Simon Rosenqvist

This paper argues that we have a moral obligation to implement certain health technologies even if we have limited or incomplete evidence of their effectiveness. The focus is on technologies used in non-emergency settings, as opposed to “exceptional cases” such as compassionate use and emergency approvals during public health emergencies. A broadly plausible moral principle – the Ecumenical Principle – is introduced and applied to a test case: the use of Digital Breast Tomosynthesis in mammographic screening. The paper concludes by exploring the implications of the Ecumenical Principle for the adoption of other new health technologies.

Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically required to use their DBTready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography.

According to hedonistic act utilitarianism, an act is morally right if and only if, and because, it produces at least as much pleasure minus pain as any alternative act available to the agent. This dissertation gives a partial defense of utilitarianism against two types of objections: action guidance objections and intuitive objections. In Chapter 1, the main themes of the dissertation are introduced. The chapter also examines questions of how to understand utilitarianism, including (a) how to best formulate the moral explanatory claim of the theory, (b) how to best interpret the phrase "pleasure minus pain," and (c) how the theory is related to act consequentialism. The first part (Chapters 2 and 3) deals with action guidance objections to utilitarianism. Chapter 2 defines two kinds of action guidance: doxastic and evidential guidance. It is argued that utilitarianism is evidentially but not doxastically guiding for us. Chapter 3 evaluates various action guidance objections to utilitarianism. These are the objections that utilitarianism, because it is not doxastically guiding, is a bad moral theory, fails to be a moral theory, is an uninteresting and unimportant moral theory, and is a false moral theory. The second part (Chapters 4, 5 and 6) deals with intuitive objections to utilitarianism. Chapter 4 presents three intuitive objections: Experience Machine, Transplant, and Utility Monster. Three defenses of utilitarianism are subsequently evaluated. Chapter 5 and 6 introduces two alternative defenses of utilitarianism against intuitive objections, both of which concern the role that imagination plays in thought experimentation. In Chapter 5, it is argued that we sometimes unknowingly carry out the wrong thought experiment when we direct intuitive objections against utilitarianism. In many such cases, we elicit moral intuitions that we believe give us reason to reject utilitarianism, but that in fact do not. In Chapter 6, it is argued that using the right kind of sensory imagination when we perform thought experiments will positively affect the epistemic trustworthiness of our moral intuitions. Moreover, it is suggested that doing so renders utilitarianism more plausible. In Chapter 7, the contents of the dissertation are summarized.

Coordination games show that all individuals can do what is right according to act‐consequentialism, even if they do not bring about the best outcome as a group. This creates two problems for act‐consequentialism. First, it cannot accommodate the intuition that there is some moral failure in these cases. Second, its formulation as a criterion of rightness conflicts with the underlying act‐consequentialist concern that the best outcome is brought about. The collectivist view solves these problems by holding that any group of two or more individual agents, and only individual agents, is a collective agent who itself can act rightly or wrongly. When such a collective agent does what is wrong, there is a moral failure. When all collective agents do what is right, the best outcome is brought about. In this paper, I defend the collectivist view against the No Act Objection, according to which the doings of many so called disunified collectives are not acts.

Jag argumenterar för att oorganiserade kollektiv, såsom kollektivet av alla människor, kan handla moraliskt rätt och fel. Storskaliga problem likt den globala uppvärmningen är till exempel resultatet av en sådan kollektiv handling, nämligen hela mänsklighetens utsläpp av växthusgaser. Denna kollektiva handling är dessutom moraliskt fel, på grund av dess dåliga konsekvenser. Jag bemöter också en invändning mot denna uppfattning om kollektivt handlande, enligt vilken det är intuitivt orimligt att oorganiserade kollektiv såsom ”hela mänskligheten” kan handla.

A pure time preference is a preference for something to occur at one point in time rather than another, merely because of when it occurs in time. Such preferences are widely regarded as paradigm examples of irrational preferences. However, Rosemary Lowry and Martin Peterson have recently argued that, for instance, a pure time preference to go to the opera tonight rather than next month may be rationally permissible, even if the amounts of intrinsic value realized in both cases are identical. In this reply, we argue that Lowry and Peterson's argument is unsuccessful.