1. Cost-Effectiveness, Equity, and Impartiality
I have a paper addressing the use of Quality-Adjusted Life-Years (QALYs) in policy decisions about the allocation of healthcare resources, asking questions such as:
- Are QALYs a reasonable and useful metric for such decisions?
- If policy-makers use QALYs as a metric, should they aim to maximize them, or is doing so unjust (e.g., to persons with differences/disabilities)?
- Should policymakers use an alternative distributive principle for QALYs, such as prioritarianism or egalitarianism?
- If one accepts a version of agent-neutral consequentialism at the level of ideal theory, should one endorse the use of QALYs as a metric and, if so, should one prescribe maximization, egalitarianism, prioritarianism, or what have you?
2. The Epistemic Significance of Causal Explanations for Moral Beliefs
- For many years, I have been interested in the philosophical significance, if any, of causal explanations of our moral beliefs. Causal explanations include the distal origins of our moral beliefs in the evolution of our species, their proximal origins in the development of social norms in our civilization, and the cognitive development of particular individuals from infancy through adulthood. Does a credible causal explanation for a moral belief of ours have any epistemic relevance to our acceptance of that belief? One form of this question asks whether our discovery of causal explanations for a belief (e.g., evolutionary, developmental, cultural, neuroscientific) could ever debunk that belief.
- Related to preceding and subsequent topics: my biological “nature” probably set limits on what I am able to believe, desire, and intend. We might say that natural selection keeps us on a doxastic and conative leash. But how long is our leash? Could we lengthen it via cognitive and/or moral enhancement technologies we might develop in the future?
3. Beneficence, Impartiality, Consequentialism
- I have long been interested in radically impersonal conceptions of impartiality, such as the purer forms of consequentialism are said to embody. A longstanding source of curiosity for me is whether we have a reason to discuss, defend, and even act upon radically impersonal, maximizing principles.
An (impossible?) thought experiment – Imagine you were a godlike being, possessing great benevolence, knowledge, intelligence, and power to affect humanity and its fate. With such powers, is there anything you would aim to maximize (or minimize)? If so, what would it be? If not, what would you do instead of maximizing something? Satisfice something?
- The idea of maximizing acquired a bad reputation in politically progressive and philosophical circles during the last decades of the 20th century through the present. In the USA, many academic philosophers regard consequentialism as dangerous and inhumane (as do non-philosophers who learn about it). Some political progressives fear consequentialism as economically conservative, favoring the pleasures of large, comfortable majorities over the needs of the less fortunate. (It doesn’t help that some neoliberal economists proceed from undefended premises that sound consequentialist.) At the same time, political moderates and conservatives fear that consequentialism threatens us with the worst excesses of communistic collectivism, disregarding individual rights and demanding that everyone slave away for the greater good. What’s one to think? Could both sides be right about consequentialism? Could both be wrong?
- Although I often find myself taking the “consequentialist” side in philosophical debates, I am not yet committed to consequentialism in general or to any particular form of consequentialism from the literature. My provisional view has long been that morality is more demanding than most people believe it to be and that we all fail to live up to our moral duties, although some of us fail more deeply than others. I coined the general term, beneficence theory, to denote moral theories that demand of us, for the sake of promoting the good, much more than common-sense morality demands. Act-utilitarianism is a limit case of beneficence theory, as it requires us to maximize the good, but there is conceptual space for less extreme beneficence theories that are still much more demanding than common-sense morality.
- Those of us who suspect that common-sense morality is deeply flawed should always keep in mind that this body of norms and inclinations has precious instrumental value in solving coordination problems and compensating for various familiar sources of human irrationality. Therefore, it’s usually inadvisable for an individual to undertake sudden, dramatic, uncoordinated departures from common-sense morality. Widely held beliefs around which people have organized their lives place limits on how I can responsibly behave, even as I quietly suspect their beliefs are deeply mistaken.
- Law is a fascinating laboratory for ethical reflection and fieldwork. Positive law is full of ingenious second-best, third-best, nth-best solutions to pressing practical problems of peaceful human coexistence – problems that can’t await first-best solutions.