Imposing Options on People in Poverty: The Harm of a Live Donor Organ Market
A prominent defence of a market in organs from living donors says that if we truly care about people in poverty, we should allow them to sell their organs. The argument is that if poor vendors would have voluntarily decided to sell their organs in a free market, then prohibiting them from selling makes them even worse off, at least from their own perspective, and that it would be unconscionably paternalistic to substitute our judgements for individuals' own judgements about what would be best for them. The author shows that this ‘Laissez-Choisir Argument’ for organ selling rests on a mistake. This is because the claim that it would be better for people in poverty to sell their organs if given the option is consistent with the claim that it would be even better for them to not have the option at all. The upshot is that objections to an organ market need not be at all paternalistic, since we need not accept that the absence of a market makes those in poverty any worse off, even from their own point of view. The author goes on to argue that there are strong theoretical and empirical reasons for believing that people in poverty would in fact be harmed by the introduction of a market for live donor organs and that the harm constitutes sufficient grounds for prohibiting a market.
Were Kant’s hypothetical imperatives wide-scope oughts?
I defend the claim that Kant held a wide-scope view of hypothetical imperatives, against objections raised by Mark Schroeder [2005]. There is an important objection, now commonly known as the ‘bootstrapping’ problem, to the alternative, narrow-scope, view which Schroeder attributes to Kant. Schroeder argues that Kant has sufficient resources to reply to the bootstrapping problem, and claims that this leaves us with no good reason to attribute to Kant the wide-scope view. I show that Schroeder's Kantian reply to the bootstrapping problem cannot fully answer it. Schroeder also offers three main textual arguments for attributing to Kant the narrow-scope view: from Kant's claim that the moral imperative is unique in virtue of its categoricity, from Kant's distinction between ‘problematic’ and ‘assertoric’ hypothetical imperatives, and from Kant's conception of analyticity together with his claim that hypothetical imperatives are analytic. I argue that each of these views can be understood as cohering with the more plausible wide-scope view of hypothetical imperatives.
On the Rational Impotence of Urges
Intuitively, it seems that certain basic desires, or urges, are rationally impotent, i.e., that they provide no reasons for action (a famous example is Warren Quinn's story of a man who has a brute urge to turn on every radio he sees). This intuition seems to conflict with the internalist, or Humean subjectivist, claim that our desires give us reasons. But Harry Frankfurt's well-known subjectivist account, with its distinction between first- order and higher-order desires and its concepts of identification and commitment, may be able to accommodate this intuition. Andrew Reitsma has argued that to do so, it needs to be supplemented with a concept of "personal ideals", which demand that we give no normative weight to certain inclinations. I argue that Reitsma's account depends on the unexplained assumption that some kinds of desire have special standing, and thus cannot improve on the explanation of the rational impotence of urges already available to Frankfurt.
How to Reverse the Organ Shortage
Thousands of lives are lost each year because of a lack of organs available for transplant, but currently, in the UK and many other countries, organs cannot be taken from a deceased donor without explicit consent from the donor or his or her relatives. Switching to an ‘opt-out’ (or ‘presumed consent’) system for organ donation could substantially increase the supply of organs, and save many lives. However, it has been argued in some quarters that there are serious ethical objections to an opt-out policy, and that it would be better to adopt a different policy known as the ‘presumptive approach’, that requires explicit consent while also attempting to sway the choices of potential donors and family in the direction of donating, using various persuasive techniques. This article shows how reflection on the impact of a well-known cognitive bias known as ‘status quo bias’ can explain (i) why moving from the status quo to an opt-out policy might be effective in increasing organ availability, even without impinging on anyone's autonomous choices, (ii) why we might have overestimated the strength of the objections to an opt-out policy, and (iii) why the presumptive approach is morally objectionable, while an opt-out policy is not.
In Defense of the Wide-Scope Instrumental Principle
I make the observation that English sentences such as “You have reason to take the bus or to take the train” do not have the logical form that they superficially appear to have. I find in these sentences a conjunctive use of “or,” as found in sentences like “You can have milk or lemon in your tea,” which gives you a permission to have milk, and a permission to have lemon, though no permission to have both. I argue that a confusion of genuine disjunctions with sentences of the above form has motivated the mistaken acceptance by some philosophers of principles like the one I call “Liberal Transmission.” This is the principle that if you have a reason to do something, then you have a reason to do it in each of the possible ways in which it can be done (though not more than one of them). I argue that Liberal Transmission and its close relatives are false. Wide-scope reasons are defined as reasons that have a conditional or other logical connective within the scope of the reason operator. For example, a wide-scope instrumental reason might be: reason(if you have an end, take the means). By refuting Liberal Transmission, I show that you could have wide-scope instrumental reasons like this while nevertheless lacking any narrow-scope reason to take the means, or narrow-scope reason to not have the end. This enables me to respond to two major objections to the wide-scope approach to the instrumental principle that have been developed by Joseph Raz and by Niko Kolodny.