Torbjörn Tännsjö

The paper is a record of a debate which took place between a group of clinicians and the author concerning a clinical trial of a drug supposed to postpone the time when HIV-patients develop AIDS. A problem with the trial was that on available (inconclusive) evidence it appeared that one patient out of 500 was killed by the drug. The question raised was whether, in view of this evidence, it was morally defensible to go on with the trial. The discussion came to involve general topics such as the appropriate role of the ideal of autonomy as well as more particular topics of quantitative and qualitative risk assessments. The main thrust of the argument is that different conceptions of rationality may provide rationales of conflicting clinical decisions. Philosophy matters to medicine. Keywords: autonomy, equipoise, hazards, the Helsinki Declaration, maximizing expected utility, potential benefits, rationality, risk assessment CiteULike Connotea Del.icio.us What's this?

It is argued that there are moral costs of our accepting ‘strict materialism’, the view that there is no such phenomenon as an irreducible first‐person point of view. If we accept strict materialism, then we have to give up some considered moral views, such as the principle of an agent‐relative morality and the hedonistic principle. The necessity involved is not logical, however, but pragmatic. Strict materialism does not imply that these moral views are false; it is our belief in them that is undermined by pur belief in strict materialism. If there is no irreducible first‐person point of view these moral views simply do not seem to make any moral sense. Since these moral views are prima facie very plausible, the moral costs of our accepting strict materialism are considerable.

When and why is it right to kill? When and why is it wrong? Torbjörn Tännsjö examines three theories on the ethics of killing in this book: deontology, a libertarian moral rights theory, and utilitarianism. The implications of each theory are worked out for different kinds of killing: trolley-cases, murder, capital punishment, suicide, assisted death, abortion, killing in war, and the killing of animals. These implications are confronted with our intuitions in relation to them, and our moral intuitions are examined in turn. Only those intuitions that survive an understanding of how we have come to hold them are seen as 'considered' intuitions. The idea is that the theory that can best explain the content of our considered intuitions gains inductive support from them. We must transcend our narrow cultural horizons and avoid certain cognitive mistakes in order to hold considered intuitions. In this volume, suitable for courses in ethics and applied ethics, Tännsjö argues that in the final analysis utilitarianism can best account for, and explain, our considered intuitions about all these kinds of killing.

We cannot easily condemn in principle a policy where people are non-voluntarily sterilized with their informed consent (where they accept sterilization, if they do, in order to avoid punishment). There are conceivable circumstances where such a policy would be morally acceptable. One such conceivable circumstance is the one (incorrectly, as it were) believed by most decent advocates of eugenics in the late nineteenth and early twentieth century to exist: to wit, a situation where the human race as such is facing a threat. Perhaps today's Chinese experience with a threat of overpopulation is a more realistic example? Finally, there is some room for a kind of non-voluntary (and coercive) sterilization without informed consent. I think of people who are severely mentally retarded, and who cannot understand how sexual intercourse relates to conception. If some of these persons are fertile and sexually active, it may very well be the morally right thing to do to sterilize these persons, in their own best interest, but without their consent - if necessary even through coercive means.

Aims The aim of this study was to examine if it is plausible to interpret the appearance of shame in a Swedish healthcare setting as a reaction to having one's honour wronged. Methods Using a questionnaire, we studied answers from a sample of long-term sick-listed patients who had experienced negative encounters (n=1628) and of these 64% also felt wronged. We used feeling wronged to examine emotional reactions such as feeling ashamed and made the assumption that feeling shame could be associated with having one's honour wronged. In statistical analyses relative risks (RRs) were computed, adjusting for age, sex, disease-labelling, educational levels, as well as their 95% CI. Results Approximately half of those who had been wronged stated that they also felt shame and of those who felt shame, 93% (CI 91 to 95) felt that they had been wronged. The RR was 4.5 (CI 3.0 to 6.8) for shame when wronged. This can be compared with the other emotional reactions where the RRs were between 1.1 (CI 0.9 to 1.3)–1.4 (CI 1.2 to 1.7). We found no association between country of birth and feeling shame after having experienced negative encounters. Conclusions We found that the RR of feeling shame when wronged was significantly higher compared with other feelings. Along with theoretical considerations, and the specific types of negative encounters associated with shame, the results indicate that our research hypothesis might be plausible. We think that the results deserve to be used as point of departure for future research

