discussion questions

for each question answer with 2 to 3 sentences max 

1. What is the difference between ‘descriptive’ versus ‘normative’ claims?

2. What are the key features of moral claims or norms, according to Vaughn? Do you agree?

3. What are the key ethical principles? Does this cover everything that matters, morally?

4. What do you think about ethical relativism?

5. What the are strengths and weaknesses of Utilitarianism and Kantian ethics?

3

CHAPTER 1

Moral Reasoning in Bioethics

Second, it would be difficult to imagine moral
issues more important— more closely gathered
around the line between life and death, health
and illness, pain and relief, hope and despair—
than those addressed by bioethics. Whatever
our view of these questions, there is little doubt
that they matter immensely. Whatever answers
we give will surely have weight, however they fall.

Third, as a systematic study of such ques­
tions, bioethics holds out the possibility of an­
swers. The answers may or may not be to our
liking; they may confirm or confute our precon­
ceived notions; they may take us far or not far
enough. But, as the following pages will show,
the trail has more light than shadow— and
thinking critically and carefully about the prob­
lems can help us see our way forward.

ethics and bioethics

Morality is about people’s moral judgments,
principles, rules, standards, and theories— all of
which help direct conduct, mark out moral prac­
tices, and provide the yardsticks for measuring
moral worth. We use morality to refer gener­
ally to these aspects of our lives (as in “Morality
is essential”) or more specifically to the beliefs
or practices of particular groups or persons (as
in “American morality” or “Kant’s morality”).
Moral, of course, pertains to morality as just
defined, though it is also sometimes employed
as a synonym for right or good, just as immoral
is often meant to be equivalent to wrong or bad.
Ethics, as used in this text, is not synonymous with
morality. Ethics is the study of morality using the
tools and methods of philosophy. Philosophy is
a discipline that systematically examines life’s

Any serious and rewarding exploration of bio­
ethics is bound to be a challenging journey.
What makes the trip worthwhile? As you might
expect, this entire text is a long answer to that
question. You therefore may not fully appreciate
the trek until you have already hiked far along
the trail. The short answer comes in three parts.

First, bioethics— like ethics, its parent disci­
pline— is about morality, and morality is about
life. Morality is part of the unavoidable, bitter­
sweet drama of being persons who think and feel
and choose. Morality concerns beliefs regarding
morally right and wrong actions and morally
good and bad persons or character. Whether we
like it or not, we seem confronted continually
with the necessity to deliberate about right and
wrong, to judge someone morally good or bad,
to agree or disagree with the moral pronounce­
ments of others, to accept or reject the moral
outlook of our culture or community, and
even to doubt or affirm the existence or nature
of moral concepts themselves. Moral issues are
thus inescapable— including (or especially) those
that are the focus of bioethics. In the twenty­first
century, few can remain entirely untouched by
the pressing moral questions of fair distribution
of health care resources, abortion and infanti­
cide, euthanasia and assisted suicide, exploitative
research on children and populations in devel­
oping countries, human cloning and genetic en­
gineering, assisted reproduction and surrogate
parenting, prevention and treatment of HIV/
AIDS, the confidentiality and consent of patients,
the refusal of medical treatment on religious
grounds, experimentation on human embryos
and fetuses, and the just allocation of scarce life­
saving organs.

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4 PART 1: PRINCIPLES AND THEORIES

some or all of these as proper guides for our ac­
tions and judgments. In normative ethics, we
ask questions like these: What moral principles,
if any, should inform our moral judgments?
What role should virtues play in our lives? Is the
principle of autonomy justified? Are there any
exceptions to the moral principle of “do not
kill”? How should we resolve conflicts between
moral norms? Is contractarianism a good moral
theory? Is utilitarianism a better theory?

A branch that deals with much deeper ethical
issues is metaethics. Metaethics is the study of
the meaning and justification of basic moral be­
liefs. In normative ethics we might ask whether
an action is right or whether a person is good,
but in metaethics we would more likely ask what
it means for an action to be right or for a person
to be good. For example, does right mean has the
best consequences, or produces the most happi-
ness, or commanded by God? It is the business of
metaethics to explore these and other equally
fundamental questions: What, if anything, is
the difference between moral and nonmoral be­
liefs? Are there such things as moral facts? If so,
what sort of things are they, and how can they
be known? Can moral statements be true or
false— or are they just expressions of emotions
or attitudes without any truth value? Can moral
norms be justified or proven?

The third main branch is applied ethics, the
use of moral norms and concepts to resolve
practical moral issues. Here, the usual challenge
is to employ moral principles, theories, argu­
ments, or analyses to try to answer moral ques­
tions that confront people every day. Many such
questions relate to a particular professional field
such as law, business, or journalism, so we have
specialized subfields of applied ethics like legal
ethics, business ethics, and journalistic ethics.
Probably the largest and most energetic subfield
is bioethics.

Bioethics is applied ethics focused on health
care, medical science, and medical technology.
(Biomedical ethics is often used as a synonym,
and medical ethics is a related but narrower term
used most often to refer to ethical problems in

big questions through critical reasoning, logical
argument, and careful reflection. Thus ethics—
also known as moral philosophy— is a reasoned
way of delving into the meaning and import of
moral concepts and issues and of evaluating the
merits of moral judgments and standards. (As
with morality and moral, we may use ethics to
say such things as “Kant’s ethics” or may use
ethical or unethical to mean right or wrong,
good or bad.) Ethics seeks to know whether an
action is right or wrong, what moral standards
should guide our conduct, whether moral prin­
ciples can be justified, what moral virtues are
worth cultivating and why, what ultimate ends
people should pursue in life, whether there are
good reasons for accepting a particular moral
theory, and what the meaning is of such notions
as right, wrong, good, and bad. Whenever we try
to reason carefully about such things, we enter
the realm of ethics: We do ethics.

Science offers another way to study morality,
and we must carefully distinguish this approach
from that of moral philosophy. Descriptive
ethics is the study of morality using the meth­
odology of science. Its purpose is to investigate
the empirical facts of morality— the actual be­
liefs, behaviors, and practices that constitute
people’s moral experience. Those who carry out
these inquiries (usually anthropologists, sociol­
ogists, historians, and psychologists) want to
know, among other things, what moral beliefs a
person or group has, what caused the subjects to
have them, and how the beliefs influence behav­
ior or social interaction. Very generally, the dif­
ference between ethics and descriptive ethics is
this: In ethics we ask, as Socrates did, How ought
we to live? In descriptive ethics we ask, How do
we in fact live?

Ethics is a big subject, so we should not be
surprised that it has three main branches, each
dealing with more or less separate but related
sets of ethical questions. Normative ethics is the
search for, and justification of, moral standards,
or norms. Most often the standards are moral
principles, rules, virtues, and theories, and the
lofty aim of this branch is to establish rationally

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Chapter 1: Moral Reasoning in Bioethics 5

about art; norms of etiquette about polite social
behavior; grammatical norms about correct use
of language; prudential norms about what is in
one’s interests; and legal norms about lawful and
unlawful acts. But moral norms differ from these
nonmoral kinds. Some of the features they are
thought to possess include the following.

Normative Dominance. In our moral practice,
moral norms are presumed to dominate other
kinds of norms, to take precedence over them.
Philosophers call this characteristic of moral
norms overridingness because moral consider­
ations so often seem to override other factors.
A maxim of prudence, for example, may suggest
that you should steal if you can avoid getting
caught, but a moral prohibition against stealing
would overrule such a principle. An aesthetic (or
pragmatic) norm implying that homeless people
should be thrown in jail for blocking the view of
a beautiful public mural would have to yield to
moral principles demanding more humane treat­
ment of the homeless. A law mandating brutal
actions against a minority group would conflict
with moral principles of justice and would there­
fore be deemed illegitimate. We usually think
that immoral laws are defective, that they need to
be changed, or that, in rare cases, they should be
defied through acts of civil disobedience.

Universality. Moral norms (but not exclusively
moral norms) have universality: Moral princi­
ples or judgments apply in all relevantly similar
situations. If it is wrong for you to tell a lie in
a particular circumstance, then it is wrong for
everyone in relevantly similar circumstances to
tell a lie. Logic demands this sort of consistency.
It makes no sense to say that Maria’s doing
action A in circumstances C is morally wrong,
but John’s doing A in circumstances relevantly
similar to C is morally right. Universality, how­
ever, is not unique to moral norms; it’s a charac­
teristic of all normative spheres.

Impartiality. Implicit in moral norms is the
notion of impartiality— the idea that everyone

medical practice.) Ranging far and wide, bio­
ethics seeks answers to a vast array of tough
ethical questions: Is abortion ever morally per­
missible? Is a woman justified in having an abor­
tion if prenatal genetic testing reveals that her
fetus has a developmental defect? Should people
be allowed to select embryos by the embryos’ sex
or other genetic characteristics? Should human
embryos be used in medical research? Should
human cloning be prohibited? Should physicians,
nurses, physicians’ assistants, and other health
care professionals always be truthful with patients
whatever the consequences? Should severely im­
paired newborns be given life­prolonging treat­
ment or be allowed to die? Should people in
persistent vegetative states be removed from life
support? Should physicians help terminally ill
patients commit suicide? Is it morally right to con­
duct medical research on patients without their
consent if the research would save lives? Should
human stem­cell research be banned? How
should we decide who gets life­saving organ trans­
plants when usable organs are scarce and many
patients who do not get transplants will die?
Should animals be used in biomedical research?

The ethical and technical scope of bioethics is
wide. Bioethical questions and deliberations
now fall to nonexpert and expert alike— to pa­
tients, families, and others as well as to philoso­
phers, health care professionals, lawyers, judges,
scientists, clergy, and public policy specialists.
Though the heart of bioethics is moral philoso­
phy, fully informed bioethics cannot be done
without a good understanding of the relevant
nonmoral facts and issues, especially the medi­
cal, scientific, technological, and legal ones.

ethics and the moral life

Morality then is a normative, or evaluative, enter­
prise. It concerns moral norms or standards that
help us decide the rightness of actions, judge the
goodness of persons or character, and prescribe the
form of moral conduct. There are, of course, other
sorts of norms we apply in life— nonmoral norms.
Aesthetic norms help us make value judg ments

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6 PART 1: PRINCIPLES AND THEORIES

the moral life— is to do moral reasoning. If our
moral judgments are to have any weight at all, if
they are to be anything more than mere per­
sonal taste or knee­jerk emotional response,
they must be backed by the best of reasons. They
must be the result of careful reflection in which
we arrive at good reasons for accepting them,
reasons that could be acknowledged as such by
any other reasoning persons.

Both logic and our commonsense moral ex­
perience demand that the thorough sifting of
reasons constitutes the main work of our moral
deliberations— regardless of our particular moral
outlook or theory. We would think it odd, per­
haps even perverse, if someone asserted that
physician­assisted suicide is always morally
wrong— and then said she has no reasons at all for
believing such a judgment but just does. What­
ever our views on physician­assisted suicide, we
would be justified in ignoring her judgment, for
we would have no way to distinguish it from
personal whim or wishful thinking. Likewise she
herself (if she genuinely had no good reasons for
her assertion) would be in the same boat, adrift
with a firm opinion moored to nothing solid.

Our feelings, of course, are also part of our
moral experience. When we ponder a moral
issue we care about (abortion, for example), we
may feel anger, sadness, disgust, fear, irritation,
or sympathy. Such strong emotions are normal
and often useful, helping us empathize with
others, deepening our understanding of human
suffering, and sharpening our insight into the
consequences of our moral decisions. But our
feelings can mislead us by reflecting not moral
truth but our own psychological needs, our own
personal or cultural biases, or our concern for
personal advantage. Throughout history, some
people’s feelings led them to conclude that
women should be burned for witchcraft, that
whole races should be exterminated, that black
men should be lynched, and that adherents of a
different religion were evil. Critical reasoning
can help restrain such terrible impulses. It can
help us put our feelings in proper perspective
and achieve a measure of impartiality. Most of

should be considered equal, that everyone’s inter­
ests should count the same. From the perspective
of morality, no person is any better than any
other. Everyone should be treated the same unless
there is a morally relevant difference between
persons. We probably would be completely baf­
fled if someone seriously said something like
“murder is wrong . . . except when committed by
myself,” when there was no morally relevant dif­
ference between that person and the rest of the
world. If we took such a statement seriously at all,
we would likely not only reject it but also would
not even consider it a bona fide moral statement.

The requirement of moral impartiality pro­
hibits discrimination against people merely be­
cause they are different— different in ways that
are not morally relevant. Two people can be dif­
ferent in many ways: skin color, weight, gender,
income, age, occupation, and so forth. But these
are not differences relevant to the way they
should be treated as persons. On the other hand,
if there are morally relevant differences between
people, then we may have good reasons to treat
them differently, and this treatment would not
be a violation of impartiality. This is how phi­
losopher James Rachels explains the point:

The requirement of impartiality, then, is at
bottom nothing more than a proscription against
arbitrariness in dealing with people. It is a rule
that forbids us from treating one person differ­
ently from another when there is no good reason
to do so. But if this explains what is wrong with
racism, it also explains why, in some special
kinds of cases, it is not racist to treat people dif­
ferently. Suppose a film director was making a
movie about the life of Martin Luther King, Jr.
He would have a perfectly good reason for ruling
out Tom Cruise for the starring role. Obviously,
such casting would make no sense. Because there
would be a good reason for it, the director’s “dis­
crimination” would not be arbitrary and so
would not be open to criticism.1

Reasonableness. To participate in morality— to
engage in the essential, unavoidable practices of

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Chapter 1: Moral Reasoning in Bioethics 7

purports to explain right actions, or make judg­
ments about right or wrong actions.

Moral values, on the other hand, generally
concern those things that we judge to be morally
good, bad, praiseworthy, or blameworthy. Nor­
mally we use such words to describe persons (as
in “He is a good person” or “She is to blame for
hurting them”), their character (“He is virtu­
ous”; “She is honest”), or their motives (“She did
wrong but did not mean to”). Note that we also
attribute nonmoral value to things. If we say that
a book or bicycle or vacation is good, we mean
good in a nonmoral sense. Such things in them­
selves cannot have moral value.

Strictly speaking, only actions are morally
right or wrong, but persons are morally good or
bad (or some degree of goodness or badness).
With this distinction we can acknowledge a

all, it can guide us to moral judgments that are
trustworthy because they are supported by the
best of reasons.

The moral life, then, is about grappling with a
distinctive class of norms marked by normative
dominance, universality, impartiality, and rea­
sonableness. As we saw earlier, these norms can
include moral principles, rules, theories, and
judgments. We should notice that we commonly
apply these norms to two distinct spheres of our
moral experience— to both moral obligations
and moral values.

Moral obligations concern our duty, what we
are obligated to do. That is, obligations are about
conduct, how we ought or ought not to behave.
In this sphere, we talk primarily about actions.
We may look to moral principles or rules to
guide our actions, or study a moral theory that

IN DEPTH

MORALITY AND THE LAW

Some people confuse morality with the law, or iden-
tify the one with the other, but the two are distinct
though they may often coincide. Laws are norms
enacted or enforced by the state to protect or pro-
mote the public good. They specify which actions
are legally right or wrong. But these same actions
can also be judged morally right or wrong, and these
two kinds of judgments will not necessarily agree.
Lying to a friend about a personal matter, deliberately
trying to destroy yourself through reckless living, or
failing to save a drowning child (when you easily
could have) may be immoral— but not illegal. Racial
bias, discrimination based on gender or sexual orien-
tation, slavery, spousal rape, and unequal treatment
of minority groups are immoral— but, depending on
the society, they may not be illegal.

Much of the time, however, morality and the law
overlap. Often what is immoral also turns out to be
illegal. This is usually the case when immoral actions
cause substantial harm to others, whether physical

or economic. Thus murder and embezzlement are
both immoral and illegal, backed by social disapproval
and severe sanctions imposed by law. Controversy
often arises when an action is not obviously or seri-
ously harmful but is considered immoral by some who
want the practice prohibited by law. The conten-
tious notion at work is that something may be made
illegal solely on the grounds that it is immoral, re-
gardless of any physical or economic harm involved.
This view of the law is known as legal moralism, and
it sometimes underlies debates about the legalization
of abortion, euthanasia, reproductive technology,
con traception, and other practices.

Many issues in bioethics have both a moral and
legal dimension, and it is important not to confuse
the two. Sometimes the question at hand is a moral
one (whether, for example, euthanasia is ever morally
permissible); whether a practice should be legal or
illegal then is beside the point. Sometimes the ques-
tion is about legality. And sometimes the discussion
concerns both. A person may consider physician-
assisted suicide morally acceptable but argue that it
should nevertheless be illegal because allowing the
practice to become widespread would harm both
patients and the medical profession.

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8 PART 1: PRINCIPLES AND THEORIES

simple fact of the moral life: A good person can
do something wrong, and a bad person can do
something right. A Gandhi can tell a lie, and a
Hitler can save a drowning man.

In addition, we may judge an action right or
wrong depending on the motive behind it. If
John knocks a stranger down in the street to pre­
vent her from being hit by a car, we would deem
his action right (and might judge him a good
person). But if he knocks her down because he
dislikes the color of her skin, we would believe
his action wrong (and likely think him evil).

The general meaning of right and wrong seems
clear to just about everyone. But we should be
careful to differentiate degrees of meaning in
these moral terms. Right can mean either “obliga­
tory” or “permissible.” An obligatory action is one
that would be wrong not to perform. We are obli­
gated or required to do it. A permissible action is
one that is permitted. It is not wrong to perform it.
Wrong means “prohibited.” A prohibited action is
one that would be wrong to perform. We are obli­
gated or required not to do it. A supererogatory
action is one that is “above and beyond” our duty.
It is praiseworthy— a good thing to do— but not
required. Giving all your possessions to the poor
is generally considered a supererogatory act.

moral principles in bioethics

As noted earlier, the main work of bioethics is
trying to solve bioethical problems using the
potent resources and methods of moral phi­
losophy, which include, at a minimum, critical
reasoning, logical argument, and conceptual
analysis. Many, perhaps most, moral philoso­
phers would be quick to point out that beyond
these tools of reason we also have the consider­
able help of moral principles. (The same could be
said about moral theories, which we explore in
the next chapter.) Certainly to be useful, moral
principles must be interpreted, often filled out
with specifics, and balanced with other moral
concerns. But both in everyday life and in bio­
ethics, moral principles are widely thought to be
indispensable to moral decision­making.

We can see appeals to moral principles in
countless cases. Confronted by a pain­racked,
terminally ill patient who demands to have his
life ended, his physician refuses to comply, rely­
ing on the principle that “it is wrong to inten­
tionally take a life.” Another physician makes a
different choice in similar circumstances, insist­
ing that the relevant principle is “ending the suf­
fering of a hopelessly ill patient is morally
permissible.” An infant is born anencephalic
(without a brain); it will never have a conscious
life and will die in a few days. The parents decide
to donate the infant’s organs to other children
so they might live, which involves taking the
organs right away before they deteriorate. A
critic of the parents’ decision argues that “it is
unethical to kill in order to save.” But someone
else appeals to the principle “save as many chil­
dren as possible.”2 In such ways moral principles
help guide our actions and inform our judg­
ments about right and wrong, good and evil.

As discussed in Chapter 2, moral principles
are often drawn from a moral theory, which is a
moral standard on the most general level. The
principles are derived from or supported by the
theory. Many times we simply appeal directly to
a plausible moral principle without thinking
much about its theoretical underpinnings.

Philosophers make a distinction between ab­
solute and prima facie principles (or duties). An
absolute principle applies without exceptions.
An absolute principle that we should not lie de­
mands that we never lie regardless of the cir­
cumstances or the consequences. In contrast, a
prima facie principle applies in all cases unless
an exception is warranted. Exceptions are justi­
fied when the principle conflicts with other
principles and is thereby overridden. W. D. Ross
is given credit for drawing this distinction in his
1930 book The Right and the Good.3 It is essen­
tial to his account of ethics, which has a core of
several moral principles or duties, any of which
might come into conflict.

Physicians have a prima facie duty to be truth­
ful to their patients as well as a prima facie duty
to promote their welfare. But if these duties come

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Chapter 1: Moral Reasoning in Bioethics 9

their consent, treating competent patients against
their will, physically restraining or confining pa­
tients for no medical reason— such practices con­
stitute obvious violations of personal autonomy.

Not all restrictions on autonomy, however,
are of the physical kind. Autonomy involves the
capacity to make personal choices, but choices
cannot be considered entirely autonomous unless
they are fully informed. When we make decisions
in ignorance— without relevant information or
blinded by misinformation— our autonomy is
diminished just as surely as if someone physi­
cally manipulated us. If this is correct, then we
have a plausible explanation of why lying is
generally prohibited: Lying is wrong because it
undermines personal autonomy. Enshrined in
bioethics and in the law, then, is the precept of
informed consent, which demands that patients
be allowed to freely consent to or decline treat­
ments and that they receive the information they
need to make informed judgments about them.

In many ways, autonomy is a delicate thing,
easily compromised and readily thwarted. Often
a person’s autonomy is severely undermined not
by other people but by nature, nurture, or his or
her own actions. Some drug addicts and alcohol­
ics, people with serious psychiatric illness, and
those with severe mental impairment are thought
to have drastically diminished autonomy (or to
be essentially nonautonomous). Bioethical ques­
tions then arise about what is permissible to do
to them and who will represent their interests or
make decisions regarding their care. Infants and
children are also not fully autonomous, and the
same sorts of questions are forced on parents,
guardians, and health care workers.

Like all the other major principles discussed
here, respect for autonomy is thought to be
prima facie. It can sometimes be overridden by
considerations that seem more important or
compelling— considerations that philosophers
and other thinkers have formulated as princi­
ples of autonomy restriction. The principles are
articulated in various ways, are applied widely
to all sorts of social and moral issues, and are
themselves the subject of debate. Chief among

in conflict— if, for example, telling a patient the
truth about his condition would somehow result
in his death— a physician might decide that the
duty of truthfulness should yield to the weight­
ier duty to do good for the patient.

Moral principles are many and varied, but in
bioethics the following have traditionally been
extremely influential and particularly relevant
to the kinds of moral issues that arise in health
care, medical research, and biotechnology. In
fact, many— perhaps most— of the thorniest issues
in bioethics arise from conflicts among these
basic principles. In one formulation or another,
each one has been integral to major moral
theories, providing evidence that the principles
capture something essential in our moral expe­
rience. The principles are (1) autonomy, (2) non­
maleficence, (3) beneficence, (4) utility, and
(5) justice.4

Autonomy
Autonomy refers to a person’s rational capacity
for self­governance or self­determination— the
ability to direct one’s own life and choose for
oneself. The principle of autonomy insists on full
respect for autonomy. One way to express the prin­
ciple is: Autonomous persons should be allowed
to  exercise their capacity for self-determination.
According to one major ethical tradition, autono­
mous persons have intrinsic worth precisely
because they have the power to make rational
decisions and moral choices. They therefore must
be treated with respect, which means not violating
their autonomy by ignoring or thwarting their
ability to choose their own paths and make their
own judgments.

The principle of respect for autonomy places
severe restraints on what can be done to an
autonomous person. There are exceptions, but in
general we are not permitted to violate people’s
autonomy just because we disagree with their
decisions, or because society might benefit, or
because the violation is for their own good. We
cannot legitimately impair someone’s autonomy
without strong justification for doing so. Con­
ducting medical experiments on patients without

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10 PART 1: PRINCIPLES AND THEORIES

these is the harm principle: a person’s autonomy
may be curtailed to prevent harm to others. To
prevent people from being victimized by thieves
and murderers, we have a justice system that
prosecutes and imprisons the perpetrators. To
discourage hospitals and health care workers
from hurting patients through carelessness or
fraud, laws and regulations limit what they can
do to people in their care. To stop someone from
spreading a deadly, contagious disease, health
officials may quarantine him against his will.

Another principle of autonomy restriction is
paternalism. Paternalism is the overriding of a
person’s actions or decision­making for her own
good. Some cases of paternalism (sometimes
called weak paternalism) seem permissible to
many people— when, for example, seriously de­
pressed or psychotic patients are temporarily
restrained to prevent them from injuring or kill­
ing themselves. Other cases are more controver­
sial. Researchers hoping to develop a life­saving
treatment give an experimental drug to some­
one without his knowledge or consent. Or a
physician tries to spare the feelings of a compe­
tent, terminally ill patient by telling her that she
will eventually get better, even though she in­
sists on being told the truth. The paternalism in
such scenarios (known as strong paternalism) is
usually thought to be morally objectionable.
Many controversies in bioethics center on the
morality of strong paternalism.

Nonmaleficence
The principle of nonmaleficence asks us not to
intentionally or unintentionally inflict harm on
others. In bioethics, nonmaleficence is the most
widely recognized moral principle. Its aphoris­
tic expression has been embraced by practitio­
ners of medicine for centuries: “Above all, do no
harm.” A more precise formulation of the prin­
ciple is: We should not cause unnecessary injury
or harm to those in our care. In whatever form,
nonmaleficence is the bedrock precept of count­
less codes of professional conduct, institutional
regulations, and governmental rules and laws
designed to protect the welfare of patients.

A health care professional violates this prin­
ciple if he or she deliberately performs an action
that harms or injures a patient. If a physician
intentionally administers a drug that she knows
will induce a heart attack in a patient, she obvi­
ously violates the principle—she clearly does
something that is morally (and legally) wrong.
But she also violates it if she injures a patient
through recklessness, negligence, or inexcusable
ignorance. She may not intend to hurt anyone,
but she is guilty of the violation just the same.

Implicit in the principle of nonmaleficence is
the notion that health professionals must exer­
cise “due care.” The possibility of causing some
pain, suffering, or injury is inherent in the care
and treatment of patients, so we cannot realisti­
cally expect health professionals never to harm
anyone. But we do expect them to use due care—
to act reasonably and responsibly to minimize
the harm or the chances of causing harm. If a
physician must cause patients some harm to
effect a cure, we expect her to try to produce the
least amount of harm possible to achieve the re­
sults. And even if her treatments cause no actual
pain or injury in a particular instance, we expect
her not to use treatments that have a higher
chance of causing harm than necessary. By the
lights of the nonmaleficence principle, subjecting
patients to unnecessary risks is wrong even if no
damage is done.

Beneficence
The principle of beneficence has seemed to many
to constitute the very soul of morality— or very
close to it. In its most general form, it says that
we should do good to others. (Benevolence is dif­
ferent, referring more to an attitude of goodwill
toward others than to a principle of right action.)
Beneficence enjoins us to advance the welfare of
others and prevent or remove harm to them.

Beneficence demands that we do more than
just avoid inflicting pain and suffering. It says
that we should actively promote the well-being of
others and prevent or remove harm to them. In
bioethics, there is little doubt that physicians,
nurses, researchers, and other professionals have

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Chapter 1: Moral Reasoning in Bioethics 11

possible benefits of the treatment outweigh its
risks by an acceptable margin. Suppose a man’s
clogged artery can be successfully treated with
open­heart surgery, a procedure that carries a
considerable risk of injury and death. But imag­
ine that the artery can also be successfully
opened with a regimen of cholesterol­lowering
drugs and a low­fat diet, both of which have a
much lower chance of serious complications.
The principle of utility seems to suggest that the
latter course is best and that the former is mor­
ally impermissible.

The principle also plays a major role in the
creation and evaluation of the health policies of
institutions and society. In these large arenas,
most people aspire to fulfill the requirements of
beneficence and maleficence, but they recognize
that perfect beneficence or maleficence is im­
possible: Trade­offs and compromises must be
made, scarce resources must be allotted, help and
harm must be balanced, life and death must be
weighed— tasks almost always informed by the
principle of utility.

Suppose, for example, we want to mandate
the immunization of all schoolchildren to pre­
vent the spread of deadly communicable dis­
eases. The cost in time and money will be great,
but such a program could save many lives.
There is a down side, however: A small number
of children— perhaps as many as 2 for every
400,000 immunizations— will die because of a
rare allergic reaction to the vaccine. It is impos­
sible to predict who will have such a reaction
(and impossible to prevent it), but it is almost
certain to occur in a few cases. If our goal is social
beneficence, what should we do? Children are
likely to die whether we institute the program
or not. Guided by the principle of utility (as well
as other principles), we may decide to proceed
with the program since many more lives would
likely be saved by it than lost because of its
implementation.

Again, suppose governmental health agencies
have enough knowledge and resources to de­
velop fully a cure for only one disease— either a
rare heart disorder or a common form of skin

such a duty. After all, helping others, promoting
their good, is a large part of what these profes­
sionals are obliged to do.

But not everyone thinks that we all have a
duty of active beneficence. Some argue that
though there is a general (applicable to all) duty
not to harm others, there is no general duty to
help others. They say we are not obligated to aid
the poor, feed the hungry, or tend to the sick.
Such acts are not required, but are supererogatory,
beyond the call of duty. Others contend that
though we do not have a general duty of active
beneficence, we are at least sometimes obligated
to look to the welfare of people we care about
most— such as our parents, children, spouses,
and friends. In any case, it is clear that in cer­
tain professions— particularly medicine, law, and
nursing— benefiting others is often not just
supererogatory but obligatory and basic.

Utility
The principle of utility says that we should pro-
duce the most favorable balance of good over bad
(or benefit over harm) for all concerned. The prin­
ciple acknowledges that in the real world, we
cannot always just benefit others or just avoid
harming them. Often we cannot do good for
people without also bringing them some harm,
or we cannot help everyone who needs to be
helped, or we cannot help some without also
hurting or neglecting others. In such situations,
the principle says, we should do what yields the
best overall outcome— the maximum good and
minimum evil, everyone considered. The utility
principle, then, is a supplement to, not a substi­
tute for, the principles of autonomy, beneficence,
and justice.

In ethics this maxim comes into play in sev­
eral ways. Most famously it is the defining pre­
cept of the moral theory known as utilitarianism
(discussed in Chapter 2). But it is also a stand­
alone moral principle applied everywhere in
bio ethics to help resolve the kind of dilemmas
just mentioned. A physician, for example, must
decide whether a treatment is right for a patient,
and that decision often hinges on whether the

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12 PART 1: PRINCIPLES AND THEORIES

cancer. Trying to split resources between these
two is sure to prevent development of any cure
at all. The heart disorder kills 200 adults each
year; the cancer occurs in thousands of people,
causing them great pain and distress, but is
rarely fatal. How best to maximize the good? On
which disease should the government spend its
time and treasure? Answering this question
(and others like it) requires trying to apply the
utility principle— a job often involving complex
calculations of costs and benefits and frequently
generating controversy.

