Consequentialist moral philosophers hold instead that if killing or
letting die have the same consequences, there is no moral difference between the
two acts. In
this paper, I argue that although it can be justified to minimize harm by
killing a smaller number of people, in preference to letting a greater number
die, the distinction between killing and letting die does have some intuitive
moral significance. This can be
accounted for from a non-consequentialist
perspective without appeal to a distinction between positive and negative
rights.
The
Possibility of Moral Reasoning
Is there a form of moral reasoning that is distinguishable from the instrumental form of practical reasoning? Agents can choose not to do what would best satisfy their goals because, by engaging in moral reasoning, they judge it immoral to do so. In this paper, I examine the possibility that moral agents have moral and prudential reasons that are distinct from each other. I suggest that in a moral struggle, moral reasoning responds to a second-order desire that is concerned with the moral acceptability of the instrumental means to an agent's ends. The presence of this desire in conflicted agents, who may not have moral ends, provides an intermediate stage in the process of moral transition. I conclude that moral reasoning that conflicts with prudential reasoning about means may not only be possible, but may well be a preliminary step on the way to moral reasoning about ends.
The ethics of gene patenting is concerned with whether human genes are the kind of thing that is appropriate for patenting, and whether it is ethical to do so. Is genetic technology a special case compared to other medical technology that have been patented? Much of the debate has revolved around the benefits and harms of allowing gene sequences to be patented. In this paper, I am concerned with a non-consequential consideration: Can someone patent my genes? If genes are the common property of humankind, are genes patentable? I present an objection to the patenting of processes used to manipulate our genes that have the potential to change human nature. Should not all members of the human species have a say regarding genetic engineering that can be used to irreversibly change what makes each one a human? I conclude with an examination of how genetic research may be democratically controlled.
Genetic Technology and the Problem of the Non-Natural
Why is genetic technology that can be used to prevent or cure diseases criticized as an intervention in nature? Why is the non-natural morally problematic? In this paper, I examine the basis of criticisms of the non-natural, drawing on David Hume's objections to the natural law tradition used to support Thomas Aquinas' opposition to suicide. I suggest that genetic technology is considered an unacceptable way of improving human lives because it is thought to be a threat to the essence of humanity. Natural law theorists work within a philosophical or theological framework in which all humans have a given nature that is the basic determinant of what the good life is. The criticism considered here of genetic technology is not just that it may be abused for purposes incompatible with human good. It is that the technology may make it possible to change human nature. I will show not only that this criticism is unsustainable, but also that the rejection of the non-natural poses a worse problem for theists than the problem of evil. The problem of the non-natural places the theists in a dilemma because it undermines the freewill solution to the problem of evil.
Moral Theory and Public Policy in Bioethics
Discussion in bioethics of methodology and moral reasoning has usually focused on providing guidance to individuals who have to make decisions in particular cases, and helping them to justify their choices. My purpose in this paper is to discuss what I see as a problem in applying moral theory to public policy making. Specifically, it seems to me that there is a tension between how an individual physician may make moral decisions on a case-by-case basis, and how the policy maker has to decide on either permitting or prohibiting all cases of a type. This tension arises because the fine distinctions that a physician may appropriately draw between cases contrast with the broad categories that policy makers have to place cases into and treat in a similar way. I show that most approaches to moral reasoning, such as utilitarianism, principlism, and casuistry, seem unable to avoid this difficulty. I then suggest that virtue ethics may have the resources to reconcile the distinct roles of physician and policy maker.
Aquinas,
Intention, and the Doctrine of Double Effect
I
discuss Aquinas' account of intention and relate it to the application of the
Doctrine of Double Effect in his example of killing in self-defense in the Summa
Theologica. I argue that, and
explain why, modern versions of the doctrine do not succeed in showing that the
evil effect, in double effect cases, is never intended.
By connecting acts of will with desire in Aristotelian fashion, I
establish that in Aquinas' account of choice and intention, every chosen means
is also intended as an end. Whereas
modern concepts of intention, that abandon the will's appetitive aspect, are
unable to block an agent from intending an evil effect known to be closely
connected to an intended means, one is not forced on the Thomistic account to
intend that effect if one does not desire it.