Should we change the human genome? The most general arguments against changing the human genome are here in focus. Distinctions are made between positive and negative gene therapy, between germ-line and somatic therapy, and between therapy where the intention is to benefit a particular individual (a future child) and where the intention is to benefit the human gene-pool.Some standard arguments against gene-therapy are dismissed. Negative somatic therapy is not controversial. Even negative, germ-line therapy is endorsed, if the intention is to cure a certain individual (a future child). In rare cases, positive therapy on somatic cells may be warranted. Germ-line therapy may become a valuable method of preventing harm, through genetic vaccination. If safe methods evolve, it is harmless (though vain), to try to achieve more ambitious goals. Prospective parents should not be prevented from exercising this harmless kind of parental authority.

On what model should a modern multi?cultural democracy work? Spinosa et al. have argued that the political order should be sustained by a set of common values instilled in the citizens, without, however, any common rank order among these values. I argue that the multi?cultural state should rather conform to what I call the Secular Model, according to which the citizens need not share any basic values at all. On the Secular Model, people individually stick to the existing constitution (only) as long as they each feel that they have good reasons to do so. To be sure, each citizen of a multi?cultural state does need a feeling of community identity, a ?we? ideology, but it is desirable that each individual can have more than one such identity. It is also important that each individual can shift as he or she pleases, from one such identity to another. So this kind of identity should not be moulded by the state, but by various different free associations, independent of the state

I conclude that the explanatory view of consequences is a fruitful one.This view accounts for our common sense view that actions are, in some sense, ‘sufficient’ for their consequences. It shows in a concrete and illuminating manner that we are or may be responsible for a vast number of events no matter how ‘innocently’ our actions may be described. It allows for the fact that individuals lack responsibility for consequences of collective actions, thereby explaining a generally felt ‘double effect’ built into our social morality. It brings into light and explains the fact that some degree of determinism seems to be presupposed if people are ever morally responsible for any events whatsoever. Finally, the explanatory view of consequences yields precise and attractive interpretations of the open and the closed views of responsibility

Conservatism has an essence, or so I argue. Typical of the conservative attitude is to take what is an established fact or order to be worthy of preservation, precisely because it is well established. The question what fact is established must be answered in a context, and people of different political bent answer it differently. This is why we have left?wing as well as right?wing conservatism, sharing a common rationale. In my Conservatism for Our Time I discuss various different aspects of this rationale, and my answer to certain strictures raised by Robert Grant concerns several of them. The most important concerns a conservative or traditionalist criticism of rationalism. This criticism has been developed by ? among others ?Michael Oakeshott. In my book, and in my answer to Grant, I defend and elaborate on this criticism

Donald Davidson brought to our attention deviant causal chains as a problem for causal theories of action. Consider Davidson's own example: " A climber might want to rid himself of the weight and danger of holding another man on a rope, and he might know that by loosening his hold on the rope he could rid himself of the weight and danger. This belief and want might so unnerve him as to cause him to loosen his hold, and yet it might be the case that he never chose to loosen his hold, nor did he do it intentionally. " The loosening of the hold on the rope is an action, according to a simple causal theory of action earlier developed by Davidson , if we can describe it in a way that renders it intentional under that description. Is there a way of describing the climber's loosening of his hold of the rope as intentional? Did he intentionally loosen his hold? Well, his loosening his hold is both rationalized and explained causally with reference to the beliefs and desires held by the climber. But there seems to be something wrong with the causal chain.Is there a simple fix? Could we not say that even if the loosening of the hold on the rope is caused by a desire held by the climber it is not caused by any proximate desire of the climber ? Or, to give a new twist to this well-known argument, could we not say that the loosening of the hold on the rope is not caused in a way that is responsive to the desire? This latter idea has recently been suggested by Markus E. Schlosser as a simple solution to the …

Different attempts have been made to answer Reich’s question of why the majority of those who are hungry don’t steal and why the majority of those who are exploited don’t strike. The two most influential approaches have been the ideological one and the gunman theory. The gunman theory seems to have the upper hand. However, there are cases where oppression takes place in the absence of any gunman. The usual example is the democratic welfare state. We can conceive of such instances of (continued) oppression by a minority of a majority as cases of rational injustice. Unless the privileged minority accepts the introduction of just institutions, there is no way of introducing them. And, for simple egoistic reasons, the minority doesn’t cooperate with the majority. So it is rational for the oppressed majority to endure