Justice
In its broadest sense, justice refers to people get­
ting what is fair or what is their due. In practice,
most of us seem to have a rough idea of what
justice entails in many situations, even if we
cannot articulate exactly what it is. We know,
for example, that it is unjust for a bus driver to
make a woman sit in the back of the bus because
of her religious beliefs, or for a judicial system to
arbitrarily treat one group of citizens more
harshly than others, or for a doctor to care for
some patients but refuse to treat others just be­
cause he dislikes them.

Questions of justice arise in different spheres
of human endeavor. Retributive justice, for ex­
ample, concerns the fair meting out of punish­
ment for wrongdoing. On this matter, some
argue that justice is served only when people are
punished for past wrongs, when they get their
just deserts. Others insist that justice demands
that people be punished not because they de­
serve punishment, but because the punishment
will deter further unacceptable behavior. Dis-
tributive justice concerns the fair distribution
of  society’s advantages and disadvantages— for
example, jobs, income, welfare aid, health care,
rights, taxes, and public service. Distributive jus­
tice is a major issue in bioethics, where many of
the most intensely debated questions are about
who gets health care, what or how much they
should get, and who should pay for it.

Distributive justice is a vast topic, and many
theories have been proposed to identify and

justify the properties, or traits, of just distribu­
tions. A basic precept of most of these theories is
what may plausibly be regarded as the core of
the principle of justice: Equals should be treated
equally. (Recall that this is one of the defining
elements of ethics itself, impartiality.) The idea
is that people should be treated the same unless
there is a morally relevant reason for treating
them differently. We would think it unjust for
a physician or nurse to treat his white diabetic
patients more carefully than he does his black
diabetic patients— and to do so without a sound
medical reason. We would think it unfair to
award the only available kidney to the trans­
plant candidate who belongs to the “right” po­
litical party or has the best personal relationship
with hospital administrators.

The principle of justice has been at the heart
of debates about just distribution of benefits and
burdens (including health care) for society as a
whole. The disagreements have generally not been
about the legitimacy of the principle, but about
how it should be interpreted. Different theories
of justice try to explain in what respects equals
should be treated equally.

Libertarian theories emphasize personal free­
doms and the right to pursue one’s own social
and economic well­being in a free market with­
out interference from others. Ideally the role
of  government is limited to night­watchman
functions— the protection of society and free
economic systems from coercion and fraud. All
other social or economic benefits are the respon­
sibility of individuals. Government should not
be in the business of helping the socially or eco­
nomically disadvantaged, for that would require
violating people’s liberty by taking resources
from the haves to give to the have­nots. So uni­
versal health care is out of the question. For the
libertarian, then, people have equal intrinsic
worth, but this does not entitle them to an equal
distribution of economic advantages. Individu­
als are entitled only to what they can acquire
through their own hard work and ingenuity.

Egalitarian theories maintain that a just dis­
tribution is an equal distribution. Ideally, social

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Chapter 1: Moral Reasoning in Bioethics 13

But moral objectivism is directly challenged
by a doctrine that some find extremely appeal­
ing and that, if true, would undermine ethics
itself: ethical relativism. According to this view,
moral standards are not objective but are rela­
tive to what individuals or cultures believe.
There simply are no objective moral truths, only
relative ones. An action is morally right if en­
dorsed by a person or culture and morally wrong
if condemned by a person or culture. So eutha­
nasia is right for person A if he approves of it but
wrong for person B if she disapproves of it, and
the same would go for cultures with similarly
diverging views on the subject. In this way, moral
norms are not discovered but made; the indi­
vidual or culture makes right and wrong. Ethi­
cal relativism pertaining to individuals is known
as subjective relativism, more precisely stated as
the view that right actions are those sanctioned
by a person. Ethical relativism regarding cultures
is called cultural relativism, the view that right
actions are those sanctioned by one’s culture.

In some ways, subjective relativism is a com­
forting position. It relieves individuals of the
burden of serious critical reasoning about mo­
rality. After all, determining right and wrong is
a matter of inventorying one’s beliefs, and any
sincerely held beliefs will do. Morality is essen­
tially a matter of personal taste, which is an ex­
tremely easy thing to establish. Determining
what one’s moral views are may indeed involve
deliberation and analysis—but neither of these
is a necessary requirement for the job. Subjective
relativism also helps people short­circuit the un­
pleasantness of moral debate. The subjective
relativist’s familiar refrain—“That may be your
truth, but it’s not my truth”—has a way of stop­
ping conversations and putting an end to rea­
soned arguments.

The doctrine, however, is difficult to maintain
consistently. On issues that the relativist cares
little about (the moral rightness of gambling,
say), she may be content to point out that moral
norms are relative to each individual and that
“to each his own.” But on more momentous
topics (such as genocide in Africa or the Middle

benefits— whether jobs, food, health care, or
some thing else— should be allotted so that every­
one has an equal share. Treating people equally
means making sure everyone has equal access to
certain minimal goods and services. To achieve
this level of equality, individual liberties will
have to be restricted, measures that libertari­
ans would never countenance. In a pure egali­
tarian society, universal health care would be
guaranteed.

Between strict libertarian and egalitarian views
of justice lie some theories that try to achieve a
plausible fusion of both perspectives. With a
nod toward libertarianism, these theories may
exhibit a healthy respect for individual liberty
and limit governmental interference in econo­
mic enterprises. But leaning toward egalitarian­
ism, they may also mandate that the basic needs
of the least well­off citizens be met.

In bioethics, the principle of justice and the
theories used to explain it are constantly being
marshaled to support or reject health care poli­
cies of all kinds. They are frequently used— along
with other moral principles— to evaluate, design,
and challenge a wide range of health care pro­
grams and strategies. They are, in other words,
far from being merely academic.

ethical relativism

The commonsense view of morality and moral
standards is this: There are moral norms or
principles that are valid or true for everyone.
This claim is known as moral objectivism, the
idea that at least some moral standards are ob­
jective. Moral objectivism, however, is distinct
from moral absolutism, the belief that objective
moral principles allow no exceptions or must be
applied the same way in all cases and cultures. A
moral objectivist can be absolutist about moral
principles, or she can avoid absolutism by ac­
cepting that moral principles are prima facie. In
any case, most people probably assume some
form of moral objectivism and would not take
seriously any claim implying that valid moral
norms can be whatever we want them to be.

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14 PART 1: PRINCIPLES AND THEORIES

East), she may slip back into objectivism and
declare that genocide is morally wrong— not
just wrong for her but wrong period.

Such inconsistencies hint that there may be
something amiss with subjective relativism, and
indeed there is: It seems to conflict violently with
commonsense realities of the moral life. For one
thing, the doctrine implies that each person is
morally infallible. An action is morally right
for someone if he approves of it— if he sincerely
believes it to be right. His approval makes the
action right, and— if his approval is genuine—
he cannot be mistaken. His believing it to be
right makes it right, and that’s the end of it. If he
endorses infanticide as a method of population
control, then infanticide is morally permissible.
His sincere approval settles the issue, and he
cannot be in error. But our commonsense moral
experience suggests that this relativist account is
absurd. Our judgments about moral matters—
actions, principles, and people— are often wide
of the mark. We are morally fallible, and we are
rightly suspicious of anyone who claims to be
otherwise.

There is a more disturbing way to frame this
point. Suppose former Iraqi leader Saddam
Hussein approved of slaughtering thousands of
Iraqis during his reign. Suppose Hitler approved

of killing millions of Jews during World War II.
Suppose American serial killer and cannibal
Jeffrey Dahmer approved of his murdering
17 men and boys. Then by the lights of subjec­
tive relativism, all these mass killings were mor­
ally right because their perpetrators deemed them
so. But we would find this conclusion almost
impossible to swallow. We would think these
actions morally wrong whether the killers ap­
proved of their own actions or not.

Subjective relativism also implies that an­
other commonplace of the moral life is an illu­
sion: moral disagreement. Consider: Hernando
tells Sophia that allowing seriously impaired
infants to die is morally right. Sophia replies
that allowing seriously impaired infants to die is
morally wrong. We may think that Hernando
and Sophia are having a straightforward dis­
agreement over an important moral issue. But
according to subjective relativism, no such dis­
agreement is happening or could ever happen.
In stating his approval of the actions in ques­
tion, Hernando is essentially expressing his per­
sonal taste on the issue, and Sophia is expressing
her personal taste. He is saying he likes some­
thing; she says she does not like it— and they
could both be correct. Subjective relativism im­
plies that they are not uttering conflicting claims

IN DEPTH

ANTHROPOLOGY
AND MORAL DIVERSITY

Many moral philosophers have been quick to point
out that differences in moral judgments from culture
to culture do not in themselves prove a difference in
moral standards. Some anthropologists have made
the same argument. Solomon Asch, for example, says,

We consider it wrong to take food away from a
hungry child, but not if he is overeating. We
consider it right to fulfill a promise, but not if it

is a promise to commit a crime. . . . It has been
customary to hold that diverse evaluations of
the same act are automatic evidence for the
presence of different principles of evaluation.
The preceding examples point to an error in
this interpretation. Indeed, an examination of
the relational factors points to the operation of
constant principles in situations that differ in
concrete details. . . . Anthropological evidence
does not furnish proof of relativism. We do not
know of societies in which bravery is despised
and cowardice held up to honor, in which
generosity is considered a vice and ingratitude
a virtue. It seems rather that the relations
between valuation and meaning are invariant.5

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Chapter 1: Moral Reasoning in Bioethics 15

it a solemn duty to surgically remove the clito­
rises of young girls; others say this is immoral
and cruel. Some commend the killing of people
who practice a different religion; others believe
such intolerance is morally reprehensible. We
are forced to conclude that diversity of moral
judgments among cultures is a reality.

But what of premise 1— is it also true? It says
that because cultures have different moral beliefs,
they must also have different moral standards,
which means morality is relative to cultures. If
diverse moral standards arise from each culture,
then morality cannot be objective, applying to
all people everywhere. There is no objective mo­
rality, just moralities.

Premise 1, however, is false. First, from the
fact that cultures have divergent moral beliefs
on an issue, it does not logically follow that there
is no objective moral truth to be sought, that
there is no opinion that is objectively correct.
People may disagree about the existence of bio­
logical life on Mars, but the disagreement does
not demonstrate that there is no fact of the
matter or that no statement on the subject could
be objectively true. Disagreements on a moral
question may simply indicate that there is an
objective fact of the matter but that someone
(or everyone) is wrong about it.

Second, a conflict between moral beliefs
does not necessarily indicate a fundamental
conflict between basic moral norms. Moral dis­
agreements between cultures can arise not just
because their basic moral principles clash, but
because they have differing nonmoral beliefs
that put those principles in a very different light.
From the annals of anthropology, for example,
we have the classic story of a culture that sanc­
tions the killing of parents when they become
elderly but not yet enfeebled. Our society would
condemn such a practice, no doubt appealing to
moral precepts urging respect for parents and
for human life. But consider: This strange (to us)
culture believes that people enter heaven when
they die and spend eternity in the same physical
condition they were in when they passed away.
Those who kill their parents are doing so because

at all— they are discussing different subjects, their
own personal feelings or preferences. But this
strange dance is not at all what we think we are
doing when we have a moral disagreement. Be­
cause subjective relativism conflicts with what
we take to be a basic fact of the moral life, we
have good reason to doubt it.

Cultural relativism seems to many to be a
much more plausible doctrine. In fact, many
people think it obviously true, supported as it is
by a convincing argument and the common con­
viction that it is admirably consistent with social
tolerance and understanding in a pluralistic
world. The argument in its favor goes like this:

1. If people’s moral judgments differ from
culture to culture, moral norms are
relative to culture (there are no objective
moral standards).

2. People’s moral judgments do differ from
culture to culture.

3. Therefore, moral norms are relative to
culture (there are no objective moral
standards).

Is this a good argument? That is, does it pro­
vide us with good reason to accept the conclu­
sion (statement 3)? For an argument to be good,
its conclusion must follow logically from the
premises, and the premises must be true. In this
case, the conclusion does indeed follow logically
from the premises (statements 1 and 2). The truth
of the premises is another matter.

Let us look first at premise 2. All sorts of
empirical evidence— including a trove of anthro­
pological and sociological data— show that the
premise is in fact true. Clearly, the moral beliefs
of people from diverse cultures often do differ
drastically on the same moral issue. Some soci­
eties condone infanticide; others condemn it.
Some approve of the killing of wives and daugh­
ters to protect a family’s honor; others think this
tradition evil. Some bury their dead; others cre­
mate them. Some judge the killing of one’s elders
to be a kindly act; others say it is cold­hearted
murder. Some think polygamy morally permis­
sible; others believe it deplorable. Some consider

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16 PART 1: PRINCIPLES AND THEORIES

terrorist bombing of Pan Am flight 103 over
Lockerbie, Scotland, killing 270 people (a tragedy
for which the Libyan government eventually
took responsibility). Then the bombing was
morally right, and those who placed the bomb
on board did no wrong. But all this seems very
much at odds with our moral experience. We
think it makes perfect sense sometimes to con­
demn other cultures for morally wrong actions.

Now consider the notion of moral progress.
We sometimes compare what people did in the
past with what they do now, noting that current
practices are morally better than they used to
be. We no longer countenance such horrors as
massacres of native peoples, slavery, and lynch­
ings, and we think that these changes are signs
of moral progress. But cultural relativism implies
that there cannot be any such thing as moral
progress. To claim legitimately that there has been
moral progress, there must be an objective, trans­
cultural standard for comparing cultures of the
past and present. But according to cultural rela­
tivism, there are no objective moral standards,
just norms relative to each culture. On the other
hand, if there is moral progress as we think there
is, then there must be objective moral standards.

Cultural relativism also has a difficult time
explaining the moral status of social reformers.
We tend to believe they are at least sometimes
right and society is wrong. When we contem­
plate social reform, we think of such moral ex­
emplars as Martin Luther King, Jr., Mahatma
Gandhi, and Susan B. Anthony, all of whom agi­
tated for justice and moral progress. But one of
the consequences of cultural relativism is that
social reformers could never be morally right.
By definition, what society judges to be morally
right is morally right, and since social reformers
disagree with society, they could not be right—
ever. But surely on occasion it’s the reformers
who are right and society is wrong.

There is also the serious difficulty of using
cultural relativism to make moral decisions.
Cultural relativism says that moral rightness is
whatever a culture or society approves of, but
determining which culture or society one truly

they do not want their elders to spend eternity
in a state of senility but rather in good health.
This culture’s way is not our way; we are unlikely
to share these people’s nonmoral beliefs. But it
is probable that they embrace the same moral
principles of respect for parents and life that we
do. According to some anthropologists, diverse
cultures often share basic moral standards while
seeming to have little or nothing in common.

The argument we are considering, then, fails
to support cultural relativism. Moreover, many
considerations count strongly against the view.
Specifically, the logical implications of the doc­
trine give us substantial reasons to doubt it.

Like subjective relativism, cultural relativism
implies moral infallibility, a very hard implica­
tion to take seriously. As the doctrine would have
it, if a culture genuinely approves of an action,
then there can be no question about the action’s
moral rightness: It is right, and that’s that. Cul­
tures make moral rightness, so they cannot be
mistaken about it. But is it at all plausible that cul­
tures cannot be wrong about morality? Through­
out history, cultures have approved of ethnic
cleansing, slavery, racism, holocausts, massacres,
mass rape, torture of innocents, burning of
heretics, and much more. Is it reasonable to
conclude that the cultures that approved of such
deeds could not have been mistaken?

Related to the infallibility problem is this
difficulty: Cultural relativism implies that we
cannot legitimately criticize other cultures. If a
culture approves of its actions, then those ac­
tions are morally right— and it does not matter
one bit whether another culture disapproves of
them. Remember, there is no objective moral
code to appeal to. Each society is its own maker
of the moral law. It makes no sense for society X
to accuse society Y of immorality, for what soci­
ety Y approves of is moral. Some may be willing
to accept this consequence of cultural relativism,
but look at what it would mean. What if the people
of Germany approved of the extermination of
millions of Jews, Gypsies, and others during World
War II? Then the extermination was morally right.
Suppose the people of Libya approved of the

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Chapter 1: Moral Reasoning in Bioethics 17

of moral precepts, codes, or commandments
to guide the conduct of adherents. In Western
civilization, this content has been so influential
in moral (and legal) matters that many now
take for granted that religion is the fundamental
basis of morality. Secular or nontheistic sys­
tems of ethics (for example, the ethics of Stoicism,
Confucianism, Buddhism, utilitarianism, and
contractarianism) have also shaped how we
think about morality. But for millions of people,
religion is the fountainhead of the moral law.

Many religious people, however, do not em­
brace a moral theory related to a religious tradi­
tion. They are comfortable being guided by one
of the nontheistic systems. Others prefer the very
influential moral perspective known as natural
law theory (discussed in Chapter 2)—a view that
comes in both secular and religious versions but
has been nurtured and adopted by the Roman
Catholic Church. Still others accept the perva­
sive idea that morality itself comes from God.

An important query in ethics is whether
this latter view of morality is correct: whether
morality depends fundamentally on religion,
whether— to state the question in its traditional
form— the moral law is constituted by the will of
God. The view that morality does have this kind
of dependence is known as the divine command
theory. It says that right actions are those com­
manded by God, and wrong actions are those
forbidden by God. God is the author of the moral
law, making right and wrong by his will.

But many people— both religious and non­
religious— have found this doctrine troubling.
Philosophers have generally rejected it, including
some famous theistic thinkers such as Thomas
Aquinas (1225– 1274), Gottfried Leibniz (1646–
1710), and Immanuel Kant (1724– 1804).

The problem is that the theory presents us
with a disconcerting dilemma first spelled out in
Plato’s Euthyphro. In this dialogue, Socrates asks
a penetrating question that is often expressed
like this: Are actions morally right because God
commands them, or does God command them
because they are morally right? In the first
option, God creates the moral law (the divine

belongs to seems almost impossible. The prob­
lem is that we each belong to many social groups,
and there is no fact of the matter regarding which
one is our “true” society. Suppose you are an
African­American Catholic Republican living
in an artists colony in Alabama and enjoying the
advantages of membership in an extremely large
extended family. What is your true society?
If you cannot identify your proper society, you
cannot tell which cultural norms apply to you.

Some people may be willing to overlook these
problems of cultural relativism because they be­
lieve it promotes cultural tolerance, an attitude
that seems both morally praiseworthy and in­
creasingly necessary in a pluralistic world. After
all, human history has been darkened repeatedly
by the intolerance of one society toward another,
engendering vast measures of bloodshed, pain,
oppression, injustice, and ignorance. The thought
is that because all cultures are morally equal,
there is no objective reason for criticizing any
of them. Tolerance is then the best policy.

Cultural relativism, however, does not neces­
sarily lead to tolerance and certainly does not
logically entail it. In fact, cultural relativism can
easily justify either tolerance or intolerance. It says
that if a society sanctions tolerance, then toler­
ance is morally right for that society. But if a soci­
ety approves of intolerance, then intolerance is
morally right for that society— and the society
cannot be legitimately criticized for endorsing
such an attitude. According to cultural relativism,
intolerance can be morally permissible just as tol­
erance can. In addition, though moral relativists
may want to advocate universal tolerance, they
cannot consistently do so. To say that all cultures
should be tolerant is to endorse an objective moral
norm, but cultural relativists insist that there are
no objective moral norms. To endorse universal
tolerance is to abandon cultural relativism.

ethics and religion

How is ethics related to religion? One obvious
connection is that historically religion has
always had moral content—mostly in the form

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18 PART 1: PRINCIPLES AND THEORIES

norms. The religious may then claim that God is
good— good because he abides perfectly by the
moral law and guides the conduct of believers
accordingly.

If moral standards are not grounded in the
divine will, if they are logically independent of
religion, then morality is a legitimate concern for
the religious and nonreligious alike, and every­
one has equal access to moral reflection and the
moral life. The best evidence for the latter is
ethics itself. The fact is that people do ethics. They
use critical reasoning and experience to deter­
mine moral norms, explore ethical issues, test
moral theories, and live a good life. The results of
these explorations are moral outlooks and stan­
dards founded on good reasons and arguments
and assented to by reflective people everywhere.

In bioethics, the informed opinions of reli­
gious people are as relevant as those of secular­
ists. But all parties must be willing to submit
their views to the tests and criteria of critical
reasoning and evidence.

But even if ethics does not have this indepen­
dent status, there are still good reasons for reli­
gious believers to know how to use the critical
tools that ethics offers. First, like many secular
moral rules, religious moral codes are often vague
and difficult to apply to conflicts and issues, es­
pecially in complex fields such as bioethics. Get­
ting around this problem requires interpreting
the codes, and this task involves consideration
of broader norms or theories, a typical job for
ethics. Second, like everyone else, believers must
deal with moral conflicts of all sorts— including
clashes between the moral beliefs of religious
adherents, religious leaders, and religious tradi­
tions. What is often needed is a neutral standard
and critical analyses to arrive at a resolution—
tools that ethics can easily provide. Third, public
debate on ethical issues in a diverse society re­
quires ground rules— chief among them being
that positions must be explained and reasons
must be given in their support. Unexplained as­
sertions without supporting reasons or argu­
ments are likely to be ignored. In this arena,
ethics is essential.

command theory); in the second, the moral law
is independent of God’s will so that even God is
subject to it. Critics of the divine command
theory have argued that the first option implies
the moral law is entirely arbitrary. The second
option denies the theory.

The arbitrariness is thought to arise like this:
If actions are morally right just because God
commands them to be so, then it is possible that
any actions whatsoever could be morally right.
The murder and rape of innocents, the oppres­
sion of the weak, the abuse of the poor— these
and many other awful deeds would be morally
permissible if God so willed. There would be no
independent standard to judge that these acts
are wrong, no moral reasons apart from God’s
will to suggest that such deeds are evil. God
would be free to establish arbitrarily any actions
whatsoever as morally right.

Defenders of the divine command theory
have replied to the arbitrariness charge by
saying that God would never command some­
thing evil because God is all­good. But critics
point out that if the theory is true, the assertion
that God is all­good would be meaningless, and
the traditional religious idea of the goodness of
God would become an empty notion. If God
makes the moral law, then the moral term good
would mean “commanded by God.” But then
“God is good” would mean something like “God
does what God commands” or even “God is
what God is,” which tells us nothing about the
goodness of God. Likewise, “God’s commands
are good” would translate as “God’s commands
are God’s commands.” This attempt to escape
the charge of arbitrariness seems to have intol­
erable implications.

Theists and nontheists alike find this horn
of Socrates’ dilemma— the idea of an arbitrary,
divinely ordained morality— incredible. They
therefore reject the divine command theory and
embrace the other horn, the view that right and
wrong are independent of God’s will. Moral
standards are external to God, binding on both
God and mortals. If there are divine commands,
they will conform to these independent moral

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Chapter 1: Moral Reasoning in Bioethics 19

fallacies, exploiting emotions and prejudices, daz­
zling with rhetorical gimmicks, hiding or distort­
ing the facts, threatening or coercing people— the
list is long. Good arguments prove something
whether or not they persuade. Persuasive ploys
can change minds but do not necessarily prove
anything.

So we formulate an argument to try to show
that a particular claim (the conclusion) should
be believed, and we analyze an argument to see
if it really does show what it purports to show. If
the argument is good, we are entitled to believe
its conclusion. If it is bad, we are not entitled to
believe it.

Consider these two simple arguments:

argument 1
Law enforcement in the city is a complete

failure. Incidents of serious crime have
doubled.

argument 2
It’s wrong to take the life of an innocent

person. Abortion takes the life of an
innocent person. So abortion is wrong.

In Argument 1, the conclusion is “Law en­
forcement in the city is a complete failure,” which
is supported by the premise “Incidents of serious
crime have doubled.” The conclusion of Argu­
ment 2 is “abortion is wrong,” and it is backed by
two premises: “It’s wrong to take the life of an
innocent person” and “Abortion takes the life of
an innocent person.” Despite the differences be­
tween these two passages (differences in content,
the number of premises, and the order of their
parts), they are both arguments because they ex­
emplify basic argument structure: a conclusion
supported by at least one premise.

Though the components of an argument
seem clear enough, people often fail to distin­
guish between arguments and strong statements
that contain no arguments at all. Suppose we
change Argument 1 into this:

Law enforcement in the city is a complete
failure. Nothing seems to work anymore.
This situation is intolerable.

moral arguments

Critical reasoning is something we employ every
time we carefully and systematically assess the
truth of a statement or the merits of a logical
argument. We ask: Are there good reasons for be­
lieving this statement? Is this a good argument—
does it prove its case? These sorts of questions
are asked in every academic field and in every
serious human endeavor. Wherever there is a need
to acquire knowledge, to separate truth from
falsity, and to come to a reliable understanding
of how the world works, these questions are
asked and answers are sought. Ethics is no excep­
tion. Critical reasoning in ethics— called moral
reasoning— employs the same general principles
of logic and evidence that guide the search for
truth in every other field. So we need not wonder
whether we use critical reasoning in ethics but
whether we use it well.

Argument Fundamentals
Most critical reasoning is concerned in one way
or another with the construction or evaluation
of arguments. As you may have guessed, here
argument denotes not an altercation but a pat­
terned set of assertions: at least one statement
providing support for another statement. We
have an argument when one or more statements
give us reasons for believing another one. The
supporting statements are premises, and the
supported statement is the conclusion. In critical
reasoning, the term statement also has a techni­
cal meaning. A statement (or claim) is an asser­
tion that something is or is not the case and is
therefore the kind of utterance that is either true
or false.

You need to understand at the outset that argu-
ment in this sense is not synonymous with persua-
sion. An argument provides us with reasons for
accepting a claim; it is an attempted “proof” for
an assertion. But persuasion does not necessarily
involve giving any reasons at all for accepting a
claim. To persuade is to influence people’s opin­
ions, which can be accomplished by offering a
good argument but also by misleading with logical

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20 PART 1: PRINCIPLES AND THEORIES

Now look at this one:

argument 3
1. All dogs are mammals.
2. Rex is a dog.
3. Therefore, Rex is a mammal.

Again, there is no way for the premises to be
true while the conclusion is false. The deductive
form of the argument guarantees this.

So a deductive argument is intended to have
this sort of airtight structure. If it actually does
have this structure, it is said to be valid. Argu­
ment 2 is deductive because it is intended to
provide logically conclusive support to its con­
clusion. It is valid because, as a matter of fact,
it  does offer this kind of support. A deductive
argument that fails to provide conclusive sup­
port to its conclusion is said to be invalid. In such
an argument, it is possible for the premises to be
true and the conclusion false. Argument 3 is in­
tended to have a deductive form, and because it
actually does have this form, the argument is
also valid.

An elementary fact about deductive argu­
ments is that their validity (or lack thereof) is a
separate issue from the truth of the premises.
Validity is a structural matter, depending en­
tirely on how an argument is put together. Truth
concerns the nature of the claims made in the
premises and conclusion. A deductive argument
is supposed to be built so that if the premises are
true, the conclusion must be true— but in a par­
ticular case, the premises might not be true.
A valid argument can have true or false premises
and a true or false conclusion. (By definition, of
course, it cannot have true premises and a false
conclusion.) In any case, being invalid or having
false premises dooms a deductive argument.

Inductive arguments are supposed to give
probable support to their conclusions. Unlike
deductive arguments, they are not designed to
support their conclusions decisively. They can
establish only that, if their premises are true,
their conclusions are probably true (more likely
to be true than not). Argument 1 is an inductive
argument meant to demonstrate the probable

Now there is no argument, just an expression
of annoyance or anger. There are no statements
giving us reasons to believe a conclusion. What
we have are some unsupported assertions that
may merely appear to make a case. If we ignore
the distinction between genuine arguments and
nonargumentative material, critical reasoning is
undone.

Assuming we can recognize an argument
when we see it, how can we tell if it is a good
one? Fortunately, the general criteria for judging
the merits of an argument are simple and clear.
A good argument— one that gives us good rea­
sons for believing a claim— must have (1) solid
logic and (2) true premises. Requirement (1)
means that the conclusion should follow logi­
cally from the premises, that there must be a
proper logical connection between supporting
statements and the statement supported. Re­
quirement (2) says that what the premises assert
must in fact be the case. An argument that fails
in either respect is a bad argument.

There are two basic kinds of arguments—
deductive and inductive— and our two require­
ments hold for both of them, even though the
logical connections in each type are distinct.
Deductive arguments are intended to give logi-
cally conclusive support to their conclusions so
that if the premises are true, the conclusion ab­
solutely must be true. Argument 2 is a deductive
argument and is therefore supposed to be con­
structed so that if the two premises are true, its
conclusion cannot possibly be false. Here it is
with its structure laid bare:

argument 2
1. It’s wrong to take the life of an innocent

person.
2. Abortion takes the life of an innocent

person.

3. Therefore, abortion is wrong.

Do you see that, given the form or structure
of this argument, if the premises are true, then
the conclusion has to be true? It would be very
strange— illogical, in fact— to agree that the two
premises are true but that the conclusion is false.

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Chapter 1: Moral Reasoning in Bioethics 21

Using our natural reasoning ability, we can ex­
amine how the premises are linked to the conclu­
sion and can see quickly whether the conclusion
follows from the premises. We are most likely to
make an easy job of it when the arguments are
simple. Many times, however, we need some
help, and help is available in the form of methods
and guidelines for evaluating arguments.

Having a familiarity with common argument
patterns, or forms, is especially useful when as­
sessing the validity of deductive arguments. We
are likely to encounter these forms again and
again in bioethics as well as in everyday life.
Here is a prime example:

argument 5
1. If the surgeon operates, then the patient

will be cured.
2. The surgeon is operating.
3. Therefore, the patient will be cured.

This argument form contains a conditional
premise— that is, a premise consisting of a con­
ditional, or if­then, statement (actually a com­
pound statement composed of two constituent
statements). Premise 1 is a conditional state­
ment. A conditional statement has two parts:
the part beginning with if (called the anteced-
ent) and the part beginning with then (known
as the consequent). So the antecedent of premise
1 is “If the surgeon operates,” and the conse­
quent is “then the patient will be cured.”

