Setting Health-Care Priorities: A Reply to Massimo Reichlin

This is a short reply to Professor Reichlin’s comment on my book Setting Health-Care Priorities. What Ethical Theories Tell Us. The version of prioritarianism I rely on in the book is defended as the most plausible one. The general claim that there is convergence between all plausible theories on distributive justice is also defended with regard to assisted reproduction, disability, and enhancement.

Dual-Process Theory as a Theory of the Classification of Information Processing Acts

The article proposes a consideration of the dual-process theory of higher cognition as a theory of the classification of acts of information processing. One of the reasons why the dual-process approach has been criticized is the fact that the information processing process can sometimes have characteristics that undermine a clear-cut attribution to one of the two traditionally defined opposite types. To avoid this criticism, it is proposed that the object of classification should not be the processes of information processing, but separate acts of combining two units of information. Unlike a process, a particular act of information processing at a particular moment in time cannot simultaneously have opposite characteristics, nor can it simultaneously have and not have some characteristic. In order to show the qualitative difference between various information processing acts as falling individually into either Type 1 or Type 2 processing, it is proposed to classify them by a feature that is present in one type and absent in another. It is suggested to take conscious control as such a feature. As a result, in the information processing acts corresponding to Type 2 category, units of information are combined in a consciously controlled way, whereas in the acts to be considered as Type 1, those units either already are combined or combine autonomously due to the existence of indirect associative connections.

How is Political Privacy Different from Personal Privacy? An Argument from Democratic Governance

In this paper I discuss the political value of the right to privacy. The classical accounts of privacy do not differentiate between privacy as the right of a citizen against other citizens vs. the right to privacy as the right against the state or the government. I shall argue that this distinction should be made, since the new context of the privacy debate has surpassed the historical frames in which the intelligence methods used by governments were comparable to those available to individuals. I also present cases in which political privacy serves as an instrument of protecting important collective agendas exceeding the context of personal privacy. I argue that due to its function, political privacy should be considered a necessary element of democratic governance with the rule of law, imposing legal bounds on governments’ discretionary actions.

Vladimir Nabokov's Lolita and the Merited-Response Argument

In attempting to answer whether Nabokov’s Lolita can be described as an unethical novel, the author ponders on what basis one could make such a determination. At (1) the author analyzes the merited-response argument offered by Gaut (and previously Hume and Carroll), which provides a conceptual framework for the resolution of the controversy surrounding Lolita. Based on this analysis, (2) the author decides what constitutes the novel’s ethical foundation and what (3) prescriptions and (4) responses can follow from it.

Organ Transplant in Present-Day Japan: Reasons behind Low Numbers of Deceased Donors

According to the International Register of Organ Donation and Transplantation, Japan is one of the countries with the lowest number of registered deceased donors. In 2019, Japan was ranked 61st out of 70 countries. The authors of this article have decided to explore the reasons for this phenomenon. In the first part of the work, religious influences (Shinto and Buddhism), the tradition of gotai manzoku, the importance of altruism and the family in the perception of death and organ transplantation by the Japanese are considered. The second part of the article presents the arguments of Alan Shewmon, who believes that brain death is not death in the biological sense. Undermining the brain’s death criterion raises doubts concerning death of patients in irreversible coma, what in result discourages transplantology in Japan. In the third part, the authors compare the results of JOTN, IRODaT and the Fact Book of Organ Transplantation 2018 in Japan from 2010 to 2018. The aim of the article is to explain the cultural determinants of transplantology in Japan, taking into account the influence of philosophical and bioethical aspects of human death.

Prioritarianism in Health-Care: Resisting the Reduction to Utilitarianism

Tännsjö’s book Setting Health-Care Priorities defends the view that there are three main normative theories in the domain of distributive justice, and that these theories are both highly plausible in themselves, and practically convergent in their normative conclusions. All three theories (utilitarianism, the maximin/leximin theory and egalitarianism) point to a somewhat radical departure from the present distribution of medical resources: in particular, they suggest redirecting resources from marginal life extension to the care of mentally ill patients. In this paper I wish to argue, firstly, that prioritarianism should not be considered as an amendment to utilitarianism, as it is in Tännsjö’s view, but as a distinctive fourth option. This can best be appreciated if we focus on a reading of the theory that emphasizes its derivation from egalitarianism and its attempt to develop an intermediate approach between utilitarian and egalitarian intuitions. Secondly, in response to Tännsjö’s central objection to prioritarianism, I will argue that the theory does not apply in intrapersonal cases but is only relevant for decisions regarding the interpersonal distribution of benefits. Finally, I will suggest that a practical convergence of the four theories on specific issues such as artificial reproduction or mood enhancement is far less likely than Tännsjö seems to believe.

How does historical faith complement Immanuel Kant’s philosophy of religion?

In modern interpretations of Kant’s philosophy of religion, a shift away from exclusionary moral reductionism occurs. Consequently, at least since the 1970s, historical faith has been appreciated as a necessary and desirable element of Kant’s philosophy of religion. One of the reasons prompting Kant to include historical faith in his system of the philosophy of religion is what commentators on Kant’s philosophy call the ‘moral gap’. For there is a disproportion between the limited competence of man as a natural being and moral goals that seem unattainable. For the believer, the content of historical faith offers a real solution to the disproportion between his limitations as a natural being and the goals set for him by practical reason. For the believer, the ‘moral gap’ is not just a theoretical problem, but an existential challenge whose solution does not lie within his own limited competence. In this article, I consider whether historical faith can also provide a theoretical supplement to the picture of one’s own life. If so, then the content of historical faith may also prove important for the non-believer.

Setting Health-Care Priorities. What Ethical Theories Tell Us. A Response to My Critics

The article provides answers to comments in this journal on my recent book, Setting Health-Care Priorities. What Ethical Theories Tell Us (Oxford University Press, 2019). Did I address all of the relevant theories? Yes, I did. Was my argument underdeveloped in any respects? Yes, at least in one as I should perhaps have discussed contractual ethical thinking more carefully. I do so in this response. Moreover, the critical comments raised have helped me to clarify my argument in many ways, for which I thank my critics.

The Symposium on “Setting Health-Care Priorities” by Torbjörn Tännsjö

The present paper constitutes an introduction to a special issue of Diametros devoted to Setting Health-Care Priorities. What Ethical Theories Tell Us by Torbjörn Tännsjö. The book in question states that there are three moral theories which have valid implications in the field of the distribution of medical resources in a healthcare system: utilitarianism (possibly conjoined with prioritarianism), the maximin/leximin view, and egalitarianism. A number of authors have contributed to this special issue with papers which challenge this thesis. Robert E. Goodin argues that, besides general moral theories, some local principles of justice might be valid. Quinn Hiroshi Gibson states that Tännsjö should have considered the Rawlsian view on justice in its contractualist reading. Jay A. Zameska argues that his “revised lexical sufficientarianism” constitutes a more reliable moral view than prioritarianism. Finally, Lasse Nielsen points out that there is more to say about distributive justice than consequentialist theories can grasp. Moreover, he puts forward an argument in defense of prioritarianism. The final article in this issue constitutes Tännsjö’s replies to his critics.