David Merli

The “therapeutic obligation” is a physician’s duty to provide his patients with what he believes is the best available treatment. We begin by discussing some prominent formulations of the obligation before raising two related considerations against those formulations. First, they do not make sense of cases where doctors are permitted to provide suboptimal care. Second, they give incorrect results in cases where doctors are choosing treatments in challenging epistemic environments. We then propose and defend an account of the therapeutic obligation that solves the problems that undermined previous efforts at formulating the TO. We conclude by considering how apparent problems with our proposal actually rest on difficulties with informed consent

This paper argues that expressivism faces serious difficulties giving an adequate account of univocal moral disagreements. Expressivist accounts of moral discourse understand moral judgments in terms of various noncognitive mental states, and they interpret moral disagreements as clashes between competing attitudes. I argue that, for various reasons, expressivists must specify just what mental states are involved in moral judgment. If they do not, we lack a way of distinguishing moral judgments from other sorts of assessment and thus for identifying narrowly moral disagreements. If they do, we can construct cases of intuitively real dispute that do not rest on the theory’s preferred mental states. This strategy is possible because our intuitions about moral concept-ascription do not track speakers’ noncognitive states. I discuss various ways of developing this basic argument, then apply it to the work of the two most sophisticated proponents of expressivism, Allan Gibbard and Simon Blackburn. I argue that neither is successful in meeting the challenge.

This paper argues that expressivism faces serious difficulties giving an adequate account of univocal moral disagreements. Expressivist accounts of moral discourse understand moral judgments in terms of various noncognitive mental states, and they interpret moral disagreements as clashes between competing attitudes. I argue that, for various reasons, expressivists must specify just what mental states are involved in moral judgment. If they do not, we lack a way of distinguishing moral judgments from other sorts of assessment and thus for identifying narrowly moral disagreements. If they do, we can construct cases of intuitively real dispute that do not rest on the theory's preferred mental states. This strategy is possible because our intuitions about moral concept-ascription do not track speakers' noncognitive states. I discuss various ways of developing this basic argument, then apply it to the work of the two most sophisticated proponents of expressivism, Allan Gibbard and Simon Blackburn. I argue that neither is successful in meeting the challenge.

In order to have genuine disagreement, interlocutors must share terms, meanings, and concepts. Without this, their dispute is merely verbal; it rests on linguistic confusion. This is true of all conversation, but many philosophers have thought that moral discourse poses special problems. Moral discourse seems to contain intractable disagreements and lacks the sorts of authority and deference relations that are typical in straightforward empirical disagreement. This yields a potent philosophical puzzle: how is it that moral evaluators can share a subject matter while thinking such different things? ;I argue that noncognitivist attempts to make sense of disagreement fail. The noncognitivist is obliged to provide an account of the mental states at work in moral discourse. These accounts either fail to identify a distinct species of moral evaluation, or to provide for genuine incompatibility between competing moral judgments, or to avoid circularity. Thus one of the most important motivations for noncognitivist accounts is undermined. ;I show how naturalistic moral realism can be defended against popular arguments against its ability to make sense of univocity. This criticism has been revived in recent work by Terence Horgan and Mark Timmons. I develop three objections to their so-called 'Moral Twin Earth' argument, and conclude that it has no force against moral realism. ;I then show that naturalistic realism faces a different problem accounting for univocity. This problem results from the fact that the path of moral inquiry is underdetermined: there is no fact of the matter about the referents of speakers' terms. I argue that common realistic appeals to the resolution of moral dispute are not sufficient, because they fail to note a distinction between different readings of the convergence claim. The most plausible ways of understanding that claim are of no help to the realist's semantic requirements. ;Finally, I consider a rejoinder suggested by recent work in the philosophy of language. Though not compatible with realism's moral semantics, this rejoinder suggests that moral and non-moral language are on a par. I offer some reasons for doubting this claim, and suggest that moralizing poses unique interpretive challenges

Moral discourse allows for speakers to disagree in many ways: about right and wrong acts, about moral theory, about the rational and conative significance of moral failings. Yet speakers’ eccentricities do not prevent them from engaging in moral conversation or from having (genuine, not equivocal) moral disagreement. Thus differences between speakers are compatible with possession of moral concepts. This paper examines various kinds of moral disagreements and argues that they provide evidence against conceptual-role and informational atomist approaches to understanding our moral concepts. Conceptual role approaches fail because they cannot account for shared concepts among speakers with different commitments to the practical and conative ramifications of moral judgments. Informational atomist views fail because speakers need not be locked on to the same moral properties to share moral concepts.

Terence Horgan and Mark Timmons's ' moral twin earth argument' raises doubts about the naturalistic realist's ability to make sense of genuine disagreement. I offer three arguments the realist's behalf. First, I argue that the example at the heart of their argument is underdescribed; when fully developed, it loses its intuitive force. Second, I suggest that taking the stipulations of the Horgan-Timmons example seriously gives us reason to revise our initial judgments. Third, I propose combining naturalistic realism about moral judgments with expressivism about the last ought before action in order to preserve the conflict between moralists and twin -moralists