The best way to appreciate the structure of
such an argument (or any deductive argument,
for that matter) is to translate it into traditional
argument symbols in which each statement is
symbolized by a letter. Here is the symbolization
for Argument 5:

1. If p, then q.
2. p.
3. Therefore, q.

We can see that p represents “the surgeon
operates,” and q represents “the patient will
be cured.” But notice that we can use this
same symbolized argument form to represent
countless other arguments— arguments with

truth that “law enforcement in the city is a com­
plete failure.” Like all inductive arguments (and
unlike deductive ones), it can have true prem­
ises and a false conclusion. So the sole premise—
“incidents of serious crime have doubled”— can
be true while the conclusion is false.

If inductive arguments succeed in lending
probable support to their conclusions, they are
said to be strong. Strong arguments are such that
if their premises are true, their conclusions are
probably true. If they fail to provide this proba­
ble support, they are termed weak. Argument 1
is a weak argument because its premise, even if
true, does not show that more likely than not
law enforcement in the city is a complete failure.
After all, even if incidents of serious crime have
doubled, law enforcement may be successful in
other ways, or incidents of serious crime may be
up for reasons unrelated to the effectiveness of
law enforcement.

But consider this inductive argument:

argument 4
1. Eighty­five percent of the students at this

university are Republicans.
2. Sonia is a student at this university.
3. Therefore, Sonia is probably a Republican.

This argument is strong. If its premises are
true, its conclusion is likely to be true. If eighty­
five percent of the university’s students are
Republicans, and Sonia is a university student,
she is more likely than not to be a Republican, too.

When a valid (deductive) argument has true
premises, it is a good argument. A good deduc­
tive argument is said to be sound. Argument 2 is
valid, but we cannot say whether it is sound until
we determine the truth of the premises. Argu­
ment 3 is valid, and if its premises are true,
it is sound. When a strong (inductive) argument
has true premises, it is also a good argument.
A good inductive argument is said to be cogent.
Argument 1 is weak, so there is no way it can be
cogent. Argument 4 is strong, and if its premises
are true, it is cogent.

Checking the validity or strength of an argu­
ment is often a plain, commonsense undertaking.

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22 PART 1: PRINCIPLES AND THEORIES

1. If p, then q.
2. Not p.
3. Therefore, not q.

The advantage of being able to recognize
these and other common argument forms is
that you can use that skill to determine readily
the validity of many deductive arguments. You
know, for example, that any argument having
the same form as modus ponens or modus tollens
must be valid, and any argument in one of the
common invalid forms must be invalid.

Patterns of Moral Arguments
All that you have learned about argument fun­
damentals thus far applies directly to that sub­
species of argument we are most interested in:
moral argument. A moral argument is an argu­
ment whose conclusion is a moral statement, an
assertion that an action is right or wrong or that
a person or motive is good or bad. We utter a
moral statement when we say such things as
“Physician­assisted suicide is wrong,” or “Maria
should not have had an abortion,” or “Dr. Jones
is a good person.” We are constantly making
moral statements and including them in our
moral arguments, which we frequently devise
and hold up for inspection and evaluation.

Recall Argument 2, a simple (and common)
moral argument:

1. It’s wrong to take the life of an innocent
person.

2. Abortion takes the life of an innocent
person.

3. Therefore, abortion is wrong.

Here, we can see all the standard features of a
typical moral argument: (1) At least one premise
(premise 1) is a moral statement asserting a gen­
eral moral norm such as a moral principle; (2) at
least one premise (premise 2) is a nonmoral
statement describing an action or circumstance;
and (3) the conclusion is a moral statement ex­
pressing a moral judgment about a specific action
or circumstance.

different statements but having the same basic
structure.

It just so happens that the underlying ar­
gument form for Argument 5 is extremely
common— common enough to have a name,
modus ponens (or affirming the antecedent). The
truly useful fact about modus ponens is that any
argument having this form is valid. We can plug
any statements we want into the formula and
the result will be a valid argument, a circum­
stance in which if the premises are true, the con­
clusion must be true.

Another common argument form is modus
tollens (or denying the consequent). For example:

argument 6
1. If the dose is low, then the healing

is slow.
2. The healing is not slow.
3. Therefore, the dose is not low.

1. If p, then q.
2. Not q.
3. Therefore, not p.

Modus tollens is also a valid form, and any
argument using this form must also be valid.

There are also common argument forms that
are invalid. Here are two of them:

affirming the consequent
argument 7
1. If the patient is getting better, then drugs

are unnecessary.
2. Drugs are unnecessary.
3. Therefore, the patient is getting better.

1. If p, then q.
2. q.
3. Therefore, p.

denying the antecedent
argument 8
1. If the rate of infection is increasing, then

the patients will die.
2. The rate of infection is not increasing.
3. Therefore, the patients will not die.

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Chapter 1: Moral Reasoning in Bioethics 23

we cannot legitimately arrive at a moral conclu­
sion. That is, from a nonmoral premise alone, a
moral conclusion does not logically follow. For
example, from the nonmoral fact that abortions
are frequently performed, we cannot conclude
that abortion is immoral. Nonmoral premises
cannot support a conclusion expressing a moral
judgment. Likewise, we cannot reason from a
moral premise alone (one affirming a general
moral principle) to a conclusion about the moral­
ity of a particular action. We need a nonmoral
premise affirming that the particular action in
question is an instance of the general class of ac­
tions referred to in the general moral premise. In
Argument 2, the moral premise tells us it’s wrong
to take the life of an innocent person, but we need
the nonmoral premise to assert that abortion is
an instance of taking the life of an innocent

Notice how natural this pattern seems. If we
want to argue that a particular action (or kind of
action) is wrong, for example, we must provide a
reason for this moral judgment. The natural
(and logical) move is to reach for a general moral
principle that supports the judgment. Why is
performing surgery on Mrs. Johnson without
her consent wrong? Because, we might say,
treating people without their consent is a viola­
tion of their autonomy (a moral principle), and
performing surgery on Mrs. Johnson without
her consent would be an instance of such a vio­
lation (a nonmoral fact).

This natural way of proceeding reflects the
logical realities of moral reasoning. In a moral ar­
gument, we must have at least one moral premise
to draw a conclusion about the morality of a par­
ticular state of affairs. Without a moral premise,

REVIEW: Valid and Invalid Argument Forms

Valid Forms
Affirming the Antecedent (Modus Ponens) Denying the Consequent (Modus Tollens)
If p, then q. If p, then q.
p. Not q.
Therefore, q. Therefore, not p.

Example: Example:
If Spot barks, a burglar is in the house. If it’s raining, the park is closed.
Spot is barking. The park is not closed.
Therefore, a burglar is in the house. Therefore, it’s not raining.

Invalid Forms
Affirming the Consequent Denying the Antecedent
If p, then q. If p, then q.
q. Not p.
Therefore, p. Therefore, not q.

Example: Example:
If the cat is on the mat, she is asleep. If the cat is on the mat, she is asleep.
She is asleep. She is not on the mat.
Therefore, she is on the mat. Therefore, she is not asleep.

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24 PART 1: PRINCIPLES AND THEORIES

IN DEPTH

FALLACIES IN MORAL
REASONING

The world is full of bad arguments. Many of them
occur again and again in different guises and con-
texts, being so common that they have been given
names and are studied by those who wish to avoid
such mistakes. These common, defective arguments
are called fallacies. Here are a few that often crop up
in moral reasoning.

STRAW MAN
The straw man fallacy is the misrepresentation of a
person’s views so they can be more easily attacked
or dismissed. Suppose you argue that because an
immunization program will save the lives of thou-
sands of children and will likely cause the death of
only 1 child out of every 500,000, we should fund
the immunization program. But then your opponent
replies that you think the life of a child isn’t worth
much. Thus your point has been distorted, made to
look extreme or unsavory— and is now an easier
target. The straw man fallacy, of course, proves
nothing, though many people fall for it every day.

APPEAL TO THE PERSON
Closely related to the straw man fallacy is appeal to
the person (also known as the ad hominem fallacy).
Appeal to the person is the rejecting of a statement
on the grounds that it comes from a particular
person, not because the statement, or claim, itself is
false or dubious. For example:

You can safely discard anything that Susan has to
say about abortion. She’s a Catholic.

Johnson argues that our current health care
system is defective. But don’t listen to him—
he’s a liberal.

These arguments are defective because they ask
us to reject a claim because of a person’s character,
background, or circumstances— things that are gen-
erally irrelevant to the truth of claims. A statement

must stand or fall on its own merits. The personal
characteristics of the person espousing the view do
not necessarily have a bearing on its truth. Only if
we can show that someone’s dubious traits some-
how make the claim dubious are we justified in re-
jecting the claim because of a person’s personal
characteristics. Such a circumstance is rare.

APPEAL TO IGNORANCE
As its name implies, this fallacy tries to prove some-
thing by appealing to what we don’t know. The
appeal to ignorance is arguing either that (1) a claim
is true because it has not been proven false or (2) a
claim is false because it has not been proven true.
For example:

No one has proven that a fetus is not a person, so it
is in fact a person.

It is obviously false that a fetus is a person because
science has not proven that it is a person.

The first argument tries to prove a claim by
pointing out that it has not been proven false. The
second argument tries to prove that a claim is false
because it has not been proven true. Both kinds of
arguments are bogus because they assume that a
lack of evidence proves something. But a lack of evi-
dence can prove nothing. Being ignorant of the facts
does not enlighten us. Notice that if a lack of evi-
dence could prove something, then you could prove
just about anything you wanted. You could reason,
for instance, that since no one can prove that horses
cannot fly, horses must be able to fly.

BEGGING THE QUESTION
The fallacy of begging the question is trying to prove
a conclusion by using that very same conclusion as
support. It is arguing in a circle. This way of trying to
prove something says, in effect, “X is true because
X is true.” Here is a classic example:

The Bible says that God exists.

The Bible is true because God wrote it.

Therefore, God exists.

The conclusion here (“God exists”) is supported
by premises that assume that very conclusion.

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Chapter 1: Moral Reasoning in Bioethics 25

premises (moral and nonmoral) are left unsaid
and are merely implied. Sometimes premises are
unstated because they are obvious assumptions
that need not be mentioned. But if we are to per­
form a thorough evaluation of an argument, we
must drag the implicit premises into the open so
they can be fully assessed. Such careful scrutiny
is especially important in moral arguments be­
cause the implicit premises are often question­
able assumptions— the secret, weak links in the
chain of reasoning. For example:

argument 9
1. In vitro fertilization is an entirely

unnatural process, as far from natural
reproduction as one could imagine.

2. Therefore, in vitro fertilization should not
be used.

As it stands, this is a bad argument; the con­
clusion does not follow from the premise. But
there is an implied (moral) premise lurking here,

person. After all, that a fetus is a person— the
kind of entity that is deserving of full moral
rights— is not obviously true and not assented to
by everyone. We must spell out in a premise what
we take to be the nonmoral fact of the matter.

This discussion underscores a previously
mentioned fact about moral disagreements.
When people disagree on a moral issue, they
may or may not be disagreeing about moral
principles. They may actually share the relevant
moral principles but disagree about the non­
moral facts— or vice versa. So when people take
contradictory stands on the conclusion of a
moral argument, the source of the conflict could
lie with the moral premises or the nonmoral
premises or both.

Unfortunately, in everyday life moral argu­
ments do not come with their premises clearly
labeled, so we need to be able to identify the
premises ourselves. This job is made more diffi­
cult by a simple fact of the moral life: Often

Here’s another one:

All citizens have the right to a fair trial because
those whom the state is obliged to protect and give
consideration are automatically due judicial criminal
proceedings that are equitable by any reasonable
standard.

This passage may at first seem like a good argu-
ment, but it isn’t. It reduces to this unimpressive
assertion: “All citizens have the right to a fair trial
because all citizens have the right to a fair trial.” The
conclusion is “All citizens have the right to a fair
trial,” but that is more or less what the premise
says. The premise— “those whom the state is
obliged to protect and give consideration are auto-
matically due judicial criminal proceedings that are
equitable by any reasonable standard”— is equiva-
lent to “All citizens have the right to a fair trial.”

SLIPPERY SLOPE
The metaphor behind this fallacy suggests the danger
of stepping on a dicey incline, losing your footing,

and sliding to disaster. The fallacy of slippery slope,
then, is arguing erroneously that a particular action
should not be taken because it will lead inevitably to
other actions resulting in some dire outcome. The
key word here is erroneously. A slippery slope sce-
nario becomes fallacious when there is no reason to
believe that the chain of events predicted will ever
happen. For example:

If dying patients are permitted to refuse treatment,
then soon doctors will be refusing the treatment on
their behalf. Then physician- assisted suicide will
become rampant, and soon killing patients for
almost any reason will become the norm.

This argument is fallacious because there are no
reasons for believing that the first step will ultimately
result in the chain of events described. If good reasons
could be given, the argument might be salvaged.

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26 PART 1: PRINCIPLES AND THEORIES

and if we make it explicit, the argument will be
valid:

1. In vitro fertilization is an entirely
unnatural process, as far from natural
reproduction as one could imagine.

2. Any process that is unnatural should not
be used.

3. Therefore, in vitro fertilization should not
be used.

Now the argument is complete, and we can
see both the nonmoral premise (premise 1) and
the moral premise (premise 2), which is a moral
principle. But now that we have brought the
moral premise into the light of day, we can see
that it is false or at least debatable. We use many
processes and products that are unnatural (for
example, modern pharmaceuticals, intravenous
feeding, surgery, CAT scans, artificial limbs,
and contact lenses), but we generally do not
regard them as morally impermissible.

Very often we can tell that an argument has
an unstated premise because there is a logical
leap between the stated premises and the con­
clusion. The inference from stated premises to
conclusion does not work unless the missing
premise is supplied. A good candidate for the
implicit premise will make the argument valid
or strong and will be plausible in the context of
the argument. The most straightforward ap­
proach, however, is to treat the argument as de­
ductive and look for a premise that will make
the argument valid, as we did in Argument 9.

Evaluating Premises
As we have seen, good arguments have true
premises. But how do we know if the premises
are true? Fortunately, there are ways to test, or
evaluate, the truth of premises. The tests differ,
however, depending on whether the premises
are nonmoral or moral.

Checking the truth of nonmoral premises
can involve the exploration of either empirical
or conceptual matters. An empirical belief, or
claim, is one that can be confirmed by sense
experience— that is, by observation or scientific

investigation. Most nonmoral premises are em­
pirical claims that we can check by examining
our own experience or that of others or by con­
sulting the relevant scientific findings. By these
methods we can test (and support) a wide variety
of empirical assertions, such as many of the non­
moral premises examined earlier: “Incidents of
serious crime have doubled”; “Eighty­five percent
of the students at this university are Republicans”;
“If the patient is getting better, then drugs are
unnecessary.”

In bioethics, among the most controversial
nonmoral premises are those affirming that a
medical treatment or program will or will not
have a particular effect on people. The issue is
whether it will help or harm and to what degree.
Sometimes reliable data are available to resolve
the issue. Sometimes no clear evidence exists,
leaving people to make educated guesses that
are often in dispute.

In any case, critical reasoning in bioethics
demands that we always seek the most reliable
evidence available and try to assess its worth ob­
jectively. It requires that our empirical claims be
supported by good empirical evidence and that
we expect the same from others who make em­
pirical assertions.

A conceptual matter has to do with the mean­
ing of terms, something we need to pay attention
to because disputes in bioethics sometimes hinge
on the meaning of a concept. For example, in
disagreements about the moral permissibility of
abortion, the crux of the matter is often how the
disputants define person (as in Argument 2), or
human life, or human being. Similarly, whether
someone supports or opposes euthanasia often
hangs on how it is defined. Some, for example,
define it in the narrow sense of taking direct
action to kill someone for his sake (mercy killing),
while others insist on a wider sense that en­
compasses both mercifully killing and allowing
to die. Whether we are devising our own argu­
ments or evaluating those of others, being clear
on the meaning of terms is essential, and any
proposed definition must be backed by good
reasons.

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Chapter 1: Moral Reasoning in Bioethics 27

there was something wrong with utilitarianism
or that other considerations (including alterna­
tive theories) outweigh utilitarian concerns.

Another possible source of support for moral
premises is what philosophers call our considered
moral judgments. These are moral judgments we
deem plausible or credible after careful reflection
that is as unbiased as possible. They may apply
to both particular cases and more general moral
statements. For example, after deliberation we
might conclude that “inflicting undeserved and
unnecessary pain on someone is wrong,” or that
“emergency care for accident victims should be
provided regardless of their race or religion,” or
that “amputating a patient’s leg for no good
reason is never morally permissible.” Like moral
principles and theories, such judgments can vary
in how much weight they carry in moral argu­
ments and can be given more or less credibility
(or undermined completely) by relevant reasons.
(We examine more closely the relationships among
theories, principles, and considered judgments
in Chapter 2.)

Moral premises can be called into question
by showing that they somehow conflict with
credible principles, theories, or judgments. One
way to do this is to cite counterexamples, in­
stances in which the moral principle in question
seems not to hold. Recall that a counterexample
helps us see that the moral premise in Argument 9
is dubious. The premise says “Any process that is
unnatural should not be used,” but we often use
unnatural products or processes (CAT scans and
contact lenses, for instance) and do not think
these actions morally wrong. In the same way,
we can use counterexamples to evaluate the
moral premise in Argument 2:

1. It’s wrong to take the life of an innocent
person.
2. Abortion takes the life of an innocent
person.
3. Therefore, abortion is wrong.

Are there no exceptions to premise 1? Is it
always wrong to kill an innocent person? We
can imagine cases in which this premise seems

Moral premises are like nonmoral ones in that
they, too, should be supported by good reasons
and be subjected to serious scrutiny. But just how
are moral premises supported and scrutinized?

Support for a moral premise (a moral principle
or standard) can come from at least three sources:
other moral principles, moral theories, or our
most reliable moral judgments. Probably the
most common way to support a moral principle
is to appeal to a higher­level principle (which
often turns out to be one of the four major moral
principles discussed earlier). Suppose the moral
premise in question is “The patient’s wishes about
whether surgery is performed on him should not
be ignored.” Some would argue that this principle
is derived from, or is based on, the higher princi­
ple that autonomous persons should be allowed
to exercise their capacity for self­determination.
Or let’s say the premise is “Individuals in a persis­
tent vegetative state should never have their feed­
ing tubes removed so they can ‘die with dignity.’”
Many would base this assertion on the principle
that human life is sacred and should be preserved
at all costs. Frequently, the higher principle ap­
pealed to is plausible, seemingly universal, or ac­
cepted by all parties so that further support for
the principle is not necessary. At other times, the
higher principle itself may be controversial and in
need of support.

Moral premises can also be supported by a
moral theory, a general explanation of what
makes an action right or a person or motive
good. (In Chapter 2 we discuss moral theories in
depth.) For example, traditional utilitarianism
is a moral theory affirming that right actions are
those that produce the greatest happiness for all
concerned. Appealing to utilitarianism, then,
someone might insist that a baby born with
severe brain damage who will die within a few
days should not be allowed to wither slowly away
in pain but should be given a lethal injection.
The justification for this policy is that it would
produce the least amount of unhappiness (in­
cluding pain and suffering) for all concerned,
including baby, parents, and caregivers. Those
who reject this policy would have to argue that

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28 PART 1: PRINCIPLES AND THEORIES

of prose. In any case, your job is to come up
with a single conclusion statement for each con­
clusion—even if you have to paraphrase large
sections of text to do it. When you identify the
conclusion, the hunt for premises gets easier.
Step 3. Identify the premises. Like the search for
a conclusion, unearthing the premises may involve
condensing large sections of text into manage­
able form—namely, single premise statements.
To do this, you need to disregard extraneous
material and keep your eye on the ‘‘big picture.’’
Remember that in moral arguments you are
looking for both moral and nonmoral premises.

Let’s see how this procedure works on the follow­
ing passage:

[1] John and Nancy Jones had a two­year­old son
who suffered from a serious but very curable bowel
obstruction. [2] For religious reasons, the Joneses
decide to treat their son with prayer instead of
modern medicine. [3] They refused medical treat­
ment even though they were told by several doc­
tors that the child would die unless medically
treated. [4] As it turned out, the boy did die.
[5] The Joneses were arrested and charged with
involuntary manslaughter. [6] Were the Joneses
wrong to refuse treatment for their son?

[7] The answer is yes. [8] Regardless of what
faith or religious dogma would have the Joneses
do, they allowed their child to die. [9] According
to just about any moral outlook, the care of a
child by the parents is a fundamental obligation.
[10] Above all other concerns, parents have a
duty to ensure the health and safety of their
children and to use whatever means are most
likely to secure those benefits. [11] In other
words, allowing a child to die when the death
could easily have been prevented is morally
reprehensible. [12] The Joneses were therefore
guilty of a shockingly immoral act.

The first order of business is to find the con­
clusion, and in doing so we can see that the first
paragraph is entirely background information.
The conclusion is in sentence 12, and with this
information, we can tell that sentence 7 is a short
affirmation of the conclusion. We can also locate

either doubtful or at least not obviously true.
What about situations in which many lives can
be saved by taking the life of one person? What
if all 50 people in a lifeboat at sea will drown
unless one of them is cast overboard? What if
the one unlucky person agrees to be cast over­
board to save all the others? Or suppose a person
is dying of cancer and is suffering unspeakable
pain that cannot be relieved by any medical
means— and she begs for a lethal injection of
morphine. Some would argue that these scenar­
ios raise serious questions about premise 1, sug­
gesting that at least in its current form, it may not
be true. In response to these counterexamples,
some who wish to defend the premise might
modify it to take the scenarios into account or
even try to show that despite its implications
premise 1 is justified.

Assessing Whole Arguments
Moral argument, like any other kind of argu­
ments, usually come to us embedded in larger
tracts of speech or writing. Often the premises
and conclusion are embellished or obscured by
other elements—by explanations, asides, reiter­
ations, descriptions, examples, amplifications,
or irrelevancies. So how do we evaluate such
arguments in the rough?

Following this procedure will help:

Step 1. Study the text until you thoroughly under­
stand it. You can’t locate the conclusion or prem­
ises until you know what you’re looking for—and
that requires having a clear idea of what the author
is driving at. Don’t attempt to find the conclusion
or premises until you ‘‘get it.’’ This understanding
entails having an overview of a great deal of text,
a bird’s­eye view of the whole work.
Step 2. Find the conclusion. When you evaluate
arguments surrounded by a lot of other prose,
your first task is to find the conclusion. There may
be a single conclusion, or several main conclu­
sions, or one primary conclusion with several
subconclusions. Or the conclusion may be
nowhere explicitly stated but embodied in meta­
phorical language or implied by large expanses

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Chapter 1: Moral Reasoning in Bioethics 29

inductive argument
metaethics
moral absolutism
moral argument
moral objectivism
morality
normative ethics
paternalism
subjective relativism

summary
Morality refers to beliefs about right and wrong
actions and morally good and bad persons or
character. Ethics is the study of morality using
the tools and methods of philosophy. The study
of morality using the methodology of science
is known as descriptive ethics. Ethics has three
main branches: (1) normative ethics, the search
for, and justification of, moral standards, or norms;
(2) metaethics, the study of the meaning and
justification of basic moral beliefs; and (3) applied
ethics, the use of moral norms and concepts to
resolve practical moral issues. Bioethics is applied
ethics focused on health care, medical science,
and medical technology.

Moral norms differ from other kinds of norms
because they are characterized by (1) normative
dominance, (2) universality, (3) impartiality, and
(4) reasonableness. We apply moral norms to
two distinct spheres of our moral experience—
obligations and values. Moral obligations concern
our duty, what we are obligated to do or not do,
and refer primarily to right and wrong actions.
Moral values generally concern those things that
we judge to be morally good, bad, praiseworthy,
or blameworthy. A right action can be obligatory
(one that would be wrong not to perform) or
permissible (one that is not wrong to perform).
A prohibited action would be one that would be
wrong to perform. A supererogatory action is one
that is “above and beyond” our duty.

In bioethics, five moral principles have been
extremely influential and particularly relevant:
(1) autonomy (autonomous persons should be
allowed to exercise their capacity for self­
determination); (2) nonmaleficence (we should

the premises. The nonmoral premise is in sen­
tence 8: the nonmoral fact is that the Joneses
permitted their child to die. The moral premise is
stated most explicitly in sentence 11. Sentences 9
and 10 are equivalent to 11, although stated more
generally.

The bare­bones arguments then is:

[8] Regardless of what faith or religious dogma
would have the Joneses do, they allowed their
child to die.
[11] In other words, allowing a child to die when
the death could easily have been prevented is
morally reprehensible.
[12] The Joneses were therefore guilty of a shock­
ingly immoral act.

This argument is deductively valid, so the
crucial question is whether the premises are
true. Presumably the nonmoral premise 8 is an
uncontested assertion. We can imagine that
everyone knows that the Joneses let their child
die. Premise 11, the moral statement, seems to be
a plausible moral principle—some would say it’s
just common sense. Most people would find it
difficult to think of a credible counterexample to
it. But that is precisely what is at issue here:
whether it’s ever morally permissible to allow a
child to die when the death can easily be pre­
vented. To justify premise 11, those who accept it
may appeal to a moral theory (utilitarianism or
Kantian ethics, say) or to more general moral
principles such as ‘‘always act to preserve life,’’
‘‘treat persons with respect,’’ or ‘‘humans have a
right to life.’’ On the other hand, it’s hard to see
how the rejection of premise 11 could be based on
anything other than a religious moral principle.

key terms
applied ethics
bioethics
cultural relativism
deductive argument
descriptive ethics
divine command theory
ethical relativism
ethics

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30 PART 1: PRINCIPLES AND THEORIES

1. Noah promised to drive Thelma to Los
Angeles, so he should stop bellyaching
and do it.

2. The refugees were shot at and lied to, and
the authorities did nothing to stop any of
this. The authorities should have
intervened.

3. There was never any imminent threat
from the Iraqi government, so the United
States should not have invaded Iraq.

4. The Indian government posed an
imminent threat to Pakistan and the
world, so the Pakistanis were justified in
attacking Indian troops.

5. Burton used a gun in the commission of a
crime; therefore he should get a long
prison term.

6. Ellen knew that a murder was going to
take place. It was her duty to try to stop it.

7. Ahmed should never have allowed his
daughter to receive in vitro fertilization.
Such a procedure is unnatural.

8. The doctors performed the experiment on
twenty patients without their consent.
Obviously, that was wrong.

9. What you did was immoral. You hacked
into a database containing personal
information on thousands of people and
invaded their privacy.

10. Ling spent all day weeding Mrs. Black’s
garden for no pay. The least Mrs. Black
should do is let Ling borrow some
gardening tools.

Exercise 1.2
For each of the following arguments, specify the
conclusion and premises and indicate where
possible whether it is cogent or sound.

1. Anyone who runs away from an
automobile accident should be arrested.
Janet ran away from an automobile
accident. She should be arrested.

2. I write in response to the Nov. 4 News
article, ‘‘Plans for group home, storage
facility opposed.” As the sister and

not cause unnecessary harm to others); (3) be­
neficence (we should do good to others and
prevent or remove harm); (4) utility (we should
produce the most favorable balance of good
over bad for all concerned); and (5) justice (we
should treat equals equally).

According to ethical relativism, moral stan­
dards are not objective but are relative to what
individuals or cultures believe. A familiar argu­
ment for cultural relativism is that if people’s
moral judgments differ from culture to culture,
then moral norms are relative to culture, and
people’s moral judgments obviously do differ from
culture to culture. But the first premise in the ar­
gument is false. In addition, cultural relativism
seems implausible because it implies moral infal­
libility, immunity of all cultures from moral crit­
icism from the outside, the automatic wrongness
of the moral stance of social reformers, and the
incoherence of the idea of moral progress. More­
over, cultural relativism does not necessarily lead
to tolerance and does not logically entail it.

The divine command theory says that right
actions are those commanded by God, and
wrong actions are those forbidden by God. But
many religious and nonreligious people have
rejected the theory because it seems to imply
that God’s commands are arbitrary.

Most critical reasoning is concerned in one
way or another with the construction or evalua­
tion of arguments. All the skills required in deal­
ing with arguments generally can be applied
directly to handling moral arguments in partic­
ular. A moral argument is one whose conclusion
is a moral statement, an assertion that an action
is right or wrong or that a person or motive is
good or bad.

ARGUMENT EXERCISES

(All answers appear in the Appendix.)

Exercise 1.1
In each of the following passages, add a moral
premise to turn it into a valid moral argument.

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Chapter 1: Moral Reasoning in Bioethics 31

2. Anyone who disagrees with the basic
moral dictums of the prevailing culture
should be censored. Dr. Tilden’s
graduation speech clearly was inconsistent
with the prevailing moral opinions on
campus. She should be reprimanded.

Exercise 1.4
Identify the moral arguments in each of the
following passages. Specify the premises and
the conclusion, adding implicit premises where
needed.

1. The movie Lorenzo’s Oil is about a family’s
struggle to find a cure for their young
son’s fatal genetic disease, an illness that
usually kills boys before they reach their
eleventh birthday. The script is based on
the true story of a family’s attempt to save
Lorenzo, their son, from this fatal genetic
disease through the use of a medicinal oil.
The movie is a tear­jerker, but it ends on a
hopeful note that suggests that the oil will
eventually cure Lorenzo and that the oil
is an effective treatment for the genetic
disease. The problem is, there is no cure
for the disease and no good scientific
evidence showing that the oil works. But
the movie touts the oil anyway—and gives
false hope to every family whose son
suffers from this terrible illness. Worse,
the movie overplays the worth of the oil,
seriously misleading people about the
medical facts. The movie, therefore, is
immoral. It violates the ageless moral
dictum to, above all else, ‘‘do no harm.’’
Lorenzo’s Oil may be just a movie, but it
has done harm nonetheless.