Autonomy, Humane Medicine, and Research Ethics: An East Asian Perspective
In Chinese Confucian medical ethics, the principle of autonomy has not been recognized. Instead, the basic values of medical practice are compassion and humaneness. Patient autonomy however lies at the foundation of Western medical ethics in general and research ethics in particular. In the modern world of biotechnology, what happens when medical research is carried out in an East Asian society? Should the society adopt principles of Western medical ethics? Or can resources to ensure ethical research be found in Confucian ethics? I consider answers to these questions in the context of a recent case of unethical research in Singapore.
To many philosophers of action, motivation by desire is not sufficient for human agency of the sort relevant to ethics. That is, for someone to perform an action for which she can be held morally responsible, it is required that her desire led to action in a particular way. A person's moral responsibility is absent or diminished if the desire motivates without her awareness or control in Freudian cases, or against her will in cases of weakness of will. Typically, we hold a person responsible for her intentional actions, which are actions motivated by her reasons for acting. As Ancombe puts it, intentional actions are those to which a certain sense of the question 'Why?' has application. For an agent to act for a reason is for the agent to have gone through a process of practical reasoning with a conclusion in favor of so acting. Since the agent could make a decision that she either fails to act on, or will only do so at a suitable time in the future, the practical conclusion may either be inert or be future-directed. The mental state that is formed in making a commitment to act now or in the future has a functional role different from the desires that are evaluated by practical reason. This mental state, according to Michael Bratman, is an intention.
In "After Anscombe," I argue that, although Bratman's account of intention "has provided a conceptual tool for many directions of research in philosophy and cognitive psychology," it cannot do the work in ethics that moral philosophers, especially Kantians, use it for. This can be shown by considering the problems in using intention to make a moral distinction in cases of double effect. If so, Bratman's is not the same concept of intention that Anscombe had in mind when she wrote her book. I show that Ancombe's account of intention is a much broader concept, with deeper historical roots. This does not mean that Bratman's concept of intention should be abandoned. Rather, we need to make a distinction between desire and intention that is implicit in Anscombe's account. That is, the aspects of intention that make her concept suited for ethics do not belong to Bratman's narrower concept and should be attributed to a concept that can be distinguished from intention. Evidence for what the latter concept is can be found in Aquinas' account of intentio from which the concept of intention has borrowed its name. Intentio for Aquinas is an act of will in regard to the end, whereas Bratman's intention is of the means that are chosen in practical reasoning. Intentio seems to be an intrinsic desire for the end. If this is right, then it is desire that is relevant for ethics, and not intention in its modern use. Recognition that desire and not intention is the relevant concept for ethics, in both Ancombe's and Aquinas' accounts of human agency, dovetails perfectly with their ethical theories, for it is Aristotle's ethics that has guided both philosophers in their ethical writings. After all, Aristotelian virtue ethicists are concerned with moral evaluation of the agent's character, which consists in a set of dispositions to seek ends that are desired for their own sake.
The Wrongful Life Argument Against Cloning
It is sometimes argued that it is wrong to create offspring that come into being in a less than satisfactory condition, or in adverse circumstances. This argument has been applied to cases described as "wrongful life". The subject of wrongful life is a puzzling one. Why may we say that a parent has wronged her offspring in not trying to avoid passing a disease to her child, but not say that the offspring is wronged for being born illegitimate? The need to properly evaluate the argument has become urgent, with forms of assisted reproduction, such as human cloning, that carry risks of harms either greater than or not otherwise present in natural reproduction.
In this essay, I discuss the meaning and justification of claims of wrongful life, and suggest that attempts to conceptualize wrongful life in terms of harms to the offspring are unsatisfactory. They are either too restrictive or too permissive. My account finds middle ground in justifying harm to the offspring on the basis of the reasons we have for reproducing, and it is able to provide a line between harms that are wrongful and harms that are not which applies to cloning as well as natural reproduction.