2. I, like many of my fellow Muslims, was
appalled by the latest bombing in Saudi
Arabia (‘Among the Saudis, Attack Has
Soured Qaeda Supporters,’ front page,
Nov. 11). Yet I was disturbed to get the
sense that Saudis were angered by this
latest act of barbarity because the targets
were mainly Arab and Muslim.

guardian of a profoundly retarded woman
who lives in a group home, I can assure
the gentlemen quoted that their fears are
very much unfounded. The home in which
my sister resides is large, lovely, brand
new, well staffed and well maintained. It
does nothing but enhance the community,
bring neighbors together and create a
wonderfully diverse neighborhood—
Letter to the editor, Buffalo News

3. Scrawling ‘‘Rape all Asian bitches and dump
them’’ on classroom walls is not a hate
crime, and graffiti should be protected by
the First Amendment, according to assis­
tant professor of communication Laura
Leets. This is outrageous. I hope Ms. Leets
is simply arguing from a narrow legalistic
interpretation and is merely insensitive to
the tremendous hurt such graffiti can
inflict, not to mention the additional
damage caused when a professor on
campus defends it. Words can be just as
destructive as physical violence. Drawing
a technical distinction between the two is
at best insensitive, at worst evil—Letter to
the editor, Stanford Magazine

4. Yolanda took the money from petty cash
even though she had plenty of money in
her pocket. People shouldn’t steal unless
they are destitute. She shouldn’t have
taken that money.

5. There is one principle we can never avoid:
We should never do anything to
disrespect human life. The artificial use of
human cells—as scientists are now doing
in stem­cell research—shows a complete
disregard for human life. Stem­cell
research is immoral.

Exercise 1.3
Evaluate the following arguments:

1. Any form of expression or speech that
offends people of faith should not be
tolerated. Penthouse magazine definitely
offends people of faith. Ban it!

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32 PART 1: PRINCIPLES AND THEORIES

Richard M. Fox and Joseph P. DeMarco, Moral Reason-
ing, 2nd ed. (New York: Harcourt, 2001).

William K. Frankena, Ethics, 2nd ed. (Englewood Cliffs,
NJ: Prentice­Hall, 1973).

Bernard Gert, Morality: Its Nature and Justification
(New York: Oxford University Press, 1998).

John­Stewart Gordon, “Bioethics,” The Internet Ency-
clopedia of Philosophy, http://www.iep.utm.edu/
(15 October 2015).

Chris Gowans, “Moral Relativism,” in The Stanford
Encyclopedia of Philosophy (Spring 2004), ed. Edward
N. Zalta, http://plato.stanford.edu/archives/spr2004/
entries/moral­relativism/.

C. E. Harris, Applying Moral Theories (Belmont, CA:
Wadsworth, 1997).

The Hastings Center, http://www.thehastingscenter.org/
(15 October 2015).

Melville Herskovits, Cultural Relativism: Perspectives
in Cultural Pluralism (New York: Vintage, 1972).

Albert R. Jonsen, The Birth of Bioethics (New York:
Oxford University Press, 1998).

Kai Nielsen, Ethics Without God (Buffalo, NY: Prometheus,
1973).

Louis P. Pojman, Ethics: Discovering Right and Wrong,
4th ed. (Belmont, CA: Wadsworth, 2002).

Louis P. Pojman and Lewis Vaughn, eds., The Moral Life,
3rd ed. (New York: Oxford University Press, 2007).

James Rachels, The Elements of Moral Philosophy,
4th ed. (New York: McGraw­Hill, 2003).

Theodore Schick, Jr. and Lewis Vaughn, Doing Philoso-
phy, 2nd ed. (New York: McGraw­Hill, 2002), chap. 5.

Russ Shafer­Landau, Whatever Happened to Good and
Evil? (New York: Oxford University Press, 2004).

Peter Singer, ed., A Companion to Ethics (Cambridge,
UK: Blackwell, 1993).

Walter T. Stace, “Ethical Relativism,” in The Concept of
Morals (New York: Macmillan, 1965), 8– 58.

Bonnie Steinbock, ed., The Oxford Handbook of Bioethics
(Oxford: Oxford University Press, 2007).

Paul Taylor, Principles of Ethics (Encino, CA: Dickenson,
1975).

Lewis Vaughn, Doing Ethics: Moral Reasoning and Con-
temporary Issues (New York: W.W. Norton, 2008).

Lewis Vaughn, The Power of Critical Thinking, 2nd ed.
(New York: Oxford University Press, 2008).

Thomas F. Wall, Thinking Critically About Moral Problems
(Belmont, CA: Wadsworth, 2003).

G. J. Warnock, The Object of Morality (London:
Methuen & Co. 1971).

You quote one person as saying of the
bombing in Riyadh in May, “At that time
it was seen as justifiable because there was
an invasion of a foreign country, there was
frustration.” Another says, “Jihad is not
against your own people.”

Regardless of whether the victims are
Muslim or not, the vicious murder of
innocent human beings is reprehensible
and repugnant, an affront to everything
Islam stands for. Any sympathy for
Al Qaeda among the minority of Saudis
should have evaporated after the May
bombings in Riyadh, and it should have
surprised no one in Saudi Arabia that
Al Qaeda would attack a housing complex
full of Arabs and Muslims.

That is what Al Qaeda is: a band of
bloodthirsty murderers.—Letter to the
editor, New York Times

further reading
Anita L. Allen, New Ethics: A Guided Tour of the Twenty-

First Century Moral Landscape (New York: Miramax,
2004).

John Arras, “Theory and Bioethics,” The Stanford Ency-
clopedia of Philosophy (Summer 2013), Edward N.
Zalta (ed.), http://plato.stanford.edu/archives/sum2013/
entries/theory­bioethics/ (15 October 2015).

Robert Audi, Moral Knowledge and Ethical Character
(New York: Oxford University Press, 1997).

Tom L. Beauchamp and James F. Childress, Principles
of Biomedical Ethics, 5th ed. (New York: Oxford
University Press, 2001).

Bioethics.com, http://www.bioethics.com/ (15 October
2015).

Richard B. Brandt, Ethical Theory (Englewood Cliffs,
NJ: Prentice­Hall, 1959).

Steven M. Cahn and Joram G. Haber, Twentieth Century
Ethical Theory (Upper Saddle River, NJ: Prentice­Hall,
1995).

Jean Bethke Elshtain, “Judge Not?,” First Things 46
(October 1994): 36– 41.

Fred Feldman, Introductory Ethics (Englewood Cliffs,
NJ: Prentice­Hall, 1978).

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Chapter 1: Moral Reasoning in Bioethics 33

notes
1. James Rachels, The Elements of Moral Philosophy,
4th ed. (New York: McGraw­Hill, 2003), 14.
2. This example is derived from James Rachels’ unique
description of the case in “Ethical Theory and Bioethics,”
from A Companion to Bioethics, ed. Helga Kuhse and
Peter Singer (Oxford: Blackwell, 2001), 16– 17.
3. W. D. Ross, The Right and the Good (Oxford:
Clarendon Press, 1930).
4. In their classic text Principles of Biomedical Ethics
(New York: Oxford University Press, 2001), Tom L.

Beauchamp and James F. Childress work out a
comprehensive approach to biomedical ethics using a
framework of four moral principles. They choose to
treat beneficence and nonmaleficence separately and
regard utility as part of beneficence.
5. Solomon Asch, Social Psychology (Englewood Cliffs,
NJ: Prentice­Hall, 1952), 378– 79.

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34

CHAPTER 2

Bioethics and Moral Theories

As we have seen, the moral life is dynamic,
complex, and inescapable. In it we wrestle with
momentous questions of moral value and moral
rightness. We assert, challenge, accept, and reject
moral statements. We make moral judgments
about the rightness of actions, the goodness of
persons or their character, and the moral quality
and worth of our lives. Through general moral
norms or principles, we direct our actions and
inform our choices. We formulate and critique
moral arguments, thereby testing what we know
or think we know about moral realities. We do
all this and one thing more: We naturally and
unavoidably venture into the realm of moral
theory, trying to see the larger moral meaning
behind particular situations and precepts. In
this chapter, we explore this realm and try to
discern how it fits into the moral life in general
and into bioethics in particular.

the nature of moral theories

In science, theories help us understand the em-
pirical world by explaining the causes of events,
why things are the way they are. The germ theory
of disease explains how particular diseases arise
and spread in a human population. The helio-
centric (sun-centered) theory of planetary motion
explains why the planets in our solar system
behave the way they do. In ethics, moral theories
have a similar explanatory role. A moral theory
explains not why one event causes another but
why an action is right or wrong or why a person
or a person’s character is good or bad. A moral
theory tells us what it is about an action that
makes it right, or what it is about a person that
makes him or her good. The divine command

theory of morality, for example, says that right
actions are those commanded or willed by God.
Traditional utilitarianism says that right actions
are those that produce the greatest happiness
for all concerned. These and other moral theories
are attempts to define rightness or goodness. In
this way, they are both more general and more
basic than moral principles or other general norms.

Moral theorizing— that is, making, using, or
assessing moral theories or parts of theories— is
normal and pervasive in the moral life, though
it is often done without much recognition that
theory is playing a part in the deliberations.
Whenever we try to understand what a moral
property such as rightness or goodness means,
or justify a moral principle or other norm, or re-
solve a conflict between two credible principles,
or explain why a particular action or practice is
right or wrong, or evaluate the plausibility of
specific moral intuitions or assumptions, we do
moral theorizing. In fact, we must theorize if
we are to make headway in such investigations.
We must stand back from the situation at hand
and try to grasp the larger pattern that only
theory can reveal.

Moral theories that concentrate on right and
wrong actions are known as theories of obliga-
tion (or duty) or simply as theories of right action.
The divine command theory and utilitarianism
are theories of right action. Philosophers often
distinguish these from moral theories that focus
on good and bad persons or character— so-called
virtue-based theories. Virtue ethics (covered later
in this chapter) is a prime example.

How do moral theories fit into our everyday
moral reasoning? In answering that, let’s focus
on theories of right action, probably the most

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Chapter 2: Bioethics and Moral Theories 35

There is also the testimony of the particular, the
evidence of individual moral judgments.

Our moral deliberations, then, involve both the
general and the particular. Suppose we embrace
a moral theory that seems to offer us a plausible
explanation of what makes an action right or
wrong. When we must decide which action is
morally right in a particular situation, we look to
our theory for general guidance. From our theory
we may glean a set of moral principles that seem to
apply to the case at hand. If the principles lead us
to conflicting choices, we look again to the theory
for insight in resolving the conflict. But we also
must take into account our considered judgments
about the case. (We may also formulate considered
judgments about the relevant principles or rules.)
If our considered judgments and the deliverances
of our theory are consistent with one another,
we have additional assurance that our decision in
the case is correct. If our judgments clash with
our theory or principles, we must decide which to
revise or discard— for critical reasoning demands
that our beliefs be coherent, that they do not
harbor contradictions. If we believe our judgments
to be more credible than the implications of our
theory (or principles), we may modify the theory
accordingly (or, rarely, regard the theory as irrepa-
rable and give it up). But if the theory seems more
credible in this case, we may conclude that our
judgment is untrustworthy and set it aside.

So a moral theory can show us what is im-
portant and reasonable in morality, guiding our
judgments through overarching insights that
may help us with specific cases and issues, some-
times correcting erring judgments along the
way. Our considered judgments are fallible indi-
cators of moral common sense and are checks
against wayward theory or f lawed principle.
In bioethics, both of these moral resources are
highly respected and widely used.

influential moral theories

Several moral theories have played major roles
in bioethics, and they continue to influence how
people think about bioethical issues. Theories of

influential type in bioethics. First, moral theo-
ries can figure directly in our moral arguments.
As we saw earlier, moral arguments contain
both moral and nonmoral premises. A moral
premise can consist of a moral principle, a moral
rule (a less general norm derived from or based
on a principle), or a claim expressing a central
tenet of a moral theory. Using such a tenet,
someone might argue, for example, that stem-
cell research should be fully funded rather than
halted altogether because such a step would
eventually lead to a greater benefit for more
people, and right actions (according to utilitari-
anism) are those that result in the greatest over-
all benefit for the greatest number. Thus the
fundamental moral standard of utilitarianism
becomes a premise in an argument for a specific
action in a particular case.

Second, theories can have an indirect impact
on moral arguments because principles ap-
pealed to are often supported in turn by a moral
theory. The principles can be either derived
from or supported by the theory’s account of
right and wrong action. Consider the prohibi-
tion against murder, the basic precept that it is
wrong to take the life of an innocent person.
This principle can be drawn from theories built
around the fundamental notion of respect for
persons. As one such theory would have it,
murder is wrong because it treats people not as
persons with inherent worth but as mere things
to be used or dispensed with as one wishes.

Some people are tempted to deduce from all
this that moral theories are the dominant force
in moral reasoning as well as in the moral life.
This view would be an oversimplification. By
design, moral theories are certainly more gen-
eral in scope than moral principles, rules, or
judgments. But from this fact it does not follow
that theories alone are the ultimate authority in
moral deliberations. For one thing, to be truly
useful, moral theories must be filled out with
details about how to apply them in real life and
the kinds of cases to which they are relevant. For
another, there is more to morality than what can
be captured in the general norms of a theory.

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36 PART 1: PRINCIPLES AND THEORIES

right action (in contrast to virtue-based theories)
have dominated the field, each usually based on
one of two broad views about the essential char-
acter of right actions. Consequentialist moral
theories insist that the rightness of actions
depends solely on their consequences or results.
The key question is what or how much good
the actions produce, however good is defined.
Deontological (or nonconsequentialist) theories
say that the rightness of actions is determined
not solely by their consequences but partly or
entirely by their intrinsic nature. For some or all
actions, rightness depends on the kind of actions
they are, not on how much good they produce.
A consequentialist theory, then, may say that
stealing is wrong because it causes more harm
than good. But a deontological theory may con-
tend that stealing is inherently wrong regardless
of its consequences, good or bad.

Utilitarianism
The leading consequentialist theory is utilitari-
anism, the view that right actions are those that
result in the most beneficial balance of good
over bad consequences for everyone involved. It
says we should maximize the nonmoral good
(the utility) of everyone affected, regardless of the
contrary urgings of moral rules or unbending
moral principles. Various forms of utilitarianism
differ in how they define utility, with some equat-
ing it with happiness or pleasure (the hedonistic
view), others with satisfaction of preferences or
desires or some other intrinsically valuable things
or states such as knowledge or perfection.

In applying the utilitarian moral standard (the
greatest good, everyone considered), some moral
philosophers concentrate on specific acts and
some on rules covering kinds of acts. The former
approach is called act-utilitarianism, the idea
that the rightness of actions depends solely on the
relative good produced by individual actions.
An act is right if in a particular situation it pro-
duces a greater balance of good over bad than any
alternative acts; determining rightness is a matter
of weighing the effects of each possible act. The
latter approach, known as rule-utilitarianism,

avoids judging rightness by specific acts and
focuses instead on rules governing categories of
acts. It says a right action is one that conforms to
a rule that, if followed consistently, would create
for everyone involved the most beneficial balance
of good over bad. We are to adhere to the rules
because they maximize the good for everyone
considered— even though a given act may pro-
duce bad effects in a particular situation.

The classic version of utilitarianism was de-
vised by English philosopher Jeremy Bentham
(1748– 1832) and given more detail and plausibil-
ity by another English philosopher, John Stuart
Mill (1806– 1873). Classic utilitarianism is he-
donistic in that the utility to be maximized is
pleasure, broadly termed happiness, the only
intrinsic good. A right action produces more net
happiness (amounts of happiness minus unhap-
piness) than any alternative action, everyone
considered. As Mill put it,

[Actions] are right in proportion as they tend
to promote happiness, wrong as they tend to
produce the reverse of happiness. By “happiness”
is intended pleasure, and the absence of pain;
by “unhappiness,” pain and the privation of
pleasure.1

Bentham and Mill, however, had different
ideas about what happiness entailed, as do many
philosophers today. Bentham thinks that happi-
ness is one-dimensional: It is pleasure, pure and
simple, something that varies only in the amount
that an agent can experience. On this scheme, it
seems that the moral ideal would be to experi-
ence maximum amounts of pleasure, as does the
glutton or the debauchee. But Mill thinks that
pleasures can vary in quality as well as quantity.
For him, there are lower and higher pleasures—
the lower and inferior ones indulged in by the
glutton and his ilk and the higher and more
satisfying ones found in such experiences as the
search for knowledge and the appreciation of art
and music. Mill famously sums up this contrast
by saying, “It is better to be a human being dis-
satisfied than a pig satisfied; better to be Socrates
dissatisfied than a fool satisfied.” 2

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Chapter 2: Bioethics and Moral Theories 37

cause enormous unhappiness— Johnny’s own
physical agony, the unimaginable misery of the
distraught parents, the anxiety of other family
members and friends, and the distress and frus-
tration of the physician and nurses who can do
little more than stand by as Johnny withers
away. On the other hand, administering the lethal
injection would immediately end Johnny’s pain
and prevent future suffering. The parents would
grieve for Johnny but would at least find some
relief— and perhaps peace— in knowing that his
torture was over. The medical staff would prob-
ably also be relieved for the same reason. There
would, of course, also be possible negative con-
sequences to take into account. In administer-
ing the lethal injection, the physician would be
risking both professional censure and criminal
prosecution. If her actions were to become public,
people might begin to mistrust physicians who
treat severely impaired children, undermining
the whole medical profession. Perhaps the phy-
sician’s action would lead to a general devaluing
of the lives of disabled or elderly people every-
where. These dire consequences, however, would
probably not be very likely if the physician acted
discreetly. On balance, the act-utilitarian might
say, greater net happiness (the least unhappiness)
would result from the mercy killing, which would
therefore be the morally permissible course.

A rule-utilitarian might judge the situation
differently. The key question would be which
rule if consistently followed would produce the
greatest net happiness. Let us say that there are
only two rules to consider. One says “Do not kill
seriously impaired children, regardless of their
suffering or the wishes of their parents.” The
other one is “Killing seriously impaired children
is permissible if they are suffering severely and
improvement is hopeless.” The rule-utilitarian
might reason that consistently following the
second rule would have terrible consequences.
It would cause widespread suspicion about the
actions and motives of physicians who treat se-
riously impaired and disabled children. People
would come to distrust physicians, which in turn
would damage the entire health care system.

Like all forms of utilitarianism, the classic
formulation demands a strong sense of impar-
tiality. When promoting happiness, we must not
only take into account the happiness of every-
one affected but also give everyone’s needs or
interests equal weight. Mill explains:

[The] happiness which forms the utilitarian stan-
dard of what is right conduct, is not the agent’s
own happiness, but that of all concerned. As be-
tween his own happiness and that of others, util-
itarianism requires him to be as strictly
impartial as a disinterested and benevolent
spectator.3

In classic utilitarianism, the emphasis is on
maximizing the total quantity of net happiness,
not ensuring that it is rationed in any particular
amounts among the people involved. This means
that an action resulting in 1,000 units of happi-
ness for 10 people is better than an action yield-
ing only 900 units of happiness for those same
10 people— regardless of how the units of happi-
ness are distributed among them. Classic utilitar-
ians do want to allocate the total amount of
happiness among as many people as possible (thus
their motto, “the greatest happiness for the greatest
number”). But maximizing total happiness is the
fundamental concern whether everyone gets an
equal portion or one person gets the lion’s share.

How might utilitarianism apply to a bioethical
issue? Consider this scenario: Johnny is a 10-year-
old boy with cerebral palsy, emaciated and bed-
ridden, hooked to feeding tubes and monitors,
his body twisted in pain that is almost impossible
to control, his days measured out by one agoniz-
ing surgical operation after another, locked in the
mental life of an infant and acknowledged by all
the experts to be without hope. His anguished
parents, wanting desperately to end his suffering,
beg the physician to give Johnny a lethal injec-
tion. What should the physician do?

Suppose in this case there are only two
options: indefinitely maintaining Johnny in his
present condition or carrying out the parents’
wishes. An act-utilitarian might reason like this.
Allowing the current situation to continue would

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38 PART 1: PRINCIPLES AND THEORIES

Society might begin to devalue the lives of dis-
abled people generally as well as the elderly and
other vulnerable populations. The rule would
also appear to entail a blatant violation of the
cardinal principle of medical practice— do no
harm. Adhering to it might therefore cause an
erosion of all ethical codes and professional stan-
dards in medicine. But following the first rule
would have no such consequences. It would permit
the suffering of some impaired children, but this
consequence seems not to be as catastrophic as
those produced by consistently conforming to
the second rule. For the rule-utilitarian, then, the
morally right action would be not to administer
the lethal injection, despite the parents’ pleas.

Kantian Ethics
From the great German philosopher Immanuel
Kant (1724– 1804) comes what is widely regarded
as probably the most sophisticated and influ-
ential deontological theory ever devised. It is
the very antithesis of utilitarianism, holding
that right actions do not depend in the least on
consequences, the maximization of utility, the

production of happiness, or the desires and needs
of human beings. For Kant, the core of morality
consists of following a rational and universally
applicable moral rule and doing so solely out of
a sense of duty. An action is right only if it con-
forms to such a rule, and we are morally praise-
worthy only if we perform it for duty’s sake alone.

In Kant’s system, all our moral duties are ex-
pressed in the form of categorical imperatives.
An imperative is a command to do something;
it  is categorical if it applies without exception
and without regard for particular needs or pur-
poses. A categorical imperative says, “Do this—
regardless.” In contrast, a hypothetical imperative
is a command to do something if we want to
achieve particular aims, as in “If you want good
pay, work hard.” The moral law, then, rests on
absolute directives that do not depend on the
contingencies of desire or utility.

Kant says that through reason and reflection
we can derive our duties from a single moral
principle, what he calls the categorical impera-
tive. He formulates it in different ways, the first
one being “Act only on that maxim through

IN DEPTH

UTILITARIANISM AND THE
GOLDEN RULE

Probably much to the dismay of his religious critics,
John Stuart Mill defended his radical doctrine of
utilitarianism by arguing that it was entirely consis-
tent with a fundamental Christian teaching:

In the golden rule of Jesus of Nazareth, we read
the complete spirit of the ethics of utility. To do
as one would be done by, and to love one’s
neighbour as oneself, constitute the ideal
perfection of utilitarian morality. As the means
of making the nearest approach to this ideal,
utility would enjoin, first, that laws and social
arrangements should place the happiness, or
(as speaking practically it may be called) the

interest, of every individual, as nearly as
possible in harmony with the interest of the
whole; and secondly, that education and
opinion, which have so vast a power over
human character, should so use that power
as to establish in the mind of every individual
an indissoluble association between his own
happiness and the good of the whole; especially
between his own happiness and the practice of
such modes of conduct, negative and positive,
as regard for the universal happiness prescribes:
so that not only he may be unable to conceive
the possibility of happiness to himself, consis-
tently with conduct opposed to the general
good, but also that a direct impulse to promote
the general good may be in every individual
one of the habitual motives of action, and the
sentiments connected therewith may fill a large
and prominent place in every human being’s
sentient existence.4

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Chapter 2: Bioethics and Moral Theories 39

are particularly relevant to bioethics. Notably
he argues that there is an absolute moral prohi-
bition against killing the innocent, lying, com-
mitting suicide, and failing to help others when
feasible.

Perhaps the most renowned formulation of
the categorical imperative is the principle of re-
spect for persons (a formulation distinct from
the first one, though Kant thought them equiva-
lent). As he puts it, “Act in such a way that you
always treat humanity, whether in your own
person or in the person of any other, never simply
as a means, but always at the same time as an
end.” 6 People must never be treated as if they
were mere instruments for achieving some fur-
ther end, for people are ends in themselves,
possessors of ultimate inherent worth. People
have ultimate value because they are the ultimate
source of value for other things. They bestow
value; they do not have it bestowed upon them.
So we should treat both ourselves and other
persons with the respect that all inherently
valuable beings deserve.

According to Kant, the inherent worth of
persons derives from their nature as free, ratio-
nal beings capable of directing their own lives,
determining their own ends, and decreeing
their own rules by which to live. Thus, the inher-
ent value of persons does not depend in any way
on their social status, wealth, talent, race, or cul-
ture. Moreover, inherent value is something that
all persons possess equally. Each person de-
serves the same measure of respect as any other.

Kant explains that we treat people merely as
a means instead of an end-in-themselves if we dis-
regard these characteristics of personhood—if we
thwart people’s freely chosen actions by coercing
them, undermine their rational decision-making
by lying to them, or discount their equality by
discriminating against them. In bioethics, clear-
cut cases of not respecting persons in Kant’s
sense would normally include experimenting
on people without their knowledge and consent,
lying to them about their medical condition and
prognosis, and forcing patients to receive treat-
ment against their will.

which you can at the same time will that it
should become a universal law.” 5 For Kant, our
actions have logical implications— they imply
general rules, or maxims, of conduct. If you tell
a lie for financial gain, you are in effect acting
according to a maxim like “It’s okay to lie to
someone when doing so benefits you financially.”
The question is whether the maxim correspond-
ing to an action is a legitimate moral law. To find
out, we must ask if we could consistently will that
the maxim become a universal law applicable to
everyone— that is, if everyone could consistently
act on the maxim and we would be willing to have
them do so. If we could do this, then the action
described by the maxim is morally permissible;
if not, it is prohibited. Thus moral laws embody
two characteristics thought to be essential to
morality itself: universality and impartiality.

To show us how to apply this formulation of
the categorical imperative to a specific situation,
Kant uses the example of a lying promise. Sup-
pose you need to borrow money from a friend,
but you know you could never pay her back. So
to get the loan, you decide to lie, falsely promising
to repay the money. To find out if such a lying
promise is morally permissible, Kant would have
you ask if you could consistently will the maxim
of your action to become a universal law, to ask,
in effect, “What would happen if everyone did
this?” The maxim is “Whenever you need to
borrow money you cannot pay back, make a lying
promise to repay.” So what would happen if ev-
eryone in need of a loan acted in accordance with
this maxim? People would make lying promises
to obtain loans, but everyone would also know
that such promises were worthless, and the
custom of loaning money on promises would
disappear. So willing the maxim to be a universal
law involves a contradiction: If everyone made
lying promises, promise-making itself would
be  no more; you cannot consistently will the
maxim to become a universal law. Therefore, your
duty is clear: Making a lying promise to borrow
money is morally wrong.

Kant’s first formulation of the categorical im-
perative yields several other duties, some of which

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40 PART 1: PRINCIPLES AND THEORIES

Notice that this formulation of the categori-
cal imperative does not actually prohibit treating
a person as a means but forbids treating a per-
son simply, or merely, as a means— as nothing
but a  means. Kant recognizes that in daily life
we often must use people to achieve our various
ends. To buy milk, we use the cashier; to find
books, we use the librarian; to get well, we use
the doctor. But because their actions are freely
chosen and we do not undermine their status as
persons, we do not use them solely as instruments
of our will. Medical researchers use their human
subjects as a means to an end— but not merely
as a means to an end if the subjects give their
informed consent to participate in the research.

Natural Law Theory
From ancient times to the present day, many
people have thought that the outlines of the moral
law are plain to see because they are written large
and true in nature itself. This basic notion has
been developed over the centuries into what is
known as natural law theory, the view that right
actions are those that conform to moral standards
discerned in nature through human reason.
Undergirding this doctrine is the belief that all
of nature (including humankind) is teleological,
that it is somehow directed toward particular
goals or ends, and that humans achieve their
highest good when they follow their true, natural
inclinations leading to these goals or ends. There
is, in other words, a way things are— natural pro-
cesses and functions that accord with the natural
law— and how things are shows how things should
be. The prime duty of humans, then, is to guide
their lives toward these natural ends, acting in
accordance with the requirements of natural law.

Implicit in all this is the element of rational-
ity. According to natural law theory, humans are
rational beings empowered by reason to perceive
the workings of nature, determine the natural
inclinations of humans, and recognize the impli-
cations therein for morally permissible actions.
That is, reason enables human beings to ascertain
the moral law implicit in nature and to apply
that objective, universal standard to their lives.

Though natural law theory has both religious
and nonreligious forms, the theistic formulation of
theologian-philosopher Thomas Aquinas (1225–
1274) has been the theory’s dominant version.
It  is not only the official moral outlook of the
Roman Catholic Church, but it has also been the
intellectual starting point for many contemporary
variations of the theory, secular and otherwise.
For Aquinas, God is the author of the natural law
who gave humans the gift of reason to discern
the law for themselves and live accordingly.
Aquinas argues that human beings naturally tend
toward— and therefore have a duty of— preserving
human life and health (and so must not kill the
innocent), producing and raising children, seek-
ing knowledge (including knowledge of God),
and cultivating cooperative social relationships.
In all this, Aquinas says, the overarching aim is
to do and promote good and avoid evil.

Natural law theory does not provide a relevant
moral rule covering every situation, but it does
offer guidance through general moral principles,
some of which are thought to apply universally
and absolutely (admitting no exceptions). Among
these principles are absolutist prohibitions against
directly killing the innocent, lying, and using
contraceptives. In his list of acts considered
wrong no matter what, Aquinas includes adul-
tery, blasphemy, and sodomy.

Of course, moral principles or rules often
conflict, demanding that we fulfill two or more
incompatible duties. We may be forced, for ex-
ample, to either tell a lie and save people’s lives
or tell the truth and cause their death— but we
cannot do both. Some moral theories address
these problems by saying that all duties are prima
facie: When duties conflict, we must decide which
ones override the others. Theories that posit ab-
solute duties— natural law theory being a prime
example— often do not have this option. How does
the natural law tradition resolve such dilemmas?
Among other resources, it uses the doctrine of
double effect.

This principle, a cornerstone of Roman
Catholic ethics, affirms that performing a bad
action to bring about a good effect is never

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Chapter 2: Bioethics and Moral Theories 41

effects, the action of taking a life is in
itself immoral, a violation of the cardinal
duty to preserve innocent life.

2. Ending the woman’s life to save her from
terrible suffering is an instance of causing
a bad effect (the woman’s death) as a
means of achieving a good effect
(cessation of pain)— a failure of test 2.

3. The death of the woman is intended; it is
not merely a tragic side effect of the
attempt solely to ease her pain. So the
action fails test 3.

4. Causing the death of an innocent person is
a great evil that cannot be counter balanced
by the good of pain relief. So the action
does not pass test 4.

The verdict in such a case would be different,
however, if the patient’s death were not inten-
tionally caused but unintentionally brought
about. Suppose, for example, that the physician
sees that the woman is in agony and so gives her
a large injection of morphine to minimize her
suffering— knowing full well that the dose will
also probably speed her death. In this scenario,
the act of easing the woman’s pain is itself mor-
ally permissible (test 1). Her death is not a means
to achieve some greater good; the goal is to ease
her suffering (test 2). Her death is not intended;
the intention is to alleviate her pain, though the
unintended (but foreseen) side effect is her has-
tened death (test 3). Finally, the good effect of
an  easier death seems more or less equivalent
in  importance to the bad effect of a hastened
death. Therefore, unintentionally but knowingly
bringing about the woman’s death in this way is
morally permissible.

We get similar results if we apply the double-
effect principle in the traditional way to abor-
tion. We find that as the intentional destruction
of an innocent human life (so-called direct),
abortion is always immoral (test 1). Moreover, it
is wrong even (or especially) if it is performed
to bring about some good result, such as saving
the mother’s life or preventing serious harm
to her (tests 2 and 3). On the other hand, actions

morally acceptable but that performing a good
action may sometimes be acceptable even if it
produces a bad effect. More precisely, the prin-
ciple says it is always wrong to intentionally per-
form a bad action to produce a good effect, but
doing a good action that results in a bad effect
may be permissible if the bad effect is not in-
tended although foreseen. In the former case, a
bad thing is said to be directly intended; in the
latter, a bad thing is not directly intended.

These requirements have been detailed in
four “tests” that an action must pass to be judged
morally permissible. We can express a tradi-
tional version of these tests like this:

1. The action itself must be morally
permissible.

2. Causing a bad effect must not be used to
obtain a good effect (the end does not
justify the means).

3. Whatever the outcome of an action, the
intention must be to cause only a good
effect (the bad effect can be foreseen but
never intended).

4. The bad effect of an action must not be
greater in importance than the good effect.

Consider the application of these tests to eu-
thanasia. Suppose an 80-year-old hopelessly ill
patient is in continuous, unbearable pain and
begs to be put out of her misery. Is it morally
permissible to grant her request (either by giving
a lethal injection or ending all ordinary life-
sustaining measures)? If we apply the doctrine of
double effect as just outlined, we must conclude
that the answer is no: Euthanasia— either active
or passive— is not a morally permissible option
here. (In the Roman Catholic view, all forms of
euthanasia are wrong, although it is permissible
not to treat a hopelessly ill person for whom
ordinary life-sustaining treatments are useless.)
Failing even one of the tests would render an
action impermissible, but in this case let us run
through all four as a natural law theorist might:

1. Taking steps to terminate someone’s life is
a clear violation of test 1. Whatever its

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42 PART 1: PRINCIPLES AND THEORIES

leading unintentionally to the death of a fetus
(so-called indirect abortion) may be permissible
in rare cases. Say a pregnant woman has an in-
fectious disease that will kill her unless she gets
injections of a powerful drug. But the drug will
abort the fetus. According to the doctrine of
double effect, receiving the injections may be
morally permissible if the action itself is morally
permissible, which it is (test 1); if the death of the
fetus is not used to rescue the woman (test 2); if
the injections are given with the intention of
curing the woman’s disease, not of inducing an
abortion (test 3); and if the death of the fetus is
balanced by the life of the woman (test 4).

Rawls’ Contract Theory
In its broadest sense, contractarianism refers
to moral theories based on the idea of a social
contract, or agreement, among individuals for
mutual advantage. The most influential contem-
porary form of contractarianism is that of phi-
losopher John Rawls (1921– 2002), who uses the
notion of a social contract to generate and defend
moral principles governing how members of a
society should treat one another. He asks, in effect,
by what principles should a just society structure
itself to ensure a fair distribution of rights, duties,
and advantages of social cooperation?

His answer is that the required principles—
essentially principles of justice— are those that
people would agree to under hypothetical con-
ditions that ensure fair and unbiased choices.
He believes that if the starting point for the
social contract is fair— if the initial conditions
and bargaining process for producing the prin-
ciples are fair— then the principles themselves
will be just and will define the essential makeup
of a just society. As Rawls says,

[The] guiding idea is that the principles of justice
for the basic structure of society are the object
of the original agreement. They are the principles
that free and rational persons concerned to
further their own interests would accept in
an initial position of equality as defining the
fundamental terms of their association. These

principles are to regulate all further agreements;
they specify the kinds of social cooperation that
can be entered into and the forms of government
that can be established.7

At the hypothetical starting point— what
Rawls calls the “original position”— a group of
normal, self-interested, rational individuals
come together to choose the principles that will
determine their basic rights and duties and their
share of society’s benefits and burdens. But to
ensure that their decisions are as fair and impar-
tial as possible, they must meet behind a meta-
phorical “veil of ignorance.” Behind the veil, no
one knows his own social or economic status,
class, race, sex, abilities, talents, level of intelli-
gence, or psychological makeup. Since the par-
ticipants are rational and self-interested but
ignorant of their situation in society, they will
not agree to principles that will put any particu-
lar group at a disadvantage because they might
very well be members of that group. They will
choose principles that are unbiased and nondis-
criminatory. The assumption is that since the
negotiating conditions in the original position
are fair, the agreements reached will also be
fair— the principles will be just.

Rawls contends that given the original posi-
tion, the participants would agree to arrange
their social relationships according to these fun-
damental principles:

1. Each person is to have an equal right to
the most extensive total system of equal
basic liberties compatible with a similar
system of liberty for all.

2. Social and economic inequalities are to be
arranged so that they are both:

(a) to the greatest benefit of the least
advantaged . . . and

(b) attached to offices and positions
open to all under conditions of fair
equality of opportunity.8

The first principle— the equal liberty
principle— says that everyone is entitled to the
most freedom possible in exercising basic rights

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Chapter 2: Bioethics and Moral Theories 43

entitled to adequate health care, which includes
all appropriate measures for eliminating or
compensating for the disadvantages of disease
and impairment.10 In such a system, there would
be universal access to a basic level of health care,
while more elaborate or elective services would
be available to anyone who could afford them.

Another implication: Suppose that to provide
a basic level of health care to everyone (and meet
the equality-of-opportunity requirement), soci-
ety would have to spend 90 percent of its health
care resources. But say that in the current
system, 50 percent of the resources are being
spent on acute care for the elderly— that is, ex-
pensive measures to extend the lives of people
who have already lived a long time. According
to Rawlsian principles, is the current system of
health care unjust?

Virtue Ethics
Most moral theories— including all those just
discussed— are theories of obligation. They em-
phasize the rightness of actions and the duties of
moral agents. Their main concern is knowing
and doing what’s right, and their chief guide to
these aims is moral principles or directives.
Virtue ethics, however, is a radically different
kind of moral theory: It focuses on the develop-
ment of virtuous character. According to virtue
ethics, character is the key to the moral life, for
it is from a virtuous character that moral con-
duct and values naturally arise. Virtues are in-
grained dispositions to act by standards of
excellence, so having the proper virtues leads as
a matter of course to right actions properly mo-
tivated. The central task in morality, then, is not
knowing and applying principles but being and
becoming a good person, someone possessing
the virtues that define moral excellence. In
virtue ethics, someone determines right action
not by consulting rules but by asking what a
truly virtuous person would do or whether an
action would accord with the relevant virtues.

Aristotle (384– 322 b.c.e.) is the primary in-
spiration for contemporary versions of virtue
ethics. For him, as for many modern virtue

and duties (for example, the right to vote and
hold office and freedom of speech, assembly,
and thought). Each person should get a maximum
degree of basic liberties but no more than anyone
else. This principle takes precedence over all
other considerations (including the second prin-
ciple) so that basic liberties cannot be reduced or
canceled just to improve economic well-being.

The second principle concerns social and
economic goods such as income, wealth, oppor-
tunities, and positions of authority. Part (b) says
that everyone is entitled to an equal chance to
try to acquire these basic goods. No one is guar-
anteed an equal share of them, but opportunities
to obtain these benefits must be open to all, re-
gardless of social standing.

Rawls knows that social and economic in-
equalities will naturally arise in society. But as he
asserts in part (a), they are not unjust if they work
to everyone’s benefit, especially to the benefit of
the least well off in society. “[There] is no injus-
tice,” he says, “in the greater benefits earned by a
few provided that the situation of persons not so
fortunate is thereby improved.” 9 For Rawls, such
a policy is far more just than one in which some
people are made to suffer for the greater good of
others: “[I]t is not just that some should have less
in order that others may prosper.”

In Rawls’ scheme, the demands of the first
principle must be satisfied before satisfying the
second, and the requirements of part (b) must
be met before those of part (a). In any just distri-
bution of benefits and burdens, then, the first
priority is to ensure equal basic liberties for all
concerned, then equality of opportunity, then the
arrangement of any inequalities to the benefit of
the least advantaged.

As a theory of distributive justice, Rawls’ con-
tractarianism seems to have significant implica-
tions for the allocation of society’s health care
resources. For example, one prominent line of
argument goes like this: As Rawls claims, every-
one is entitled to fair equality of opportunity,
and adequate (basic) health care enables fair
equality of opportunity (by ensuring “normal
species functioning”). Therefore, everyone is

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44 PART 1: PRINCIPLES AND THEORIES

people’s character and actions. The friend we
saved from drowning would probably be appalled
if we declared that we saved her out of duty even
though we did not really care whether she lived
or died. Many moral philosophers agree that mo-
tivations are indeed important considerations in
moral judgments, and they have incorporated
virtues into their theories of obligation.

Virtue ethics fits well with the emphasis on
virtues that has always been part of the healing
arts. Physicians and nurses are expected to pos-
sess particular virtues, including compassion,
trustworthiness, justice, and honesty. They are
expected to be more than just technically skilled
and knowledgeable and to do more than merely
follow the rules of conduct or procedure. They
are obliged to do right by their patients, and this
obligation is most likely met through the culti-
vation and possession of virtues.

The virtue ethics approach to bioethical issues
is distinctive. On abortion, for example, the
virtue ethicist might argue that a woman’s deci-
sion to have an abortion should be judged by
the virtues (or lack thereof) that she draws on in
deciding what to do. If she decides to have an
abortion just because she is afraid of the respon-
sibilities of parenthood, she shows cowardice. If
she wants to go through with an abortion merely
because pregnancy would disrupt her vacation
plans, she shows self-centeredness and callous-
ness. In neither case is the virtue ethicist likely
to call the woman’s decision virtuous.11

The Ethics of Care
The ethics of care is a distinctive moral perspec-
tive that arose out of feminist concerns and
grew to challenge core elements of most other
moral theories. Generally those theories empha-
size abstract principles, general duties, individ-
ual rights, impartial judgments, and deliberative
reasoning. But the ethics of care shifts the focus
to the unique demands of specific situations and
to the virtues and feelings that are central to close
personal relationships— empathy, compassion,
love, sympathy, and fidelity. The heart of the
moral life is feeling for and caring for those with

ethicists, the highest goal of humanity is the
good life, or “human flourishing” (what Aristotle
calls eudaimonia, or happiness), and developing
virtues is the way to achieve such a rich and
satisfying life. Thus virtues are both the traits
that make us good persons and the dispositions
that enable us to live good lives. The good life
is the virtuous life.

Unlike many theories of obligation, virtue
ethics asks us to do more than just observe min-
imal moral rules— it insists that we aspire to
moral excellence, that we cultivate the virtues
that will make us better persons. In this sense,
virtue ethics is goal-directed, not rule-guided.
The moral virtues— benevolence, honesty, loyalty,
compassion, fairness, and the like— are ideals
that we must ever strive to attain. (There are also
nonmoral virtues such as patience, prudence,
and reasonableness, which need not concern us
here.) By the lights of both Aristotle and modern
virtue ethicists, character is not static. We can
become more virtuous by reflecting on our lives
and those of others, practicing virtuous behavior,
or imitating moral exemplars such as Gandhi,
Buddha, Jesus, Muhammad, and Socrates. We
can— and should— be better than we are.

To the virtue ethicist, possessing the right
virtues means having the proper motivations
that naturally accompany those virtues. To act
morally, we must act from virtue, and acting
from virtue means acting with the appropriate
motives. It is not enough to do right; we must
do right for the right motivating reasons. If we
save a drowning friend, we should do so out of
genuine feelings of compassion, kindness, or
loyalty— not because of the prodding of moral
rules or social expectations. In contrast, some
moral theories (notably Kant’s) maintain that
acting morally is solely a matter of acting for
duty’s sake— performing an action simply be-
cause duty requires it. Virtuous motives are
irrelevant; we act morally if we do our duty re-
gardless of our motivations. But this notion
seems to many to offer a barren picture of the
moral life. Surely, they say, motivations for
acting are often relevant to our evaluations of

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Chapter 2: Bioethics and Moral Theories 45

impartiality too far. Recall that impartiality in
morality requires us to consider everyone as equal,
counting everyone’s interests the same. The
principle applies widely, especially in matters of
public justice, but less so in personal relationships
of love, family, friendship, and the like. We seem
to have special obligations (partiality) to close
friends, family members, and others we care for,
duties that we do not have to strangers or to uni-
versal humanity. As some philosophers explain it,

The care perspective is especially meaningful for
roles such as parent, friend, physician, and nurse,
in which contextual response, attentiveness to
subtle clues, and deepening special relationships
are likely to be more important morally than
impartial treatment.14

May I devote my time and resources to caring
for my own friends and family, even if this
means ignoring the needs of other people whom
I could also help? From an impartial point of
view, our duty is to promote the interests of
everyone alike. But few of us accept that view.
The ethics of care confirms the priority that we
naturally give to our family and friends, and so
it seems a more plausible moral conception.15

Most moral theories emphasize duties and
downplay the role of emotions, attitudes, and
motivations. Kant, for example, would have us do
our duty for duty’s sake, whatever our feelings.
For him, to be a morally good parent, we need
only act from duty. But taking care of our chil-
dren as a matter of moral obligation alone seems

whom you have a special, intimate connection—
an approach that especially resonates with phy-
sicians and nurses.

Early on, the ethics of care drew inspiration
from the notion that men and women have
dramatically different styles of moral decision-
making, with men seizing on principles, duties,
and rights, and women homing in on personal
relationships, caring, and empathy. This differ-
ence was highlighted in research done by psy-
chologist Carol Gilligan and published in her 1982
book In a Different Voice.13 Typically men recog-
nize an ethic of justice and rights, she says, and
women are guided by an ethic of compassion
and care. In her view the latter is as legitimate as
the former, and both have their place in ethics.

Other research has suggested that the differ-
ences between men and women in styles of moral
thinking may not be as great as Gilligan sug-
gests. But the credibility of the empirical claim
does not affect the larger insight that the research
seemed to some writers to suggest: Caring is an
essential part of morality, and the most influential
theories have not fully taken it into account.

These points get support along several lines.
First, virtue ethics reminds us that virtues are
part of the moral life. If caring is viewed as a
virtue— in the form of compassion, empathy, or
kindness— then caring too must be an element
of morality. A moral theory then would be defi-
cient if it made no room for care.

Moreover many argue that unlike the ethics of
care, most moral theories push the principle of

IN DEPTH

CAN VIRTUE BE TAUGHT?

Aristotle believes that moral virtues are not the
sort of thing you can learn by merely studying them,
as you would if you wanted to learn calculus. He
insists that moral virtues can only be learned
through practice, by living the virtues. As he says,

[M]oral virtue comes about as a result of
habit. . . . From this it is also plain that none
of the moral virtues arises in us by nature. . . .
[B]ut the virtues we get by first exercising
them, as also happens in the case of the arts
as well. For the things we have to learn before
we can do them, we learn by doing them, e.g.,
men become builders by building and lyreplayers
by playing the lyre; so too we become just by
doing just acts, temperate by doing temperate
acts, brave by doing brave acts.12

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46 PART 1: PRINCIPLES AND THEORIES

an empty exercise. Surely being a morally good
parent also involves having feelings of love and
attitudes of caring. The ethics of care eagerly
takes these emotional elements into account.

Many philosophers, including several writ-
ing from a feminist perspective, have lodged
such criticisms against the most influential
moral theories while suggesting that a mature
morality should accommodate both an ethic of
obligation and an ethic of care. Annette Baier,
for example, has taken this approach:

It is clear, I think, that the best moral theory has
to be a cooperative product of women and men,
has to harmonize justice and care. The morality
it theorizes about is after all for all persons, for
men and for women, and will need their com-
bined insights. As Gilligan said, what we need
now is a “marriage” of the old male and the
newly articulated female insights.16

For many nurses, the ethics of care seems like
a fitting, natural approach to morality in nursing
practice. After all, caring has always been an es-
sential part of what nurses do and how they think
about their jobs. When the focus of concern is,
say, a very sick patient and her family, traditional
moral theories would have those involved attend
to relevant moral principles, strive for an im-
partial stance, emphasize individual rights, and
engage in impassive moral deliberations. But the
ethics of care insists that medical care providers
pay more attention to the specific needs of the
patient and her family, be aware of the special re-
lationships they have with each other, understand
the attitudes and feelings at work among them,
and act with compassion, sympathy, and respect.

Feminist Ethics
Feminist ethics is an approach to morality
aimed at advancing women’s interests and cor-
recting injustices inflicted on women through
social oppression and inequality. It is defined by
a distinctive focus on these issues, rather than
by a set of doctrines or common ideology among
feminists, many of whom may disagree on the
nature of feminist ethics or on particular moral

issues. A variety of divergent perspectives have
been identified as examples of feminist ethics,
including the ethics of care.

Feminist ethics generally downplays the role of
moral principles and traditional ethical concepts,
insisting instead that moral reflection must take
into account the social realities— the relevant social
practices, relationships, institutions, and power
arrangements. Many feminists think that the
familiar principles of Western ethics— autonomy,
utility, freedom, equality, and so forth— are too
broad and abstract to help us make moral judg-
ments about specific persons who are enmeshed
in concrete social situations. It is not enough, for
example, to respect a woman’s decision to have an
abortion if she is too poor to have one, or if her
culture is so oppressive (or oppressed) as to make
abortion impossible to obtain, or if social condi-
tioning leads her to believe that she has no choice
or that her views don’t count. Theoretical auton-
omy does not mean much if it is so thoroughly
undermined in reality.

Many theorists in feminist ethics also reject
the traditional concept of the moral agent. Jan
Crosthwaite says that the old notion is that of
“abstract individuals as fundamentally autono-
mous agents, aware of their own preferences and
values, and motivated by rational self-interest
(though not nece ssarily selfish).” 17 But, she says,
many feminists

present a richer conception of persons as histori-
cally and culturally located, socially related and
essentially embodied. Individuals are located in
and formed by specific relationships (chosen and
unchosen) and ties of affection and responsibil-
ity. . . . Such a conception of socially embedded
selves refocuses thinking about autonomy,
shifting the emphasis from independent self-
determination towards ideals of integrity within
relatedness. . . . Respecting autonomy becomes
less a matter of protecting individuals from
“coercive” influences than one of positive empow-
erment, recognizing people’s interdependence
and supporting individuals’ development of their
own understanding of their situation and options.18

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Chapter 2: Bioethics and Moral Theories 47

Some critics also question the ability of casu-
istry to justify a moral decision or the selection
of a paradigm case. Casuists hold that justifi-
cation comes from a society’s traditions, values,
or conventions. But it seems that a solid set of
principles or standards would be necessary to
counteract the bias, arbitrariness, or vagueness
of these influences.

Casuistry has made valuable contributions to
our understanding and use of moral reasoning.
But in its purest form it seems problematic. More
recent scholarship, however, has demonstrated
ways that casuistry can take into account some
moral principles or norms.

criteria for judging
moral theories

As you can see, as explanations of what makes
actions right or character good, moral theories
can  differ dramatically in both content and
quality. In their own fashion, they try to identify
the true determinants of rightness or goodness,
and they vary in how close they seem to get to
the mark. Most moral philosophers would read-
ily agree: Some moral theories are better than
others, and a vital task in ethics is to try to tell
which is which. Moral theories can be useful
and valuable to us only if there are criteria for
judging their worth— and fortunately there are
such standards.

In several ways, moral theories are analogous
to scientific theories. Scientists devise theories
to explain the causes of events. The germ theory
is offered to explain the cause and spread of
infectious diseases. The Big Bang theory is used
to explain the structure and expansion of the
universe. The “greenhouse effect” is put forth to
explain climate change. For each phenomenon
to be explained, scientists usually have several
possible theories to consider, and the challenge
is to determine which one is best (and is there-
fore most likely to be correct). The superior theory
is the one that fares best when judged by gener-
ally accepted yardsticks known as the scientific
criteria of adequacy. One criterion often invoked

Though all adherents of feminist ethics sup-
port liberation and equality for women, they dis-
agree on how these values apply to specific moral
issues. Most support unimpeded access to abor-
tion, but some do not. As later chapters show,
opinions among feminists also diverge on sur-
rogacy and reproductive technologies such as
in vitro fertilization.

Casuistry
Casuistry is a method of moral reasoning that
emphasizes cases and analogy rather than uni-
versal principles and theories from which
moral judgments are supposed to be deduced.
Casuists say reasonable moral judgments are
arrived at not by applying theories, rights, and
rules, but by paying careful attention to spe-
cific cases and circumstances. In casuistry,
judgments about new cases are made by anal-
ogy with similar or paradigm cases; as in law,
casuistry operates by consulting precedent.
Casuists point out that problems in moral rea-
soning are especially likely when theories or
principles are strictly applied without regard to
the relevant details of cases. They also note that
we are often far more confident of specific
moral judgments than we are of decisions
based on general principles.

Moral philosophers, however, have voiced
several concerns about the method. For one thing,
it seems that casuistry is dependent on rules or
principles just as moral theories are. Consider
this criticism:

Casuists sometimes write as if paradigm cases
speak for themselves or inform moral judgment
by their facts alone, an implausible thesis. For the
casuist to move constructively from case to case,
a recognized and morally relevant norm must
connect the cases. The norm is not part of the
facts or narrative of the cases involved; it is a
way of interpreting, evaluating, and linking
cases. All analogical reasoning in casuistry
requires a connecting norm to indicate that
one sequence of events is morally like or unlike
another sequence in relevant respects.19

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48 PART 1: PRINCIPLES AND THEORIES

is fruitfulness— whether the theory makes suc-
cessful predictions of previously unknown phe-
nomena. All things being equal, a theory that
makes successful predictions of novel phenomena
is more likely to be true than one that does not.
Another important criterion is conservatism—
how well a theory fits with established facts,
with what scientists already know. All things
being equal, a theory that conflicts with what
scientists already have good reasons to believe is
less likely to be true than a theory that has no
such conflicts. Of course, an unconservative
theory can turn out to be correct, and a conser-
vative theory wrong, but the odds are against
this outcome. Analogously, moral theories are
meant to explain what makes an action right or
a person good, and to try to determine which
moral theory is most likely correct, we apply
conceptual yardsticks— the moral criteria of
adequacy. Any plausible moral theory must mea-
sure up to these critical standards.

An important criterion of adequacy for moral
theories is Criterion I: consistency with our con-
sidered moral judgments. Any plausible scien-
tific theory must be consistent with the data that
the theory is supposed to explain; there should
be no conflicts between the theory and the rele-
vant facts. A theory put forth to explain plane-
tary motion, for example, must account for
the relevant data— scientific observations of the
movements of the planets and related objects.
Likewise, a moral theory must also be consistent
with the data it is supposed to explain: our con-
sidered moral judgments, what some call our
moral common sense. We arrive at these judg-
ments after careful deliberation that is as free of
bias, self-interest, and other distorting influences
as possible. Moral philosophers grant these judg-
ments considerable respect and try to take them
into account in their moral theorizing. As we
have seen, these judgments are fallible, and they
are often revised under pressure from trustworthy
principles or theories. But we are entitled to trust
them unless we have good reason to doubt them.
Therefore, any moral theory that is seriously in-
consistent with our considered judgments must

be regarded as badly flawed, perhaps fatally so,
and in need of radical revision. Our considered
judgments, for example, tell us that slavery,
murder, rape, and genocide are wrong. A moral
theory that implies otherwise fails this criterion
and is a candidate for rejection.

In applying this standard, we must keep in
mind that in both science and ethics, there is
tension between theory and data. A good theory
explains the data, which in turn influence the
shape of the theory. Particularly strong data can
compel scientists to alter a theory to account for
the information, but a good theory can also give
scientists reasons to question or reject particular
data. In the same way, there is a kind of give and
take between a moral theory and the relevant
data. Our considered moral judgments may give
us good reasons for altering or even rejecting
our moral theory. But if our moral theory is co-
herent and well supported, it may oblige us to
rethink or reject our considered judgments. In
both science and ethics, the goal is to ensure
that the fit between theory and data is as tight
as possible. The fit is acceptably close when no
further changes in the theory or the data are
necessary— when there is a kind of balance be-
tween the two that moral philosophers call
“reflective equilibrium.”

Another test of adequacy is Criterion II: con-
sistency with the facts of the moral life. In sci-
ence, good theories are consistent with scientific
background knowledge, with what scientists
already have good reasons to believe. They are,
as mentioned earlier, conservative. This back-
ground knowledge includes other well-founded
theories, highly reliable findings, and scientific
(natural) laws. Moral theories should also be
consistent with background knowledge— the
moral background knowledge, the basic, ines-
capable experiences of the moral life. These ex-
periences include making moral judgments,
disagreeing with others on moral issues, being
mistaken in our moral beliefs, and giving rea-
sons for accepting moral beliefs. That we do in
fact experience these things from time to time
is a matter of moral common sense— seemingly

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Chapter 2: Bioethics and Moral Theories 49

as we judge a theory’s worth. But the criteria
do help us make broad judgments on rational
grounds about a theory’s strengths and weak-
nesses. We must use them as guides, relying on
our best judgment in applying them, just as sci-
entists must use their own educated judgment
in wielding their kind of criteria of adequacy. In
neither case is there a neat algorithm for theory
assessment, but nonetheless in both arenas the
process is objective, reasonable, and essential.

We should also remember that no moral theory
is perfect, and none is likely to get the highest
marks on every test. But there is much to learn
even from flawed theories. If we look closely, we
can see that each of the most influential theories
of past centuries, even with its faults apparent,
seems to have grasped at least a modest, gleam-
ing piece of the truth about the moral life.

Utilitarianism
For simplicity’s sake, let us try to apply the criteria
to classic act-utilitarianism, the view that right
actions are those that result in the greatest overall
happiness for everyone involved. First, note that
the theory seems to pass the test suggested by Cri-
terion II (consistency with the facts of the moral
life). Utilitarianism assumes that we can indeed
make moral judgments, have moral disagree-
ments, be mistaken in our moral beliefs, and pro-
vide supporting reasons for our moral judgments.

The theory, however, has been accused of a lack
of usefulness— failing Criterion III (resourceful-
ness in moral problem-solving). The usual charge
is that utilitarianism is a poor guide to the moral
life because the theory demands too much of us
and blurs the distinction between obligatory and
supererogatory actions. Utilitarianism says that

obvious facts of the moral life. Thus, any moral
theory that is inconsistent with these aspects
of  the moral life is deeply problematic. It is
possible that we are deluded about the moral
life— that we, for example, merely think we are
disagreeing with others on moral issues but are
actually just venting our feelings. But our expe-
rience gives us good grounds for taking the
commonsense view until we are given good rea-
sons to believe otherwise.

Finally, we have Criterion III: resourcefulness
in moral problem-solving. If a scientific theory
helps scientists answer questions, solve problems,
and control facets of the natural world, it dem-
onstrates both its plausibility and usefulness. All
things being equal, such a resourceful theory is
better than one that has none of these advan-
tages. Much the same is true for moral theories.
A resourceful moral theory helps us solve moral
problems. It can help us identify morally relevant
aspects of conduct, judge the rightness of actions,
resolve conflicts among moral principles and
judgments, test and correct our moral intuitions,
and understand the underlying point of morality
itself. Any moral theory that lacks problem-solving
resourcefulness is neither useful nor credible.

applying the criteria

In this section, we apply the three moral criteria
of adequacy to two theories we discussed earlier
(one consequentialist, the other deontological).
As we do, keep in mind that evaluating moral
theories using these yardsticks is not a rote pro-
cess. There is no standard procedure for applying
the criteria to a theory and no set of instructions
for assigning conceptual weight to each criterion

REVIEW: Evaluating Moral Theories: Criteria of Adequacy

Criterion I: consistency with our considered moral judgments
Criterion II: consistency with the facts of the moral life
Criterion III: resourcefulness in moral problem-solving

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50 PART 1: PRINCIPLES AND THEORIES

we should always try to maximize happiness for
everyone considered, to do our utmost to in-
crease overall utility. But some say this require-
ment would lead us to extreme beneficence— to,
for example, give away most of our possessions,
spend most of our time in charity work, and
deem mandatory many acts that we would nor-
mally consider above and beyond the call of
duty. Some defenders of the theory have sug-
gested that it can be modified easily to ease the
demands that it places on us. A few utilitarians
have insisted that, contrary to the popular view,
the commonsense distinction between obliga-
tory and supererogatory acts is mistaken and
that morality does demand the kind of sacrifice
that utilitarianism implies.

The most serious accusation against classic
utilitarianism is that it flies in the face of our
considered moral judgments (Criterion I), espe-
cially concerning issues of justice and rights.
Consider the case of a medical researcher trying
to develop a cure for Alzheimer’s disease. To devise
this cure that would save countless lives, she needs
only to conduct a single, secret experiment in
which she gives a lethal drug to 10 early-stage
Alzheimer’s patients (without their knowledge)
and does a postmortem examination on their
brains. By increasing the unhappiness of 10 people
(and depriving them of all possible happiness in
the future), she can maximize happiness for
thousands. Should she conduct the experiment?
According to classic utilitarianism, if her actions
would go undetected and have no additional un-
happy effects, the answer is yes. The experiment
would be justified by the enormous amount of
net happiness it would generate. But the utili-
tarian verdict seems to conflict strongly with
our considered judgments about justice. Taking
the lives of a few people to benefit many others
appears unjust, regardless of the good conse-
quences that would flow from the deed. Critics
claim that cases like this show that utilitarianism
is a seriously inadequate theory.

Now consider the case of a competent patient
with a serious illness who refuses medical treat-
ment on religious grounds. He knows that he
would suffer much less pain and have a longer

and happier life if he were treated, but he still
objects. But his physician wants to maximize the
happiness and well-being of all her patients, so
she surreptitiously treats the patient anyway
without his consent. (Let us assume that no ad-
ditional legal, professional, or psychological con-
sequences ensue.) Does the physician do right?
The utilitarian seems obliged to say yes. But our
commonsense judgment would likely be that
the physician violated her patient’s autonomy—
specifically, his right of self-determination.