Foot on Practical Rationality and Acting Well
The virtuous person excels at using her reason to make the right choices. Virtue ethicists have attempted to provide accounts of practical rationality that would preclude immoral choices. Philippa Foot rejects the self-interest theory and the desire-fulfillment theory of moral reasons. Her account makes moral goodness a criterion of practical rationality so that the moral goodness of an act is always a reason in its favor. I suggest that her move away from a neo-Humean theory of reasons for action is premature. Foot's account would deny the possibility of rationally pursuing the bad, whereas the view that moral reasons are desire-dependent would not. If we pay attention to examples where ordinary moral agents are conflicted between what they have practical reasons to do and their moral scruples, there is evidence for moral reasoning as a different form of reasoning. Moral reasons here depend on a general desire to do only what is morally right, which is not an input into practical reasoning but constrains the choice of means. Such a desire is important for ethical development in agents who do not have the specific desires of a fully virtuous person, but although common, is admittedly not universal among humans.
Falling From Virtue: Natural Goodness and Human Nature
In neo-Aristotelian virtue ethics, the appropriate goals for human action are drawn from human nature. Human virtues are excellences of character that enable humans to accomplish the best life they are capable of. If so, it is human nature to seek to act virtuously. Why then is it a struggle for humans to do the right thing? Why is virtue so uncommon? In this paper, I show that the ethics of Foot and Hursthouse cannot avoid the problem of 'falling from virtue'. I then look for the source of the problem in the nature of the human good, and in the motivational psychology of the agent who acts. If the latter, does the problem lie with the agent's desires or her intellect? Finally, as a solution, I suggest that human nature is not just reason alone, but also having and acting on non-rational desires that humans share with other animals.
How War Affects People: Lessons from Euripides
What do philosophers have to say about war beyond appeal to the just war
doctrine? I suggest that they should
concern themselves with the harmful consequences of war for the people who
experience it. The ancient Greek
tragedian Euripides was a moral philosopher of his time who wrote the plays
Hecuba
and
The Trojan Women
from the perspective of the losers in the Trojan War.
There are striking parallels to the
In this paper, I seek a philosophical account that will explain the proper role of faith in political leadership. I will evaluate an argument from faith-based morality, which starts with the premise that decisions made by a person who is sustained by faith are morally better than decisions made without faith. Is this true? And if so, does it follow that we should prefer leaders who make faith-based political decisions?
The Importance of Jus in Bello
The
traditional just war doctrine comprises of one set of principles concerned with
justice in going to war (jus ad bellum), and another set with justice in
the conduct of war (jus in
My paper critiques the comparability requirement that practical reason is limited by the possibility of comparing alternatives. I describe methods of reasoning that are compatible with choice between incomparable options, and discuss a mistake about intention that supports the view that comparing alternatives is the only way to choose rationally. I then explain how a model of rational choice that prescribes the comparison of alternatives invents unacceptable concepts to make comparability possible. Finally, I criticize the assumption of the unity of practical reason that requires that prudential and moral choices are both made by comparing alternatives. It turns out that moral conflicts that are intractable for those who reason with a method of comparison may be resolvable by using moral reasoning that does not involve the comparison of alternatives in terms of a comprehensive value. Making room for such forms of reasoning is preferable to denying incomparability.
Desire Ownership and the
Hierarchical Model
Frankfurt's 'hierarchical model' of human agency has been associated with narrow accounts of desire ownership where agents have to make desires their own, typically by reasoning, and to reject desires as not their own. I argue that such accounts do not accord with how we attribute moral responsibility and how we identify a person's true self. In this paper, I suggest an alternative view of how desires are owned and 'disowned', drawing out implications for accounts of the self, agency and moral responsibility. The Frankfurtian hierarchy of different orders of desires is compatible with a more liberal view of desire ownership, as decisive identification with a desire is not required for ownership in the morally relevant sense. Although reflective endorsement adds a layer of complexity to a person's will, my examples show that unendorsed and even rejected desires may have moral significance.