Some utilitarians have replied to such Crite-
rion I criticisms by saying that scenarios like those
just presented are unrealistic and misleading.
In the real world, they say, actions that seem to
conflict with our moral intuitions almost always
produce such bad consequences that the actions
cannot be justified even on utilitarian grounds.
Once all the possible consequences are taken
into account, it becomes clear that the proposed
actions do not maximize happiness and that
commonsense morality and utilitarianism co-
incide. In real life, for example, the deeds of the
researcher and the physician would almost cer-
tainly be exposed, resulting in a great deal of un-
happiness for all concerned. Critics respond to
the utilitarian by admitting that many times the
judgments of commonsense morality and utili-
tarianism do in fact coincide when all the facts
are known— but not always. Even the utilitarian
must admit that there could be cases in which
actions that maximize utility do clash with our
considered moral judgments, and this possibility
raises doubts about the utilitarian standard.

Kant’s Theory
Like utilitarianism, Kant’s theory seems gener-
ally consistent with the basic facts of the moral
life (Criterion II), but many philosophers argue
that it is not consistent with moral common sense
(Criterion I). A major cause of the problem, they
say, is Kant’s insistence that we have absolute (or
“perfect”) duties— obligations that must be hon-
ored without exception. Thus in Kantian ethics,
we have an absolute duty not to lie or to break a
promise or to kill the innocent, come what may.
Imagine that a band of killers wants to murder

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Chapter 2: Bioethics and Moral Theories 51

objective. But if it is subjective in the way just
described, its helpfulness as a guide for living
morally is dubious. Defenders of Kant’s theory,
however, believe there are remedies for this dif-
ficulty. Some argue, for example, that the prob-
lem disappears if the second formulation is
viewed as a supplement to the first, rather than
as two independent principles.

key terms
act-utilitarianism
consequentialist theory
contractarianism
deontological (or nonconsequentialist)

theory
doctrine of double effect
moral theory
natural law theory
rule-utilitarianism
utilitarianism
virtue ethics

summary
A moral theory explains why an action is right
or wrong or why a person or a person’s character
is good or bad. Making, using, or assessing
moral theories is a normal, pervasive feature of
the moral life.

Consequentialist moral theories assume that
the rightness of actions depends on their conse-
quences or results. Deontological theories say
that the rightness of actions is determined partly
or wholly by their intrinsic nature. The leading
consequentialist theory is utilitarianism, the
view that right actions are those that result in
the most beneficial balance of good over bad
consequences for everyone involved. The theory
comes in two main types. Act-utilitarianism is
the idea that the rightness of actions depends on
the relative good produced by individual ac-
tions. Rule-utilitarianism says a right action is
one that conforms to a rule that, if followed con-
sistently, would create for everyone involved the
most beneficial balance of good over bad. Kan-
tian ethics is opposed to consequentialist theo-
ries, holding that morality consists of following
a rational and universally applicable moral rule

an innocent man who has taken refuge in your
house, and the killers come to your door and ask
you point blank if he is in your house. To say
no is to lie; to answer truthfully is to guarantee
the man’s death. What should you do? In a case
like this, says Kant, you must do your duty— you
must tell the truth though murder is the result
and a lie would save a life. But in this case such
devotion to moral absolutes seems completely
askew, for saving an innocent life seems far
more important morally than blindly obeying
a rule. Our considered judgments suggest that
sometimes the consequences of our actions do
matter more than adherence to the letter of the
law, even if the law is generally worthy of our
respect and obedience.

Some have thought that Kant’s theory can
yield implausible results for another reason.
Recall that the first formulation of the categori-
cal imperative says that an action is permissi-
ble if persons could consistently act on the
relevant maxim, and we would be willing to
have them do so. This requirement seems to
make sense if the maxim in question is some-
thing like “Do not kill the innocent” or “Treat
equals equally.” But what if the maxim is “En-
slave all Christians” or “Kill all Ethiopians”?
We could— without contradiction— will either
one of these precepts to become a universal
law. And if we were so inclined, we could be
willing for everyone to act accordingly, even if
we ourselves were Christians or Ethiopians. So
by Kantian lights, these actions could very well
be morally permissible, and their permissibil-
ity would depend on whether someone was
willing to have them apply universally. Critics
conclude that because the first formulation of
the categorical imperative seems to sanction
such obviously immoral acts, the theory is
deeply flawed. Defenders of Kant’s theory, on
the other hand, view the problems as repair-
able and have proposed revisions.

This apparent arbitrariness in the first for-
mulation can significantly lessen the theory’s
usefulness (Criterion III). The categorical im-
perative is supposed to help us discern moral
directives that are rational, universal, and

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52 PART 1: PRINCIPLES AND THEORIES

and doing so solely out of a sense of duty. An
action is right only if it conforms to such a rule,
and we are morally praiseworthy only if we per-
form it for duty’s sake alone. Natural law theory
is a centuries-old view of ethics that maintains
that right actions are those conforming to moral
standards discerned in nature through human
reason. Rawls’ theory is a form of contractarian-
ism, which means it is based on the idea of a
social contract, or agreement, among individu-
als for mutual advantage. He argues for a set of
moral principles that he believes would be ar-
rived at through a fair, but hypothetical, bar-
gaining process. Virtue ethics focuses on the
development of virtuous character. The central
task in morality is not knowing and applying
principles but being and becoming a good
person, someone possessing the virtues that
define moral excellence. The ethics of care em-
phasizes the virtues and feelings that are central
to close personal relationships.

The worth of moral theories can be assessed
through the application of the moral criteria of
adequacy. Criterion I is consistency with our
considered moral judgments; Criterion II, con-
sistency with the facts of the moral life; and
Criterion III, resourcefulness in moral problem-
solving.

further reading
Thomas Aquinas, Summa Theologica, in Basic Writings

of St. Thomas Aquinas, trans. A. C. Pegis (New York:
Random House, 1945), volume II, 3–46.

Jeremy Bentham, “Of the Principle of Utility,” in An In-
troduction to the Principles of Morals and Legislation
(Oxford: Clarendon Press, 1879), 1– 7.

Baruch A. Brody, Moral Theory and Moral Judgments in
Medical Ethics (Dordrecht: Kluwer, 1988).

Curtis Brown, “Ethical Theories Compared,” http://
www.trinity.edu/cbrown/intro/ethical_theories.html
(19 October 2015).

Stephen Buckle, “Natural Law,” in A Companion to Ethics,
ed. Peter Singer (Cambridge, UK: Blackwell, 1993),
161– 74.

Steven M. Cahn and Joram G. Haber, Twentieth Century
Ethical Theory (Upper Saddle River, NJ: Prentice-Hall,
1995).

Robert Cavalier, Online Guide to Ethics and Moral
Philosophy, http://caae.phil.cmu.edu/Cavalier/80130/
part2/sect9.html (19 October 2015).

Fred Feldman, “Act Utilitarianism: Pro and Con,” in
Introductory Ethics (Englewood Cliffs, NJ: Prentice-
Hall, 1978), 30–60.

John Finnis, Natural Law and Natural Rights (New York:
Oxford University Press, 1980).

William K. Frankena, Ethics, 2nd ed. (Englewood Cliffs,
NJ: Prentice-Hall, 1973).

C. E. Harris, Applying Moral Theories (Belmont, CA:
Wadsworth, 1997).

Dale Jamieson, “Method and Moral Theory,” in A Com-
panion to Ethics, ed. Peter Singer (Cambridge, UK:
Blackwell, 1993), 476– 87.

Rob Lawlor, “Moral Theories in Teaching Applied
Ethics,” Journal of Medical Ethics, June 2007, vol. 33,
no. 6, http://www.ncbi.nlm.nih.gov/pmc/articles/
PMC2598269/ (19 October 2015).

Mark Murphy, “The Natural Law Tradition in Ethics,”
in The Stanford Encyclopedia of Philosophy (Winter
2002 ed.), ed. Edward N. Zalta, http://plato.stanford
.edu/archives/win2002/entries/natural-law-ethics/.

Kai Nielsen, “A Defense of Utilitarianism,” Ethics 82
(1972): 113– 24.

Kai Nielsen, Ethics Without God (Buffalo, NY:
Prometheus, 1973).

Robert Nozick, “The Experience Machine,” in Anarchy,
State and Utopia (New York: Basic Books, 1974).

Onora O’Neill, “Kantian Ethics,” in A Companion to Ethics,
ed. Peter Singer, (Cambridge, UK: Blackwell, 1993),
175– 85.

Louis P. Pojman and Lewis Vaughn, eds., The Moral Life,
3rd ed. (New York: Oxford University Press, 2007).

James Rachels, The Elements of Moral Philosophy,
4th ed. (New York: McGraw-Hill, 2003).

James Rachels, ed., Ethical Theory 2: Theories About
How We Should Live (Oxford: Oxford University
Press, 1998).

John Rawls, “Some Remarks About Moral Theory,” in A
Theory of Justice (Cambridge, MA: Harvard Univer-
sity Press, 1999), 40– 46.

J. J. C. Smart, “Extreme and Restricted Utilitarianism,”
in Essays Metaphysical and Moral (Oxford: Blackwell,
1987).

Bonnie Steinbock, ed., The Oxford Handbook of Bio-
ethics (Oxford: Oxford University Press, 2007).

Paul Taylor, Principles of Ethics (Encino, CA: Dickenson,
1975).

Lewis Vaughn, Doing Ethics: Moral Reasoning and Con-
temporary Issues (New York: W.W. Norton, 2008).

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Chapter 2: Bioethics and Moral Theories 53

11. Examples from Rosalind Hursthouse, Beginning
Lives (Oxford: Blackwell, 1987), cited in Justin Oakley,
“A Virtue Ethics Approach,” in A Companion to
Bioethics (Oxford: Blackwell, 2001), 86– 97.
12. Aristotle, Nicomachean Ethics, trans. W. D. Ross,
re vised by J. L. Ackrill and J. O. Urmson (Oxford:
Oxford University Press, 1925, 1980), book II, chap. 1.
13. Carol Gilligan, In a Different Voice: Psychological
Theory and Women’s Development (Cambridge, MA:
Harvard University Press, 1982).
14. Tom L. Beauchamp and James F. Childress,
Principles of Biomedical Ethics, 5th ed. (New York:
Oxford University Press, 2001), 372.
15. James Rachels, The Elements of Moral Philosophy
(New York: McGraw-Hill, 2003), 168.
16. Annette C. Baier, “The Need for More Than
Justice,” Canadian Journal of Philosophy, suppl. vol. 13
(1988):56.
17. Jan Crosthwaite, “Gender and Bioethics,” in A
Companion to Bioethics, ed. Helga Kuhse and Peter
Singer (Malden, MA: Blackwell, 2001), 32– 40.
18. Ibid., 37.
19. Tom L. Beauchamp and James F. Childress,
Principles of Biomedical Ethics (New York: Oxford
University Press, 2013), 401.

Bernard Williams, “A Critique of Utilitarianism,” in
Utilitarianism: For and Against, ed. J. J. C. Smart
and Bernard Williams (New York: Cambridge Uni-
versity Press, 1973), 82–117.

Scott D. Wilson, “Ethics,” The Internet Encyclopedia of
Philosophy, http://www.iep.utm.edu/ (19 October
2015).

notes
1. John Stuart Mill, “What Utilitarianism Is,” in Util i-
tarianism, 7th ed. (London: Longmans, Green, and Co.,
1879), chap. 2.
2. Ibid.
3. Ibid.
4. Mill, Utilitarianism, chap. II.
5. Immanuel Kant, Groundwork of the Metaphysics of
Morals, trans. H. J. Paton (New York: Harper & Row,
1964), 88.
6. Ibid., 96.
7. John Rawls, A Theory of Justice, rev. ed. (Cambridge,
MA: Harvard University Press, 1999), 10.
8. Ibid., 266.
9. Ibid., 13.
10. Norman Daniels, Just Health Care (New York:
Cam bridge University Press, 1985), 34– 58.

From Utilitarianism, 7th ed. (London: Longmans, Green,
and Co., 1879).

Utilitarianism
JOHN STUART MILL

English philosopher John Stuart Mill argues for his view of ethics in Utilitarianism
(1861), from which this excerpt is taken. He explains that utilitarians judge the
morality of conduct by a single standard, the principle of utility: Right actions are
those that result in greater overall well-being (or utility) for the people involved
than any other possible actions. We are duty bound to maximize the utility of
everyone affected, regardless of the contrary urgings of moral rules or unbending
moral principles.

R E A D I N G S

. . . The creed which accepts as the foundation of
morals, Utility, or the Greatest Happiness Principle,
holds that actions are right in proportion as they
tend to promote happiness, wrong as they tend to

produce the reverse of happiness. By happiness is
intended pleasure, and the absence of pain; by un-
happiness, pain, and the privation of pleasure. To
give a clear view of the moral standard set up by the
theory, much more requires to be said; in particular,
what things it includes in the ideas of pain and
pleasure; and to what extent this is left an open

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54 PART 1: PRINCIPLES AND THEORIES

question. But these supplementary explanations do
not affect the theory of life on which this theory of
morality is grounded—namely, that pleasure, and
freedom from pain, are the only things desirable
as ends; and that all desirable things (which are as
numerous in the utilitarian as in any other scheme)
are desirable either for the pleasure inherent in
themselves, or as means to the promotion of plea-
sure and the prevention of pain.

Now, such a theory of life excites in many minds,
and among them in some of the most estimable in
feeling and purpose, inveterate dislike. To suppose
that life has (as they express it) no higher end than
pleasure—no better and nobler object of desire and
pursuit—they designate as utterly mean and grovel-
ing; as a doctrine worthy only of swine, to whom
the followers of Epicurus were, at a very early period,
contemptuously likened; and modern holders of
the  doctrine are occasionally made the subject of
equally polite comparisons by its German, French,
and English assailants.

When thus attacked, the Epicureans have always
answered, that it is not they, but their accusers, who
represent human nature in a degrading light; since
the accusation supposes human beings to be capable
of no pleasures except those of which swine are ca-
pable. If this supposition were true, the charge could
not be gainsaid, but would then be no longer an
imputation; for if the sources of pleasure were pre-
cisely the same to human beings and to swine, the
rule of life which is good enough for the one would
be good enough for the other. The comparison of the
Epicurean life to that of beasts is felt as degrading,
precisely because a beast’s pleasures do not satisfy a
human being’s conceptions of happiness. Human
beings have faculties more elevated than the animal
appetites, and when once made conscious of them,
do not regard anything as happiness which does not
include their gratification. I do not, indeed, consider
the Epicureans to have been by any means faultless
in drawing out their scheme of consequences from
the utilitarian principle. To do this in any sufficient
manner, many Stoic, as well as Christian elements re-
quire to be included. But there is no known Epicurean
theory of life which does not assign to the pleasures
of the intellect; of the feelings and imagination, and
of the moral sentiments, a much higher value as

pleasures than to those of mere sensation. It must be
admitted, however, that utilitarian writers in general
have placed the superiority of mental over bodily
pleasures chiefly in the greater permanency, safety,
uncostliness, &c., of the former—that is, in their cir-
cumstantial advantages rather than in their intrinsic
nature. And on all these points utilitarians have fully
proved their case; but they might have taken the
other, and, as it may be called, higher ground, with
entire consistency. It is quite compatible with the
principle of utility to recognise the fact, that some
kinds of pleasure are more desirable and more valu-
able than others. It would be absurd that while, in
estimating all other things, quality is considered as
well as quantity, the estimation of pleasures should
be supposed to depend on quantity alone.

If I am asked, what I mean by difference of qual-
ity in pleasures, or what makes one pleasure more
valuable that another, merely as a pleasure, except
its being greater in amount, there is but one possible
answer. Of two pleasures, if there be one to which
all or almost all who have experience of both give a
decided preference, irrespective of any feeling of
moral obligation to prefer it, that is the more desir-
able pleasure. If one of the two is, by those who are
competently acquainted with both, placed so far
above the other that they prefer it, even though
knowing it to be attended with a greater amount
of  discontent, and would not resign it for any
quantity of the other pleasure which their nature is
capable of, we are justified in ascribing to the pre-
ferred enjoyment a superiority in quality, so far out-
weighing quantity as to render it, in comparison, of
small account.

Now it is an unquestionable fact that those who
are equally acquainted with, and equally capable of
appreciating and enjoying, both, do give a most
marked preference to the manner of existence which
employs their higher faculties. Few human creatures
would consent to be changed into any of the lower
animals, for a promise of the fullest allowance of a
beast’s pleasures; no intelligent human being would
consent to be a fool, no instructed person would be
an ignoramus, no person of feeling and conscience
would be selfish and base, even though they should
be persuaded that the fool, the dunce, or the rascal
is better satisfied with his lot than they are with

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Chapter 2: Bioethics and Moral Theories 55

the pig, is of a different opinion, it is because they
only know their own side of the question. The other
party to the comparison knows both sides.

It may be objected, that many who are capable of
the higher pleasures, occasionally, under the influ-
ence of temptation, postpone them to the lower. But
this is quite compatible with a full appreciation of the
intrinsic superiority of the higher. Men often, from
infirmity of character, make their election for the
nearer good, though they know it to be the less valu-
able; and this no less when the choice is between two
bodily pleasures, than when it is between bodily and
mental. They pursue sensual indulgences to the
injury of health, though perfectly aware that health is
the greater good. It may be further objected, that
many who begin with youthful enthusiasm for ev-
erything noble, as they advance in years sink into
indolence and selfishness. But I do not believe that
those who undergo this very common change, vol-
untarily choose the lower description of pleasures in
preference to the higher. I believe that before they
devote themselves exclusively to the one, they have
already become incapable of the other. Capacity for
the nobler feelings is in most natures a very tender
plant, easily killed, not only by hostile influences, but
by mere want of sustenance; and in the majority of
young persons it speedily dies away if the occupa-
tions to which their position in life has devoted them,
and the society into which it has thrown them, are
not favourable to keeping that higher capacity in ex-
ercise. Men lose their high aspirations as they lose
their intellectual tastes, because they have not time
or opportunity indulging them; and they addict
themselves to inferior pleasures, not because they de-
liberately prefer them, but because they are either the
only ones to which they have access, or the only ones
which they are any longer capable of enjoying. It may
be questioned whether any one who has remained
equally susceptible to both classes of pleasures, ever
knowingly and calmly preferred the lower; though
many, in all ages, have broken down in an ineffectual
attempt to combine both.

From this verdict of the only competent judges,
I apprehend there can be no appeal. On a question
which is the best worth having of two pleasures, or
which of two modes of existence is the most grateful
to the feelings, apart from its moral attributes and

theirs. They would not resign what they possess
more than he, for the most complete satisfaction of
all the desires which they have in common with
him. If they ever fancy they would, it is only in cases
of unhappiness so extreme, that to escape from it
they would exchange their lot for almost any other,
however undesirable in their own eyes. A being of
higher faculties requires more to make him happy,
is capable probably of more acute suffering, and is
certainly accessible to it at more points, than one of
an inferior type; but in spite of these liabilities, he
can never really wish to sink into what he feels to
be a lower grade of existence. We may give what ex-
planation we please of this unwillingness; we may
attribute it to pride, a name which is given indis-
criminately to some of the most and to some of the
least estimable feelings of which mankind are ca-
pable; we may refer it to the love of liberty and per-
sonal independence, an appeal to which was with
the Stoics one of the most effective means for the
inculcation of it; to the love of power, or to the love
of excitement, both of which do really enter into
and contribute to it: but its most appropriate appel-
lation is a sense of dignity, which all human beings
possess in one form or other, and in some, though
by no means in exact, proportion to their higher
faculties, and which is so essential a part of the hap-
piness of those in whom it is strong, that nothing
which conflicts with it could be, otherwise than
momentarily, an object of desire to them. Whoever
supposes that this preference takes place at a sacri-
fice of happiness—that the superior being, in any-
thing like equal circumstances, is not happier than
the inferior—confounds the two very different
ideas, of happiness, and content. It is indisputable
that the being whose capacities of enjoyment are
low, has the greatest chance of having them fully
satisfied; and a highly-endowed being will always
feel that any happiness which he can look for, as the
world is constituted, is imperfect. But he can learn
to bear its imperfections, if they are at all bearable;
and they will not make him envy the being who is
indeed unconcious of the imperfections, but only
because he feels not at all the good which those im-
perfections qualify. It is better to be a human being
dissatisfied than a pig statisfied; better to be Socrates
dissatisfied than a fool satisfied. And if the fool, or

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56 PART 1: PRINCIPLES AND THEORIES

from its consequences, the judgment of those who
are qualified by knowledge of both, or, if they differ,
that of the majority among them, must be admitted
as final. And there needs be the less hesitation to
accept this judgment respecting the quality of plea-
sures, since there is no other tribunal to be referred
to even on the question of quantity. What means are
there of determining which is the acutest of two pains,
or the intensest of two pleasurable sensations, except
the general suffrage of those who are familiar with
both? Neither pains nor pleasures are homogeneous,

and pain is always heterogeneous with pleasure.
What is there to decide whether a particular plea-
sure is worth purchasing at the cost of a particular
pain, except the feelings and judgment of the experi-
enced? When, therefore, those feelings and judg-
ment declare the pleasures derived from the higher
faculties to be preferable in kind, apart from the
question of intensity, to those of which the animal
nature, disjoined from the higher faculties, is sus-
ceptible, they are entitled on this subject to the
same regard. . . .

Reprinted from The Foundations of the Metaphysic of
morals, translated by T. K. Abbott (this translation first
published in 1873).

The Moral Law
IMMANUEL KANT

Kant argues that his moral theory is the very antithesis of utilitarianism, holding
that right actions do not depend in the least on consequences, the production of
happiness, or the desires and needs of human beings. For Kant, the core of morality
consists of following a rational and universally applicable moral rule—the Categori-
cal Imperative—and doing so solely out of a sense of duty. An action is right only if
it conforms to such a rule, and we are morally praiseworthy only if we perform it
for duty’s sake alone.

Preface
As my concern here is with moral philosophy, I limit
the question suggested to this: Whether it is not of
the utmost necessity to construct a pure moral phi-
losophy, perfectly cleared of everything which is
only empirical, and which belongs to anthropology?
for that such a philosophy must be possible is evident
from the common idea of duty and of the moral
laws. Everyone must admit that if a law is to have
moral force, i.e., to be the basis of an obligation, it
must carry with it absolute necessity; that, for ex-
ample, the precept, ‘‘Thou shall not lie,’’ is not valid
for men alone, as if other rational beings had no
need to observe it; and so with all the other moral
laws properly so called; that, therefore, the basis of
obligation must not be sought in the nature of man,

or in the circumstances in the world in which he is
placed, but a priori simply in the conception of pure
reason; and although any other precept which is
founded on principles of mere experience may be in
certain respects universal, yet in as far as it rests even
in the least degree on an empirical basis, perhaps
only as to motive, such a precept, while it may be a
practical rule, can never be called a moral law. . . .

The Good Will
Nothing can possibly be conceived in the world, or
even out of it, which can be called good, without
qualification, except a Good Will. Intelligence, wit,
judgment, and the other talents of the mind, how-
ever they may be named, or courage, resolution,
perseverance, as qualities of temperament, are un-
doubtedly good and desirable in many respects; but
these gifts of nature may also become extremely
bad and mischievous if the will which is to make
use of them, and which, therefore, constitutes what
is called character, is not good. It is the same with

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Chapter 2: Bioethics and Moral Theories 57

can neither add to nor take away anything from
this value. It would be, as it were, only the setting
to enable us to handle it the more conveniently in
common commerce, or to attract to it the attention
of those who are not yet connoisseurs, but not to
recommend it to true connoisseurs, or to determine
its value. . . .

The Supreme Principle of Morality:
The Categorical Imperative
As I have deprived the will of every impulse which
could arise to it from obedience to any law, there
remains nothing but the universal conformity of its
actions to law in general, which alone is to serve the
will as principle, i.e., I am never to act otherwise
than so that I could also will that my maxim should
become a universal law. Here, now, it is the simple
conformity to law in general, without assuming any
particular law applicable to certain actions, that
serves the will as its principle, and must so serve it,
if duty is not to be a vain delusion and a chimerical
notion. The common reason of men in its practical
judgments perfectly coincides with this, and always
has in view the principle here suggested. Let the
question be, for example: May I when in distress
make a promise with the intention not to keep it?
I readily distinguish here between the two significa-
tions which the question may have: Whether it is
prudent, or whether it is right, to make a false
promise? The former may undoubtedly often be the
case. I see clearly indeed that it is not enough to ex-
tricate myself from a present difficulty by means
of  this subterfuge, but it must be well considered
whether there may not hereafter spring from this lie
much greater inconvenience than that from which
I now free myself, and as, with all my supposed
cunning, the consequences cannot be so easily fore-
seen but the credit once lost may be much more
injurious to me than any mischief which I seek to
avoid at present, it should be considered whether it
would not be more prudent to act herein according
to a universal maxim, and to make it a habit to
promise nothing except with the intention of keep-
ing it. But it is soon clear to me that such a maxim
will still only be based on the fear of consequences.
Now it is a wholly different thing to be truthful from
duty, and to be so from apprehension of injurious

the gifts of fortune. Power, riches, honour, even
health, and the general well-being and contentment
with one’s conditions which is called happiness,
inspire pride, and often presumption, if there is not
a good will to correct the influence of these on the
mind, and with this also to rectify the whole prin-
ciple of acting, and adapt it to its end. The sight of a
being who is not adorned with a single feature of a
pure and good will, enjoying unbroken prosperity,
can never give pleasure to an impartial rational
spectator. Thus a good will appears to constitute the
indispensable condition even of being worthy of
happiness.

There are even some qualities which are of service
to this good will itself, and may facilitate its action,
yet which have no intrinsic unconditional value, but
always presuppose a good will, and this qualifies the
esteem that we justly have for them, and does not
permit us to regard them as absolutely good. Mod-
eration in the affections and passions, self-control,
and calm deliberation are not only good in many
respects, but even seem to constitute part of the in-
trinsic worth of the person but they are far from
deserving to be called good without qualification,
although they have been so unconditionally praised
by the ancients. For without the principles of a good
will, they may become extremely bad; and the cool-
ness of a villain not only makes him far more danger-
ous, but also directly makes him more abominable in
our eyes than he would have been without it.

A good will is good not because of what it per-
forms or effects, not by its aptness for the attain-
ment of some proposed end, but simply by virtue of
the volition, that is, it is good in itself, and consid-
ered by itself to be esteemed much higher than all
that can be brought about by it in favor of any in-
clination, nay, even of the sum-total of all inclina-
tions. Even if it should happen that, owing to
special disfavor of fortune, or the niggardly provi-
sion of a step-motherly nature, this will should
wholly lack powder to accomplish its purpose, if
with its greatest efforts it should yet achieve nothing,
and there should remain only the good will (not,
to be sure, a mere wish, but the summoning of all
means in our power), then, like a jewel, it would
still shine by its own light, as a thing which has its
whole value in itself. Its usefulness or fruitlessness

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consequences. In the first case, the very notion of
the action already implies a law for me; in the
second case, I must first look about elsewhere to see
what results may be combined with it which would
affect myself. For to deviate from the principle of
duty is beyond all doubt wicked; but to be unfaith-
ful to my maxim of prudence may often be very
advantageous to me, although to abide by it is cer-
tainly safer. The shortest way, however, and an un-
erring one, to discover the answer to this question
whether a lying promise is consistent with duty, is
to ask myself, Should I be content that my maxim
(to extricate myself from difficulty by a false prom-
ise) should hold good as a universal law, for myself
as well as for others? And should I be able to say to
myself, ‘‘Every one may make a deceitful promise
when he finds himself in a difficulty from which he
cannot otherwise extricate himself ’’? Then I pres-
ently become aware that while I can will the lie,
I can by no means will that lying should be a uni-
versal law. For with such a law there would be no
promises at all, since it would be in vain to allege
my intention in regard to my future actions to
those who would not believe this allegation, or if
they over-hastily did so, would pay me back in my
own coin. Hence my maxim, as soon as it should
be made a universal law, would necessarily destroy
itself.

I do not, therefore, need any far-reaching pene-
tration to discern what I have to do in order that
my will may be morally good. Inexperienced in the
course of the world, incapable of being prepared for
all its contingencies, I only ask myself: canst thou
also will that thy maxim should be a universal law?
It not, then it must be rejected, and that not because
of a disadvantage accruing from myself or even to
others, but because it cannot enter as a principle into
a possible universal legislation, and reason extorts
from me immediate respect for such legislation. I do
not indeed as yet discern on what this respect is
based (this the philosopher may inquire), but at
least I understand this, that it is an estimation of the
worth which far outweighs all worth of what is rec-
ommended by inclination, and that the necessity
of acting from pure respect for the practical law is
what constitutes duty, to which every other motive
must give place, because it is the condition of a will

being good in itself, and the worth of such a will is
above everything.

Thus, then, without quitting the moral knowledge
of common human reason, we have arrived at its
principle. And although, no doubt, common men
do not conceive it in such an abstract and universal
form, yet they always have it really before their eyes,
and use it as the standard of their decision. . . .

Nor could anything be more fatal to morality
than that we should wish to derive it from examples.
For every example of it that is set before me must be
first itself tested by principles of morality, whether it
is worthy to serve as an original example, i.e., as a
pattern, but by no means can it authoritatively fur-
nish the conception of morality. Even the Holy one of
the Gospels must first be compared with our ideal of
moral perfection before we can recognize Him as
such; and so He says of Himself, ‘‘Why call ye Me
[whom you see] good; none is good [the model of
good] but God only [whom ye do not see].’’ But whence
have we the conception of God as the supreme good?
Simply from the idea of moral perfection, which
reason frames a priori, and connects inseparably
with the notion of a free will. Imitation finds no place
at all in morality, and examples serve only for en-
couragement, i.e., they put beyond doubt the feasibil-
ity of what the law commands, they make visible that
which the practical rule expresses more generally,
but they can never authorize us to set aside the true
original which lies in reason, and to guide ourselves
by examples.

From what has been said, it is clear that all moral
conceptions have their seat and origin completely a
priori in the reason, and that, moreover, in the com-
monest reason just as truly as in that which is in the
highest degree speculative; that they cannot be ob-
tained by abstraction from any empirical, and there-
fore merely contingent knowledge; that it is just this
purity of their origin that makes them worthy to serve
as our supreme practical principle, and that just in
proportion as we add anything empirical, we detract
from their genuine influence, and from the absolute
value of actions; that it is not only of the greatest
necessity, in a purely speculative point of view, but
is also of the greatest practical importance, to derive
these notions and laws from pure reason, to present
them pure and unmixed, and even to determine the

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thou canst at the same time will that it should become
a universal law.

Now if all imperatives of duty can be deduced
from this one imperative as from their principle,
then, although it should remain undecided whether
what is called duty is not merely a vain notion, yet at
least we shall be able to show what we understand
by it and what this notion means.

Since the universality of the law according to
which effects are produced constitutes what is prop-
erly called nature in the most general sense (as to
form), that is the existence of things so far as it is
determined by general laws, the imperative of duty
may be expressed thus: Act as if the maxim of tby
action were to become by tby will a universal law of
nature.

Four Illustrations
We will now enumerate a few duties, adopting the
usual division of them into duties to ourselves and
to others and into perfect and imperfect duties.

1. A man reduced to despair by a series of misfor-
tunes feels wearied of life, but is still so far in posses-
sion of his reason that he can ask himself whether it
would not be contrary to his duty to himself to take
his own life. Now he inquires whether the maxim of
his action could become a universal law of nature.
His maxim is: From self-love I adopt it as a principle
to shorten my life when its longer duration is likely to
bring more evil than satisfaction. It is asked then
simply whether this principle founded on self-love
can become a universal law of nature. Now we see at
once that a system of nature of which it should be a
law to destroy life by means of the very feeling whose
special nature it is to impel to the improvement of life
would contradict itself, and therefore could not exist
as a system of nature, and consequently would be
wholly inconsistent with the supreme principle of
all duty.

2. Another finds himself forced by necessity to
borrow money. He knows that he will not be able to
repay it, but sees also that nothing will be lent to him,
unless he promises stoutly to repay it in a definite
time. He desires to make this promise, but he has
still so much conscience as to ask himself: Is it not
unlawful and inconsistent with duty to get out of a

compass of this practical or pure rational knowledge,
i.e. to determine the whole faculty of pure practical
reason; and, in doing so, we must not make its prin-
ciples dependent on the particular nature of human
reason, though in speculative philosophy this may be
permitted, or may even at times be necessary; but
since moral laws ought to hold good for every ratio-
nal creature, we must derive them from the general
concept of a rational being. In this way, although for
its application to man morality has need of anthro-
pology, yet, in the first instance, we must treat it in-
dependently as pure philosophy, i.e., as metaphysic,
complete in itself (a thing which in such distinct
branches of science is easily done); knowing well that
unless we are in possession of this, it would not only
be vain to determine the moral element of duty in right
actions for purposes of speculative criticism, but it
would be impossible to base morals on their genuine
principles, even for common practical purposes, es-
pecially of moral instruction, so as to produce pure
moral dispositions, and to engraft them on men’s
minds to the promotion of the greatest possible good
in the world. . . .

First Formulation of the Categorical
Imperative: Universal Law
In this problem we will first inquire whether the
mere conception of a categorical imperative may
not perhaps supply us also with the formula of it,
containing the proposition which alone can be a
categorical imperative; for even if we know the tenor
of such an absolute command, yet how it is possible
will require further special and laborious study,
which we postpone to the last section.

When I conceive a hypothetical imperative, in
general I do not know beforehand what it will contain
until I am given the condition. But when I conceive a
categorical imperative, I know at once what it con-
tains. For as the imperative contains besides the law
only the necessity that the maxims shall conform to
this law, while the law contains no conditions re-
stricting it, there remains nothing but the general
statement that the maxim of the action should con-
form to a universal law, and it is this conformity alone
that the imperative properly represents as necessary.

There is therefore but one categorical impera-
tive, namely, this: Act only in that maxim whereby

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difficulty in this way? Suppose, however, that he re-
solves to do so, then the maxim of his action would
be expressed thus: When I think myself in want of
money, I will borrow money and promise to repay it,
although I know that I never can do so. Now this
principle of self-love or of one’s own advantage may
perhaps be consistent with my whole future welfare;
but the question is, Is it right? I change then the sug-
gestion of self-love into a universal law, and state the
question thus: How would it be if my maxim were a
universal law? Then I see at once that it could never
hold as a universal law of nature, but would necessar-
ily contradict itself. For supposing it to be a universal
law that everyone when he thinks himself in a diffi-
culty should be able to promise whatever he pleases,
with the purpose of not keeping his promise, the
promise itself would become impossible, as well as
the end that one might have in view in it, since no
one would consider that anything was promised to
him, but would consider that anything was promised
to him, but would ridicule all such statements as vain
pretenses.

3. A third finds in himself a talent which with the
help of some culture might make him a useful man
in many respects. But he finds himself in comfort-
able circumstances, and prefers to indulge in pleasure
rather than to take pains in enlarging and improv-
ing his happy natural capacities. He asks, however,
whether his maxim of neglect of his natural gifts,
besides agreeing with his inclination to indulgence,
agrees also with what is called duty. He sees then
that a system of nature could indeed subsist with
such a universal law although men (like the South
Sea islanders) should let their talents rest, and re-
solve to devote their lives merely to idleness, amuse-
ment, and propagation of their species— in a word,
to enjoyment; but he cannot possibly will that this
should be a universal law of nature, or be implanted
in us as such by a natural instinct. For, as a rational
being, he necessarily wills that his faculties be de-
veloped, since they serve him, and have been given
him, for all sorts of possible purposes.

4. A fourth, who is in prosperity, while he sees
that others have to contend with great wretchedness
and that he could help them, thinks: What concern
is it of mine? Let everyone be as happy as Heaven

Pleases, or as he can make himself; I will take nothing
from him nor even envy him, only I do not wish to
contribute anything to his welfare or to his assis-
tance in distress! Now no doubt if such a mode of
thinking were a universal law, the human race might
very well subsist, and doubtless even better than in a
state in which everyone talks of sympathy and good-
will, or even takes care occasionally to put it into
practice, but, on the other side, also cheats when he
can, betrays the right of men, or otherwise violates
them. But although it is possible that a universal
law of nature might exist in accordance with that
maxim, it is impossible to will that such a principle
should have the universal validity of a law of nature.
For a will which resolved this would contradict itself,
inasmuch as many cases might occur in which one
would have need of the love and sympathy of others,
and in which, by such a law of nature, sprung from
his own will, he would deprive himself of all hope
of the aid he desires.

These are a few of the many actual duties, or at
least what we regard as such, which obviously fall
into two classes on the one principle that we have laid
down. We must be able to will that a maxim of our
action should be a universal law. This is the canon of
the moral appreciation of the action generally. Some
actions are of such a character that their maxim
cannot without contradiction be even conceived as a
universal law of nature, far from it being possible
that we should will that it should be so. In others this
intrinsic impossibility is not found, but still it is im-
possible to will that their maxim should be raised to
the universality of a law of nature, since such a will
would contradict itself. It is easily seen that the
former violate strict or rigorous (inflexible) duty; the
latter only laxer (meritorious) duty. Thus it has been
completely shown by these examples how all duties
depend as regards the nature of the obligation (not
the object of the action) on the same principle.

Second Formulation of the Categorical
Imperative: Humanity as an End in Itself
. . . Now I say: man and generally any rational being
exists as an end in himself, not merely as a means
to be arbitrarily used by this or that will, but in all

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Chapter 2: Bioethics and Moral Theories 61

principle is: rational nature exists as an end in itself.
Man necessarily conceives his own existence as being
so; so far then this is a subjective principle of human
actions. But every other rational being regards its
existence similarly, just on the same rational prin-
ciple that holds for me: so that it is at the same time
an objective principle, from which as a supreme
practical law all laws of the will must be capable of
being deduced. Accordingly the practical imperative
will be as follows. So act as to treat humanity, whether
in thine own person or in that of any other, in every
case as an end withal, never as means only. . . .

. . . Looking back now on all previous attempts to
discover the principle of morality, we need not
wonder why they all failed. It was seen that man
was bound to laws by duty, but it was not observed
that the laws to which he is subject are only those of
his own giving, though at the same time they are
universal, and that he is only bound to act in con-
formity with his own will; a will, however, which is
designed by nature to give universal laws. For when
one has conceived man only as subject to a law (no
matter what), then this law required some interest,
either by way of attraction or constraint, since it did
not originate as a law from his own will, but his will
was according to a law obliged by something else
to act in a certain manner. Now by this necessary
consequence all the labour spent in finding a su-
preme principle of duty was irrevocably lost. For men
never elicited duty, but only a necessity of acting
from a certain interest. Whether this interest was
private or otherwise, in any case the imperative
must be conditional, and could not by any means
be capable of being a moral command. I will there-
fore call this the principle of Autonomy of the will,
in contrast with every other which I accordingly
reckon as Heteronomy.

his actions, whether they concern himself or other
rational beings, must be always regarded at the
same time as an end. All objects of the inclinations
have only a conditional worth; for if the inclina-
tions and the wants founded on them did not exist,
then their object would be without value. But the
inclinations themselves being sources of want are
so far from having an absolute worth for which they
should be desired, that on the contrary, it must be
the universal wish of every rational being to be
wholly free from them. Thus the worth of any object
which is to be acquired by our action is always con-
ditional. Beings whose existence depends not on
our will but on nature’s, have nevertheless, if they
are nonrational beings, only a relative value as means,
and are therefore called things; rational beings, on
the contrary, are called persons, because their very
nature points them out as ends in themselves, that
is as something which must not be used merely as
means, and so far therefore restricts freedom of action
(and is an object of respect). These, therefore, are not
merely subjective ends whose existence has a worth
for us as an effect of our action, but objective ends,
that is things whose existence is an end in itself:
an end moreover for which no other can be substi-
tuted, which they should subserve merely as means,
for otherwise nothing whatever would possess
absolute worth; but if all worth were conditioned
and therefore contingent, then there wouldbe no
supreme practical principle of reason whatever.

If then there is a supreme practical principle
or, in respect of the human will, categorical impera-
tive, it must be one which, being drawn from the
conception of that which is necessarily an end for
everyone because it is an end in itself, constitutes an
objective principle of will, and can therefore serve
as a universal practical law. The foundation of this

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62 PART 1: PRINCIPLES AND THEORIES

for Kant, fulfilling an obligation; again it is a qual-
ity of character, or, rather, a whole range of quali-
ties of character, some of which may actually be
defects, such as tactlessness, boastfulness, and so
on—a point which can be brought out, in terms of
principles, only with the greatest complexity and
artificiality, but quite simply and naturally in terms
of character.

If we wish to enquire about Aristotle’s moral
views, it is no use looking for a set of principles. Of
course we can find some principles to which he
must have subscribed—for instance, that one ought
not to commit adultery. But what we find much
more prominently is a set of character-traits, a list
of certain types of person—the courageous man,
the niggardly man, the boaster, the lavish spender,
and so on. The basic moral question, for Aristotle, is
not. What shall I do? but, What shall I be?

These contrasts between doing and being, nega-
tive and positive, and modern as against Greek mo-
rality were noted by John Stuart Mill; I quote from
the Essay on Liberty:

Christian morality (so-called) has all the characters
of a reaction; it is, in great part, a protest against
Paganism. Its ideal is negative rather than positive,
passive rather than active; Innocence rather than
Nobleness; Abstinence from Evil, rather than
energetic Pursuit of the Good; in its precepts (as
has been well said) “Thou shalt not” predominates
unduly over “Thou shalt . . . ” Whatever exists of
magnanimity, high-mindedness, personal dignity,
even the sense of honour, is derived from the purely
human, not the religious part of our education, and
never could have grown out of a standard of ethics
in which the only worth, professedly recognized,
is that of obedience.

The philosophy of moral principles, which is charac-
teristic of Kant and the post-Kantian era, is some-
thing of which hardly a trace exists in Plato. . . . Plato
says nothing about rules or principles or laws, except
when he is talking politics. Instead he talks about
virtues and vices, and about certain types of human
character. The key word in Platonic ethics is Virtue;
the key word in Kantian ethics is Duty. And modern
ethics is a set of footnotes, not to Plato, but to Kant. . . .

Attention to the novelists can be a welcome cor-
rection to a tendency of philosophical ethics of the
last generation or two to lose contact with the ordi-
nary life of man which is just what the novelists, in
their own way, are concerned with. Of course there
are writers who can be called in to illustrate prob-
lems about Duty (Graham Greene is a good exam-
ple). But there are more who perhaps never mention
the words duty, obligation, or principle. Yet they
are all concerned—Jane Austen, for instance, en-
tirely and absolutely—with the moral qualities or
defects of their heroes and heroines and other
characters. This points to a radical one-sidedness in
the philosophers’ account of morality in terms of
principles: it takes little or no account of qualities, of
what people are. It is just here that the old-fashioned
word Virtue used to have a place; and it is just here
that the work of Plato and Aristotle can be instruc-
tive. Justice, for Plato, though it is closely con-
nected with acting according to law, does not mean
acting according to law: it is a quality of character,
and a just action is one such as a just man would
do. Telling the truth, for Aristotle, is not, as it was

From Ethics and the Moral Life. Copyright © 1958 by
Macmillan. Reprinted by permission of Palgrave Macmillan.

Virtue and the Moral Life
BERNARD MAYO

The British philosopher Bernard Mayo (1920–2000) is the author of Ethics and the
Moral Life, from which this excerpt is taken. He contrasts moral theories based on
right actions with those that emphasize moral character. He argues that saints and
heroes demonstrate that moral examples are what is really important in morality,
not rigid rules. We should strive not to regiment our lives according to moral
tenets, but to be virtuous people.

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Chapter 2: Bioethics and Moral Theories 63

(or forbidding) all actions of a certain type in situa-
tions of a certain type, and, secondly, a statement to
the effect that this is a situation of that type, falling
under that rule. In practice the emphasis may be
on supplying only one of these premises, the other
being assumed or taken for granted: one may
answer the question “What ought I to do?” either by
quoting a rule which I am to adopt, or by showing
that my case is legislated for by a rule which I do
adopt. . . . [I]f I am in doubt whether to tell the truth
about his condition to a dying man, my doubt may
be resolved by showing that the case comes under a
rule about the avoidance of unnecessary suffering,
which I am assumed to accept. But if the case is
without precedent in my moral career, my problem
may be soluble only by adopting a new principle
about what I am to do now and in the future about
cases of this kind.

This second possibility offers a connection with
moral ideas. Suppose my perplexity is not merely
an unprecedented situation which I could cope
with by adopting a new rule. Suppose the new rule
is thoroughly inconsistent with my existing moral
code. This may happen, for instance, if the moral
code is one to which I only pay lip-service, if . . . its
authority is not yet internalised, or if it has ceased
to be so; it is ready for rejection, but its final rejec-
tion awaits a moral crisis such as we are assuming
to occur. What I now need is not a rule for decid-
ing how to act in this situation and others of its
kind. I need a whole set of rules, a complete moral-
ity, new principles to live by.

Now, according to the philosophy of moral char-
acter, there is another way of answering the funda-
mental question “What ought I to do?” Instead of
quoting a rule, we quote a quality of character, a
virtue: we say “Be brave,” or “Be patient” or “Be le-
nient.” We may even say “Be a man”: if I am in doubt,
say, whether to take a risk, and someone says “Be a
man,” meaning a morally sound man, in this case a
man of sufficient courage. (Compare the very different
ideal invoked in “Be a gentleman.” I shall not discuss
whether this is a moral ideal.) Here, too, we have the
extreme cases, where a man’s moral perplexity ex-
tends not merely to a particular situation but to his
whole way of living. And now the question “What
ought I to do?” turns into the question “What
ought I to be?”—as, indeed, it was treated in the

Of course, there are connections between being
and doing. It is obvious that a man cannot just be;
he can only be what he is by doing what he does; his
moral qualities are ascribed to him because of his
actions, which are said to manifest those qualities.
But the point is that an ethics of Being must in-
clude this obvious fact, that Being involves Doing;
whereas an ethics of Doing, such as I have been ex-
amining, may easily overlook it. As I have suggested,
a morality of principles is concerned only with what
people do or fail to do, since that is what rules are
for. And as far as this sort of ethics goes, people
might well have no moral qualities at all except the
possession of principles and the will (and capacity)
to act accordingly.

When we speak of a moral quality such as cour-
age, and say that a certain action was courageous,
we are not merely saying something about the action.
We are referring, not so much to what is done, as to
the kind of person by whom we take it to have been
done. We connect, by means of imputed motives
and intentions, with the character of the agent as
courageous. This explains, incidentally, why both
Kantians and Utilitarians encounter, in their differ-
ent ways, such difficulties in dealing with motives,
which their principles, on the face of it, have no
room for. A Utilitarian, for example, can only praise
a courageous action in some such way as this: the
action is of a sort such as a person of courage is
likely to perform, and courage is a quality of char-
acter the cultivation of which is likely to increase
rather than diminish the sum total of human hap-
piness. But Aristotelians have no need of such circum-
locution. For them a courageous action just is one
which proceeds from and manifests a certain type of
character, and is praised because such a character
trait is good, or better than others, or is a virtue.
An  evaluative criterion is sufficient: there is no
need to look for an imperative criterion as well, or
rather instead, according to which it is not the
character which is good, but the cultivation of the
character which is right. . . .

No doubt the fundamental moral question is just
“What ought I to do?” And according to the philoso-
phy of moral principles, the answer (which must be
an imperative “Do this”) must be derived from a con-
junction of premises consisting (in the simplest case)
firstly of a rule, or universal imperative, enjoining

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64 PART 1: PRINCIPLES AND THEORIES

first place. (“Be brave.”) It is answered, not by quot-
ing a rule or a set of rules, but by describing a quality
of character or a type of person. And here the ethics
of character gains a practical simplicity which off-
sets the greater logical simplicity of the ethics of
principles. We do not have to give a list of charac-
teristics or virtues, as we might list a set of princi-
ples. We can give a unity to our answer.

Of course we can in theory give a unity to our
principles: this is implied by speaking of a set of
principles. But if such a set is to be a system and not
merely aggregate, the unity we are looking for is a
logical one, namely the possibility that some prin-
ciples are deductible from others, and ultimately
from one. But the attempt to construct a deductive
moral system is notoriously difficult, and in any case
ill-founded. Why should we expect that all rules of
conduct should be ultimately reducible to a few?

Saints and Heroes
But when we are asked “What shall I be?” we can
readily give a unity to our answer, though not a
logical unity. It is the unity of character. A person’s
character is not merely a list of dispositions; it has
the organic unity of something that is more than
the sum of its parts. And we can say, in answer to
our morally perplexed questioner, not only “Be
this” and “Be that,” but also “Be like So-and-So”—
where So-and-So is either an ideal type of character,
or else an actual person taken as representative of
the ideal, as exemplar. Examples of the first are
Plato’s “just man” in the Republic; Aristotle’s man
of practical wisdom, in the Nicomachean Ethics;
Augustine’s citizen of the City of God; the good
Communist; the American way of life (which is a
collective expression for a type of character). Exam-
ples of the second kind, the exemplar, are Socrates,
Christ, Buddha, St. Francis, the heroes of epic writ-
ers and of novelists. Indeed the idea of the Hero,
as well as the idea of the Saint, are very much the

expression of this attitude to morality. Heroes and
saints are not merely people who did things. They
are people whom we are expected, and expect our-
selves, to imitate. And imitating them means not
merely doing what they did; it means being like
them. Their status is not in the least like that of leg-
islators whose laws we admire; for the character of a
legislator is irrelevant to our judgment about his
legislation. The heroes and saints did not merely
give us principles to live by (though some of them
did that as well): they gave us examples to follow.

Kant, as we should expect, emphatically rejects
this attitude as “fatal to morality.” According to him,
examples serve only to render visible an instance of
the moral principle, and thereby to demonstrate its
practical feasibility. But every exemplar, such as
Christ himself, must be judged by the independent
criterion of the moral law, before we are entitled to
recognize him as worthy of imitation. I am not sug-
gesting that the subordination of exemplars to prin-
ciples is incorrect, but that it is one-sided and fails
to do justice to a large area of moral experience.

Imitation can be more or less successful. And
this suggests another defect of the ethics of princi-
ples. It has no room for ideals, except the ideal of a
perfect set of principles (which, as a matter of fact,
is intelligible only in terms of an ideal character
or way of life), and the ideal of perfect conscien-
tiousness (which is itself a character-trait). This re-
sults, of course, from the “black-or-white” nature of
moral verdicts based on rules. There are degrees by
which we approach or recede from the attainment
of a certain quality or virtue; if there were not, the
word “ideal” would have no meaning. Heroes and
saints are not people whom we try to be just like,
since we know that is impossible. It is precisely be-
cause it is impossible for ordinary human beings
to achieve the same qualities as the saints, and in
the same degree, that we do set them apart from the
rest of humanity. It is enough if we try to be a little
like them. . . .

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Chapter 2: Bioethics and Moral Theories 65

they often see the need to reconceptualize these
considerations.

Features of the Ethics of Care
Some advocates of the ethics of care resist gener-
alizing this approach into something that can be
fitted into the form of a moral theory. They see it as
a mosaic of insights and value the way it is sensitive
to contextual nuance and particular narratives
rather than making the abstract and universal
claims of more familiar moral theories.2 Still, I think
one can discern among various versions of the ethics
of care a number of major features.

First, the central focus of the ethics of care is
on the compelling moral salience of attending to
and meeting the needs of the particular others for
whom we take responsibility. Caring for one’s child,
for instance, may well and defensibly be at the fore-
front of a person’s moral concerns. The ethics of
care recognizes that human beings are dependent
for many years of their lives, that the moral claim
of those dependent on us for the care they need is
pressing, and that there are highly important moral
aspects in developing the relations of caring that
enable human beings to live and progress. All per-
sons need care for at least their early years. Pros-
pects for human progress and flourishing hinge
fundamentally on the care that those needing it
receive, and the ethics of care stresses the moral
force of the responsibility to respond to the needs
of the dependent. Many persons will become ill
and dependent for some periods of their later lives,
including in frail old age, and some who are per-
manently disabled will need care the whole of their
lives. Moralities built on the image of the indepen-
dent, autonomous, rational individual largely over-
look the reality of human dependence and the

The ethics of care is only a few decades old.1 Some
theorists do not like the term “care” to designate this
approach to moral issues and have tried substituting
“the ethic of love,” or “relational ethics,” but the dis-
course keeps returning to “care” as the so far more
satisfactory of the terms considered, though dissat-
isfactions with it remain. The concept of care has
the advantage of not losing sight of the work in-
volved in caring for people and of not lending itself
to the interpretation of morality as ideal but im-
practical to which advocates of the ethics of care
often object. Care is both value and practice.

By now, the ethics of care has moved far beyond
its original formulations, and any attempt to evalu-
ate it should consider much more than the one or two
early works so frequently cited. It has been devel-
oped as a moral theory relevant not only to the so-
called private realms of family and friendship but
to medical practice, law, political life, the organiza-
tion of society, war, and international relations.

The ethics of care is sometimes seen as a potential
moral theory to be substituted for such dominant
moral theories as Kantian ethics, utilitarianism,
or Aristotelian virtue ethics. It is sometimes seen
as a form of virtue ethics. It is almost always devel-
oped as emphasizing neglected moral considerations
of at least as much importance as the consider-
ations central to moralities of justice and rights or
of utility and preference satisfaction. And many
who contribute to the understanding of the ethics
of care seek to integrate the moral considerations,
such as justice, which other moral theories have
clarified, satisfactorily with those of care, though

The Ethics of Care
VIRGINIA HELD

Virginia Held has taught philosophy at Hunter College and The Graduate Center
of the City University of New York. In this reading, she explores the ethics of care,
identifying its central themes, showing how it relates to an “ethic of justice,” and
distinguishing it from virtue ethics.

From The Ethics of Care: Personal, Political, and Global by
Virginia Held (2006). “The Ethics of Care as Moral Theory.”

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66 PART 1: PRINCIPLES AND THEORIES

morality for which it calls. The ethics of care attends
to this central concern of human life and delin-
eates the moral values involved. It refuses to relegate
care to a realm “outside morality.” How caring for
particular others should be reconciled with the
claims of, for instance, universal justice is an issue
that needs to be addressed. But the ethics of care
starts with the moral claims of particular others,
for instance, of one’s child, whose claims can be
compelling regardless of universal principles.

Second, in the epistemological process of trying
to understand what morality would recommend
and what it would be morally best for us to do and
to be, the ethics of care values emotion rather than
rejects it. Not all emotion is valued, of course, but in
contrast with the dominant rationalist approaches,
such emotions as sympathy, empathy, sensitivity,
and responsiveness are seen as the kind of moral
emotions that need to be cultivated not only to help
in the implementation of the dictates of reason
but to better ascertain what morality recommends.3
Even anger may be a component of the moral indig-
nation that should be felt when people are treated
unjustly or inhumanely, and it may contribute to
(rather than interfere with) an appropriate inter-
pretation of the moral wrong. This is not to say that
raw emotion can be a guide to morality; feelings
need to be reflected on and educated. But from the
care perspective, moral inquiries that rely entirely
on reason and rationalistic deductions or calcula-
tions are seen as deficient.

The emotions that are typically considered and
rejected in rationalistic moral theories are the
egoistic feelings that undermine universal moral
norms, the favoritism that interferes with impar-
tiality, and the aggressive and vengeful impulses for
which morality is to provide restraints. The ethics
of care, in contrast, typically appreciates the emo-
tions and relational capabilities that enable morally
concerned persons in actual interpersonal contexts
to understand what would be best. Since even the
helpful emotions can often become misguided or
worse—as when excessive empathy with others
leads to a wrongful degree of self-denial or when
benevolent concern crosses over into controlling
domination—we need an ethics of care, not just care
itself. The various aspects and expressions of care

and caring relations need to be subjected to moral
scrutiny and evaluated, not just observed and
described.

Third, the ethics of care rejects the view of the
dominant moral theories that the more abstract
the reasoning about a moral problem the better
because the more likely to avoid bias and arbitrari-
ness, the more nearly to achieve impartiality. The
ethics of care respects rather than removes itself
from the claims of particular others with whom
we share actual relationships.4 It calls into ques-
tion the universalistic and abstract rules of the
dominant theories. When the latter consider such
actual relations as between a parent and child, if
they say anything about them at all, they may see
them as permitted and cultivating them a prefer-
ence that a person may have. Or they may recog-
nize a universal obligation for all parents to care
for their children. But they do not permit actual
relations ever to take priority over the require-
ments of impartiality. As Brian Barry expresses
this view, there can be universal rules permitting
people to favor their friends in certain contexts,
such as deciding to whom to give holiday gifts, but
the latter partiality is morally acceptable only be-
cause universal rules have already so judged it.5
The ethics of care, in contrast, is skeptical of such
abstraction and reliance on universal rules and
questions the priority given to them. To most ad-
vocates of the ethics of care, the compelling moral
claim of the particular other may be valid even
when it conflicts with the requirement usually
made by moral theories that moral judgments be
universalizeable, and this is of fundamental moral
importance.6 Hence the potential conflict between
care and justice, friendship and impartiality, loy-
alty and universality. To others, however, there
need be no conflict if universal judgments come to
incorporate appropriately the norms of care previ-
ously disregarded.

Annette Baier considers how a feminist approach
to morality differs from a Kantian one and Kant’s
claim that women are incapable of being fully moral
because of their reliance on emotion rather than
reason. She writes, “Where Kant concludes ‘so much
the worse for women,’ we can conclude ‘so much the
worse for the male fixation on the special skill of

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Chapter 2: Bioethics and Moral Theories 67

drafting legislation, for the bureaucratic mentality
of rule worship, and for the male exaggeration
of  the importance of independence over mutual
interdependence.” 7

Margaret Walker contrasts what she sees as femi-
nist “moral understanding” with what has tradition-
ally been thought of as moral “knowledge.” She sees
the moral understanding she advocates as involving
“attention, contextual and narrative appreciation,
and communication in the event of moral delibera-
tion.” This alternative moral epistemology holds that
“the adequacy of moral understanding decreases as its
form approaches generality through abstraction.” 8

The ethics of care may seek to limit the applica-
bility of universal rules to certain domains where
they are more appropriate, like the domain of law,
and resist their extension to other domains. Such
rules may simply be inappropriate in, for instance,
the contexts of family and friendship, yet relations
in these domains should certainly be evaluated, not
merely described, hence morality should not be
limited to abstract rules. We should be able to give
moral guidance concerning actual relations that are
trusting, considerate, and caring and concerning
those that are not.

Dominant moral theories tend to interpret
moral problems as if they were conflicts between
egoistic individual interests on the one hand, and
universal moral principles on the other. The ex-
tremes of “selfish individual” and “humanity” are
recognized, but what lies between these is often
overlooked. The ethics of care, in contrast, focuses
especially on the area between these extremes.
Those who conscientiously care for others are not
seeking primarily to further their own individual
interests; their interests are intertwined with the
persons they care for. Neither are they acting for
the sake of all others or humanity in general; they
seek instead to preserve or promote an actual
human relation between themselves and particu-
lar others. Persons in caring relations are acting
for self-and-other together. Their characteristic
stance is neither egoistic nor altruistic; these are
the options in a conflictual situation, but the well-
being of a caring relation involves the cooperative
well-being of those in the relation and the well-
being of the relation itself.

In trying to overcome the attitudes and prob-
lems of tribalism and religious intolerance, dominant
moralities have tended to assimilate the domains of
family and friendship to the tribal, or to a source of
the unfair favoring of one’s own. Or they have seen
the attachments people have in these areas as
among the nonmoral private preferences people are
permitted to pursue if restrained by impartial moral
norms. The ethics of care recognizes the moral value
and importance of relations of family and friend-
ship and the need for moral guidance in these do-
mains to understand how existing relations should
often be changed and new ones developed. Having
grasped the value of caring relations in such con-
texts as these more personal ones, the ethics of care
then often examines social and political arrange-
ments in the light of these values. In its more devel-
oped forms, the ethics of care as a feminist ethic
offers suggestions for the radical transformation of
society. It demands not just equality for women in
existing structures of society but equal consider-
ation for the experience that reveals the values, im-
portance, and moral significance, of caring.

A fourth characteristic of the ethics of care is
that like much feminist thought in many areas, it
re-conceptualizes traditional notions about the
public and the private. The traditional view, built
into the dominant moral theories, is that the house-
hold is a private sphere beyond politics into which
government, based on consent, should not intrude.
Feminists have shown how the greater social, po-
litical, economic, and cultural power of men has
structured this “private” sphere to the disadvantage
of women and children, rendering them vulnerable
to domestic violence without outside interference,
often leaving women economically dependent on
men and subject to a highly inequitable division of
labor in the family. The law has not hesitated to in-
tervene into women’s private decisions concerning
reproduction but has been highly reluctant to in-
trude on men’s exercise of coercive power within
the “castles” of their homes.

Dominant moral theories have seen “public” life
as relevant to morality while missing the moral
significance of the “private” domains of family and
friendship. Thus the dominant theories have assumed
that morality should be sought for unrelated,

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68 PART 1: PRINCIPLES AND THEORIES

independent, and mutually indifferent individuals
assumed to be equal. They have posited an abstract,
fully rational “agent as such” from which to con-
struct morality, 9 while missing the moral issues
that arise between interconnected persons in the
contexts of family, friendship, and social groups.
In the context of the family, it is typical for rela-
tions to be between persons with highly unequal
power who did not choose the ties and obligations
in which they find themselves enmeshed. For in-
stance, no child can choose her parents yet she may
well have obligations to care for them. Relations of
this kind are standardly noncontractual, and con-
ceptualizing them as contractual would often un-
dermine or at least obscure the trust on which their
worth depends. The ethics of care addresses rather
than neglects moral issues arising in relations
among the unequal and dependent, relations that
are often laden with emotion and involuntary, and
then notices how often these attributes apply not
only in the household but in the wider society as
well. For instance, persons do not choose which
gender, racial, class, ethnic, religious, national, or
cultural groups to be brought up in, yet these sorts
of ties may be important aspects of who they are
and how their experience can contribute to moral
understanding.

A fifth characteristic of the ethics of care is the
conception of persons with which it begins. This
will be dealt with in the next section.

The Critique of Liberal Individualism
The ethics of care usually works with a conception of
persons as relational, rather than as the self-sufficient
independent individuals of the dominant moral the-
ories. The dominant theories can be interpreted as
importing into moral theory a concept of the person
developed primarily for liberal political and eco-
nomic theory, seeing the person as a rational, auton-
omous agent, or a self-interested individual. On this
view, society is made up of “independent, autono-
mous units who cooperate only when the terms of
cooperation are such as to make it further the ends of
each of the parties,” in Brian Barry’s words.10 Or, if
they are Kantians, they refrain from actions that
they could not will to be universal laws to which
all fully rational and autonomous individual agents

could agree. What such views hold, in Michael
Sandel’s critique of them, is that “what separates us
is in some important sense prior to what connects
us—epistemologically prior as well as morally prior.
We are distinct individuals first and then we form
relationships.” 11 In Martha Nussbaum’s liberal fem-
inist morality, “the flourishing of human beings
taken one by one is both analytically and norma-
tively prior to the flourishing” of any group.12

The ethics of care, in contrast, characteristically
sees persons as relational and interdependent,
morally and epistemologically. Every person starts
out as a child dependent on those providing us care,
and we remain interdependent with others in thor-
oughly fundamental ways throughout our lives.
That we can think and act as if we were independent
depends on a network of social relations making it
possible for us to do so. And our relations are part
of what constitute our identity. This is not to say
that we cannot become autonomous; feminists have
done much interesting work developing an alterna-
tive conception of autonomy in place of the liberal
individualist one.13 Feminists have much experience
rejecting or reconstituting relational ties that are
oppressive. But it means that from the perspective of
an ethics of care, to construct morality as if we
were Robinson Crusoes, or, to use Hobbes’s image,
mushrooms sprung from nowhere, is misleading.14
As Eva Kittay writes, this conception fosters the il-
lusion that society is composed of free, equal, and
independent individuals who can choose to asso-
ciate with one another or not. It obscures the very
real facts of dependency for everyone when they are
young, for most people at various periods in their
lives when they are ill or old and infirm, for some
who are disabled, and for all those engaged in unpaid
“dependency work.” 15 And it obscures the innumer-
able ways persons and groups are interdependent in
the modern world.

Not only does the liberal individualist concep-
tion of the person foster a false picture of society and
the persons in it, it is, from the perspective of the
ethics of care, impoverished also as an ideal. The
ethics of care values the ties we have with particular
other persons and the actual relationships that
partly constitute our identity. Although persons
often may and should reshape their relations with

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Chapter 2: Bioethics and Moral Theories 69

singular noun. Some moral philosophers have tried to
establish a definitional distinction between “ethics” and
“morality”; I think such efforts fail, and I use the terms
more or less interchangeably, though I certainly distinguish
between the moral or ethical beliefs groups of people in
fact have and moral or ethical recommendations that are
justifiable or admirable.
2. See, for example, Annette C. Baier, Moral Prejudices:
Essays on Ethics (Cambridge, Mass.: Harvard University
Press, 1994), esp. chap. 1; Peta Bowden, Caring: Gender Sen-
sitive Ethics (London: Routledge, 1997); and Margaret Urban
Walker, “Feminism, Ethics, and the Question of Theory,”
Hypatia: A Journal of Feminist Philosophy 7 (1992): 23–38.
3. See, for example, Baier, Moral Prejudices, Virginia Held,
Feminist Morality: Transforming Culture, Society, and
Politics (Chicago: University of Chicago Press, 1993); Diana
Tietjens Meyers, Subjection and Subjectivity (New York:
Routledge, 1994); and Margaret Urban Walker, Moral
Understandings: A Feminist Study in Ethics (New York:
Routledge, 1998).
4. See, for example, Seyla Benhabib, Situating the Self:
Gender, Community, and Postmodernism in Contemporary
Ethics (New York: Routledge, 1992); Marilyn Friedman,
What Are Friends For? Feminist Perspectives on Personal
Relationships (Ithaca, N.Y.: Cornell University Press, 1993);
Held, Feminist Morality; and Eva Feder Kittay, Love’s Labor:
Essays on Women, Equality, and Dependency (New York:
Routledge, 1999).
5. See Brian Barry, Justice as Impartiality (Oxford: Oxford
University Press, 1995); Diemut Bubeck, Care, Gender, and
Justice (Oxford: Oxford University Press, 1995), pp. 239–40;
and Susan Mendus, Impartiality in Moral and Political
Philosophy (Oxford: Oxford University Press, 2002).
6. It is often asserted that to count as moral, a judgment
must be universalizeable: If we hold that it would be right
(or wrong) for one person to do something, then we are
committed to holding that it would be right (or wrong) for
anyone similar in similar circumstances to do it. The sub-
ject terms in moral judgments must thus be universally
quantified variables and the predicates universal. “I ought
to take care of Jane because she is my child” is not univer-
sal; “all parents ought to take care of their children” is.
The former judgment could be universalizeable if it were
derived from the latter, but if, as many advocates of the
ethics of care think, it is taken as a starting moral commit-
ment (rather than as dependent on universal moral judg-
ments), it might not be universalizeable.
7. Baier, Moral Prejudices, p. 26.
8. Margaret Urban Walker, “Moral Understandings:
Alternative ‘Epistemology’ for a Feminist Ethics,” Hypatia 4
(summer 1989): 15–28, pp. 19–20.
9. Good examples are Stephen L. Darwall, Impartial
Reason (Ithaca, N.Y.: Cornell University Press, 1983), and

others—distancing themselves from some persons
and groups and developing or strengthening ties
with others—the autonomy sought within the ethics
of care is a capacity to reshape and cultivate new re-
lations, not to ever more closely resemble the unen-
cumbered abstract rational self of liberal political
and moral theories. Those motivated by the ethics
of care would seek to become more admirable rela-
tional persons in better caring relations.

Even if the liberal ideal is meant only to instruct
us on what would be rational in the terms of its
ideal model, thinking of persons as the model pres-
ents them has effects that should not be welcomed.
As Annette Baier writes, “Liberal morality, if un-
supplemented, may unfit people to be anything other
than what its justifying theories suppose them to
be, ones who have no interest in each other’s inter-
ests.” 16 There is strong empirical evidence of how
adopting a theoretical model can lead to behavior
that mirrors it. Various studies show that studying
economics, with its “repeated and intensive expo-
sure to a model whose unequivocal prediction” is
that people will decide what to do on the basis of
self-interest, leads economics students to be less
cooperative and more inclined to free ride than
other students.17

The conception of the person adopted by the
dominant moral theories provides moralities at best
suitable for legal, political, and economic interac-
tions between relative strangers, once adequate trust
exists for them to form a political entity.18 The ethics
of care is, instead, hospitable to the relatedness of
persons. It sees many of our responsibilities as not
freely entered into but presented to us by the acci-
dents of our embeddedness in familial and social
and historical contexts. It often calls on us to take
responsibility, while liberal individualist morality
focuses on how we should leave each other alone. The
view of persons as embedded and encumbered seems
fundamental to much feminist thinking about mo-
rality and especially to the ethics of care. . . .

notes
1. I use the term “ethics” to suggest that there are multiple
versions of this ethic, though they all have much in
common, making it understandable that some prefer “the
ethic of care.” I use “the ethics of care” as a collective and

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70 PART 1: PRINCIPLES AND THEORIES

David Gauthier, Morals by Agreement (Oxford: Oxford
University Press, 1986).
10. Brian Barry, The Liberal Theory of Justice (London:
Oxford University Press, 1973), p. 166.
11. Michael Sandel, Liberalism and the Limits of Justice (Cam-
bridge, U.K.: Cambridge University Press, 1982), p. 133. Other
examples of the communitarian critique that ran parallel to
the feminist one are Alasdair Maclntyre, After Virtue: A Study
in Moral Theory (Notre Dame, Ind.: University of Notre Dame
Press, 1981), and Whose Justice? Which Rationality? (Notre
Dame, Ind.: University of Notre Dame Press, 1988); Charles
Taylor, Hegel and Modern Society (Cambridge , U.K.: Cam-
bridge University Press, 1979); and Roberto Mangabeire
Unger, Knowledge and Politics (New York: Free Press, 1975).
12. Martha Nussbaum, Sex and Social Justice (New York:
Oxford University Press, 1999), p. 62.
13. See, for example, Diana T. Meyers, Self, Society, and
Personal Choice (New York: Columbia University Press,
1989); Grace Clement, Care, Autonomy, and Justice (Boulder,
Colo.: Westview Press, 1996); Diana T. Meyers, ed.,
Feminists Rethink the Self (Boulder, Colo.: Westview Press,
1997); and Catriona MacKenzie and Natalie Stoljar, eds.,

Relational Autonomy: Feminist Perspectives on Autonomy,
Agency, and the Social Self (New York: Oxford University
Press, 2000). See also Marina Oshana, “Personal Autonomy
and Society,” Journal of Social Philosophy 29(1) (spring
1998): 81–102.
14. This image is in Thomas Hobbes’s The Citizen:
Philosophical Rudiments Concerning Government and
Society, ed. B. Gert (Garden City, N.Y.: Doubleday, 1972),
p. 205. For a contrasting view, see Sibyl Schwarzenbach,
“On Civic Friendship,” Ethics 107(1) (1996): 97–128.
15. Kittay, Love’s Labor.
16. Baier, Moral Prejudices, p. 29.
17. See Robert A. Frank, Thomas Gilovich, and Dennis T.
Regan, “Does Studying Economics Inhibit Cooperation?”
Journal of Economic Perspectives 7(2) (spring 1993): 159–71;
and Gerald Marwell and Ruth Ames, “Economists Free
Ride, Does Anyone Else?: Experiments on the Provision
of Public Goods, IV,” Journal of Public Economics 15(3)
(June 1981): 295–310.
18. See Virginia Held, Rights and Goods: Justifying Social
Action (Chicago: University of Chicago Press, 1989), chap. 5,
“The Grounds for Social Trust.”

moral saints
SUSAN WOLF

Susan Wolf is a professor of philosophy at the University of North Carolina, Chapel
Hill, working mostly in ethics and the related areas of philosophy of mind, philoso-
phy of action, political philosophy, and aesthetics. In this selection, she examines the
idea of moral saints, exploring the implications of moral sainthood for utilitarianism,
Kantian ethics, and moral philosophy generally.

I don’t know whether there are any moral saints.
But if there are, I am glad that neither I nor those
about whom I care most are among them. By moral
saint I mean a person whose every action is as
morally good as possible, a person, that is, who is
as  morally worthy as can be. Though I shall in a
moment acknowledge the variety of types of person
that might be thought to satisfy this description,
it  seems to me that none of these types serve as
unequivocally compelling personal ideals. In other

words, I believe that moral perfection, in the sense
of moral saintliness, does not constitute a model of
personal well-being toward which it would be par-
ticularly rational or good or desirable for a human
being to strive.

Outside the context of moral discussion, this
will strike many as an obvious point. But, within
that context, the point, if it be granted, will be
granted with some discomfort. For within that con-
text it is generally assumed that one ought to be as
morally good as possible and that what limits there
are to morality’s hold on us are set by features of
human nature of which we ought not to be proud.
If, as I believe, the ideals that are derivable from

From Susan Wolf, “Moral Saints,” Journal of Philosophy,
vol. LXXIX, no. 8, 1982.

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Chapter 2: Bioethics and Moral Theories 71

makes him a moral saint is rather that he pays little
or no attention to his own happiness in light of the
overriding importance he gives to the wider con-
cerns of morality. In other words, this person sacri-
fices his own interests to the interests of others, and
feels the sacrifice as such.

Roughly, these two models may be distinguished
according to whether one thinks of the moral saint
as being a saint out of love or one thinks of the
moral saint as being a saint out of duty (or some
other intellectual appreciation and recognition of
moral principles). We may refer to the first model
as the model of the Loving Saint; to the second, as
the model of the Rational Saint.

The two models differ considerably with respect
to the qualities of the motives of the individuals who
conform to them. But this difference would have
limited effect on the saints’ respective public person-
alities. The shared content of what these individuals
are motivated to be—namely, as morally good as
possible—would play the dominant role in the de-
termination of their characters. Of course, just as a
variety of large-scale projects, from tending the sick
to political campaigning, may be equally and maxi-
mally morally worthy, so a variety of characters
are compatible with the ideal of moral sainthood.
One moral saint may be more or less jovial, more or
less garrulous, more or less athletic than another.
But, above all, a moral saint must have and cultivate
those qualities which are apt to allow him to treat
others as justly and kindly as possible. He will have
the standard moral virtues to a nonstandard degree.
He will be patient, considerate, even-tempered, hos-
pitable, charitable in thought as well as in deed. He
will be very reluctant to make negative judgments
of other people. He will be careful not to favor some
people over others on the basis of properties they
could not help but have.

Perhaps what I have already said is enough to
make some people begin to regard the absence of
moral saints in their lives as a blessing. For there
comes a point in the listing of virtues that a moral
saint is likely to have where one might naturally
begin to wonder whether the moral saint isn’t, after
all, too good—if not too good for his own good, at
least too good for his own well-being. For the moral
virtues, given that they are, by hypothesis, all present

common sense and philosophically popular moral
theories do not support these assumptions, then
something has to change. Either we must change our
moral theories in ways that will make them yield
more palatable ideals, or, as I shall argue, we must
change our conception of what is involved in af-
firming a moral theory.

In this paper, I wish to examine the notion of a
moral saint, first, to understand what a moral saint
would be like and why such a being would be unat-
tractive, and, second, to raise some questions about
the significance of this paradoxical figure for moral
philosophy. I shall look first at the model(s) of moral
sainthood that might be extrapolated from the
morality or moralities of common sense. Then I shall
consider what relations these have to conclusions that
can be drawn from utilitarian and Kantian moral
theories. Finally, I shall speculate on the implica-
tions of these considerations for moral philosophy.

Moral Saints and Common Sense
Consider first what, pretheoretically, would count for
us—contemporary members of Western culture—
as a moral saint. A necessary condition of moral
sainthood would be that one’s life be dominated by
a commitment to improving the welfare of others
or of society as a whole. As to what role this com-
mitment must play in the individual’s motivational
system, two contrasting accounts suggest themselves
to me which might equally be thought to qualify a
person for moral sainthood.

First, a moral saint might be someone whose
concern for others plays the role that is played in
most of our lives by more selfish, or, at any rate, less
morally worthy concerns. For the moral saint, the
promotion of the welfare of others might play the
role that is played for most of us by the enjoyment of
material comforts, the opportunity to engage in the
intellectual and physical activities of our choice, and
the love, respect, and companionship of people whom
we love, respect, and enjoy. The happiness of the
moral saint, then, would truly lie in the happiness
of others, and so he would devote himself to others
gladly, and with a whole and open heart.

On the other hand, a moral saint might be some-
one for whom the basic ingredients of happiness
are not unlike those of most of the rest of us. What

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one which rests on the decision not to justify every
activity against morally beneficial alternatives, and
this is a decision a moral saint will never make.
Presumably, an interest in high fashion or interior
design will fare much the same, as will, very possi-
bly, a cultivation of the finer arts as well.

A moral saint will have to be very, very nice. It is
important that he not be offensive. The worry is
that, as a result, he will have to be dull-witted or
humorless or bland.

This worry is confirmed when we consider what
sorts of characters, taken and refined both from life
and from fiction, typically form our ideals. One
would hope they would be figures who are morally
good—and by this I mean more than just not mor-
ally bad—but one would hope, too, that they are not
just morally good, but talented or accomplished or
attractive in nonmoral ways as well. We may make
ideals out of athletes, scholars, artists—more frivo-
lously, out of cowboys, private eyes, and rock stars.
We may strive for Katharine Hepburn’s grace, Paul
Newman’s “cool”; we are attracted to the high-
spirited passionate nature of Natasha Rostov; we
admire the keen perceptiveness of Lambert Strether.
Though there is certainly nothing immoral about
the ideal characters or traits I have in mind, they
cannot be superimposed upon the ideal of a moral
saint. For although it is a part of many of these
ideals that the characters set high, and not merely
acceptable, moral standards for themselves, it is
also essential to their power and attractiveness that
the moral strengths go, so to speak, alongside of
specific, independently admirable, nonmoral ground
projects and dominant personal traits.

When one does finally turn one’s eyes toward
lives that are dominated by explicitly moral com-
mitments, moreover, one finds oneself relieved at
the discovery of idiosyncrasies or eccentricities not
quite in line with the picture of moral perfection.
One prefers the blunt, tactless, and opinionated
Betsy Trotwood to the unfailingly kind and patient
Agnes Copperfield; one prefers the mischievous-
ness and the sense of irony in Chesterton’s Father
Brown to the innocence and undiscriminating love
of St. Francis.

It seems that, as we look in our ideals for people
who achieve nonmoral varieties of personal excellence

in the same individual, and to an extreme degree,
are apt to crowd out the nonmoral virtues, as well as
many of the interests and personal characteristics
that we generally think contribute to a healthy, well-
rounded, richly developed character.

In other words, if the moral saint is devoting all
his time to feeding the hungry or healing the sick or
raising money for Oxfam, then necessarily he is not
reading Victorian novels, playing the oboe, or im-
proving his backhand. Although no one of the in-
terests or tastes in the category containing these
latter activities could be claimed to be a necessary
element in a life well lived, a life in which none of
these possible aspects of character are developed
may seem to be a life strangely barren.

The reasons why a moral saint cannot, in gen-
eral, encourage the discovery and development of
significant nonmoral interests and skills are not
logical but practical reasons. There are, in addition,
a class of nonmoral characteristics that a moral
saint cannot encourage in himself for reasons that
are not just practical. There is a more substantial
tension between having any of these qualities un-
ashamedly and being a moral saint. These qualities
might be described as going against the moral grain.
For example, a cynical or sarcastic wit, or a sense of
humor that appreciates this kind of wit in others,
requires that one take an attitude of resignation and
pessimism toward the flaws and vices to be found in
the world. A moral saint, on the other hand, has
reason to take an attitude in opposition to this—he
should try to look for the best in people, give them
the benefit of the doubt as long as possible, try to
improve regrettable situations as long as there is any
hope of success. This suggests that, although a moral
saint might well enjoy a good episode of Father
Knows Best, he may not in good conscience be able
to laugh at a Marx Brothers movie or enjoy a play by
George Bernard Shaw.

An interest in something like gourmet cooking
will be, for different reasons, difficult for a moral
saint to rest easy with. For it seems to me that no
plausible argument can justify the use of human
resources involved in producing a paté de canard en
croute against possible alternative beneficent ends
to which these resources might be put. If there is a
justification for the institution of haute cuisine, it is

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Chapter 2: Bioethics and Moral Theories 73

qualities and being a moral saint it does not follow
that having any of these qualities is immoral. For it
is not part of common-sense morality that one
ought to be a moral saint. Still, if someone just hap-
pened to want to be a moral saint, he or she would
not have or encourage these qualities, and, on the
basis of our common-sense values, this counts as a
reason not to want to be a moral saint. . . .

Moral Saints and Moral Theories
I have tried so far to paint a picture—or, rather, two
pictures—of what a moral saint might be like, draw-
ing on what I take to be the attitudes and beliefs
about morality prevalent in contemporary, common-
sense thought. To my suggestion that common-
sense morality generates conceptions of moral saints
that are unattractive or otherwise unacceptable,
it is open to someone to reply, “so much the worse
for common-sense morality.” After all, it is often
claimed that the goal of moral philosophy is to cor-
rect and improve upon common-sense morality, and
I have as yet given no attention to the question of
what conceptions of moral sainthood, if any, are gen-
erated from the leading moral theories of our time.

A quick, breezy reading of utilitarian and Kantian
writings will suggest the images, respectively, of the
Loving Saint and the Rational Saint. A utilitarian,
with his emphasis on happiness, will certainly prefer
the Loving Saint to the Rational one, since the
Loving Saint will himself be a happier person than
the Rational Saint. A Kantian, with his emphasis
on  reason, on the other hand, will find at least as
much to praise in the latter as in the former. Still,
both models, drawn as they are from common sense,
appeal to an impure mixture of utilitarian and
Kantian intuitions. A more careful examination of
these moral theories raises questions about whether
either model of moral sainthood would really be
advocated by a believer in the explicit doctrines as-
sociated with either of these views.

Certainly, the utilitarian in no way denies the
value of self-realization. He in no way disparages
the development of interests, talents, and other per-
sonally attractive traits that I have claimed the moral
saint would be without. Indeed, since just these fea-
tures enhance the happiness both of the individuals
who possess them and of those with whom they

in conjunction with or colored by some version of
high moral tone, we look in our paragons of moral
excellence for people whose moral achievements
occur in conjunction with or colored by some inter-
ests or traits that have low moral tone. In other
words, there seems to be a limit to how much mo-
rality we can stand. . . .

Moreover, there is something odd about the idea
of morality itself, or moral goodness, serving as the
object of a dominant passion in the way that a more
concrete and specific vision of a goal (even a con-
crete moral goal) might be imagined to serve. Mo-
rality itself does not seem to be a suitable object of
passion. Thus, when one reflects, for example, on
the Loving Saint easily and gladly giving up his
fishing trip or his stereo or his hot fudge sundae at
the drop of the moral hat, one is apt to wonder not
at how much he loves morality, but at how little he
loves these other things. One thinks that, if he can
give these up so easily, he does not know what it is
to truly love them. There seems, in other words, to
be a kind of joy which the Loving Saint, either by
nature or by practice, is incapable of experiencing.
The Rational Saint, on the other hand, might retain
strong nonmoral and concrete desires—he simply
denies himself the opportunity to act on them. But
this is no less troubling. The Loving Saint one might
suspect of missing a piece of perceptual machinery,
of being blind to some of what the world has to
offer. The Rational Saint, who sees it but foregoes it,
one suspects of having a different problem—a path-
ological fear of damnation, perhaps, or an extreme
form of self-hatred that interferes with his ability to
enjoy the enjoyable in life.

In other words, the ideal of a life of moral saint-
hood disturbs not simply because it is an ideal of a
life in which morality unduly dominates. The normal
person’s direct and specific desires for objects, ac-
tivities, and events that conflict with the attainment
of moral perfection are not simply sacrificed but
removed, suppressed, or subsumed. The way in which
morality, unlike other possible goals, is apt to dom-
inate is particularly disturbing, for it seems to re-
quire either the lack or the denial of the existence of
an identifiable, personal self. . . .

It must be remembered that from the fact that
there is a tension between having any of these

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74 PART 1: PRINCIPLES AND THEORIES

aspirations on his sleeve. If it is not too difficult, the
utilitarian will try not to make those around him
uncomfortable. He will not want to appear “holier
than thou”; he will not want to inhibit others’ abil-
ity to enjoy themselves. In practice, this might make
the perfect utilitarian a less nauseating companion
than the moral saint I earlier portrayed. But insofar
as this kind of reasoning produces a more bearable
public personality, it is at the cost of giving him a
personality that must be evaluated as hypocritical
and condescending when his private thoughts and
attitudes are taken into account.

Still, the criticisms I have raised against the saint
of common-sense morality should make some dif-
ference to the utilitarian’s conception of an ideal
which neither requires him to abandon his utili-
tarian principles nor forces him to fake an interest
he does not have or a judgment he does not make.
For it may be that a limited and carefully monitored
allotment of time and energy to be devoted to the
pursuit of some nonmoral interests or to the devel-
opment of some nonmoral talents would make a
person a better contributor to the general welfare
than he would be if he allowed himself no indul-
gences of this sort. The enjoyment of such activities
in no way compromises a commitment to utilitar-
ian principles as long as the involvement with these
activities is conditioned by a willingness to give them
up whenever it is recognized that they cease to be in
the general interest.

This will go some way in mitigating the picture
of the loving saint that an understanding of utilitari-
anism will on first impression suggest. But I think it
will not go very far. For the limitations on time and
energy will have to be rather severe, and the need to
monitor will restrict not only the extent but also the
quality of one’s attachment to these interests and
traits. They are only weak and somewhat peculiar
sorts of passions to which one can consciously
remain so conditionally committed. Moreover, the
way in which the utilitarian can enjoy these “extra-
curricular” aspects of his life is simply not the way
in which these aspects are to be enjoyed insofar as
they figure into our less saintly ideals.

The problem is not exactly that the utilitarian
values these aspects of his life only as a means to an
end, for the enjoyment he and others get from these

associate, the ability to promote these features both
in oneself and in others will have considerable posi-
tive weight in utilitarian calculations.

This implies that the utilitarian would not support
moral sainthood as a universal ideal. A world in
which everyone, or even a large number of people,
achieved moral sainthood—even a world in which
they strove to achieve it—would probably contain
less happiness than a world in which people realized
a diversity of ideals involving a variety of personal
and perfectionist values. More pragmatic consid-
erations also suggest that, if the utilitarian wants to
influence more people to achieve more good, then
he would do better to encourage them to pursue
happiness-producing goals that are more attractive
and more within a normal person’s reach.

These considerations still leave open, however,
the question of what kind of an ideal the committed
utilitarian should privately aspire to himself. Utili-
tarianism requires him to want to achieve the
greatest general happiness, and this would seem to
commit him to the ideal of the moral saint.

One might try to use the claims I made earlier as
a basis for an argument that a utilitarian should
choose to give up utilitarianism. If, as I have said, a
moral saint would be a less happy person both to be
and to be around than many other possible ideals,
perhaps one could create more total happiness by
not trying too hard to promote the total happiness.
But this argument is simply unconvincing in light
of the empirical circumstances of our world. The
gain in happiness that would accrue to oneself and
one’s neighbors by a more well-rounded, richer life
than that of the moral saint would be pathetically
small in comparison to the amount by which one
could increase the general happiness if one devoted
oneself explicitly to the care of the sick, the down-
trodden, the starving, and the homeless. Of course,
there may be psychological limits to the extent to
which a person can devote himself to such things
without going crazy. But the utilitarian’s individual
limitations would not thereby become a positive
feature of his personal ideals.

The unattractiveness of the moral saint, then,
ought not rationally convince the utilitarian to aban-
don his utilitarianism. It may, however, convince
him to take efforts not to wear his saintly moral

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Chapter 2: Bioethics and Moral Theories 75

duties to ourselves, duties to increase our natural as
well as our moral perfection. These duties are un-
limited in the degree to which they may dominate a
life. If action in accordance with and motivated by
the thought of these duties is considered virtuous, it
is natural to assume that the more one performs
such actions, the more virtuous one is. Moreover,
of virtue in general Kant says, “it is an ideal which
is unattainable while yet our duty is constantly to
approximate to it.” 1 On this interpretation, then,
the Kantian moral saint, like the other moral saints
I have been considering, is dominated by the moti-
vation to be moral.

Which of these interpretations of Kant one pre-
fers will depend on the interpretation and the
importance one gives to the role of the imperfect
duties in Kant’s over-all system. Rather than choose
between them here, I shall consider each briefly
in turn.

On the second interpretation of Kant, the Kantian
moral saint is, not surprisingly, subject to many of
the same objections I have been raising against other
versions of moral sainthood. Though the Kantian
saint may differ from the utilitarian saint as to which
actions he is bound to perform and which he is bound
to refrain from performing, I suspect that the range
of activities acceptable to the Kantian saint will
remain objectionably restrictive. Moreover, the
manner in which the Kantian saint must think
about and justify the activities he pursues and
the character traits he develops will strike us, as it
did with the utilitarian saint, as containing “one
thought too many.” As the utilitarian could value
his activities and character traits only insofar as
they fell under the description of “contributions to
the general happiness,” the Kantian would have to
value his activities and character traits insofar as
they were manifestations of respect for the moral
law. If the development of our powers to achieve
physical, intellectual, or artistic excellence, or the
activities directed toward making others happy are
to have any moral worth, they must arise from a
reverence for the dignity that members of our spe-
cies have as a result of being endowed with pure
practical reason. This is a good and noble motiva-
tion, to be sure. But it is hardly what one expects
to be dominantly behind a person’s aspirations to

aspects are not a means to, but a part of, the general
happiness. Nonetheless, he values these things only
because of and insofar as they are a part of the
general happiness. He values them, as it were, under
the description “a contribution to the general hap-
piness.” This is to be contrasted with the various
ways in which these aspects of life may be valued by
nonutilitarians. A person might love literature be-
cause of the insights into human nature literature
affords. Another might love the cultivation of roses
because roses are things of great beauty and deli-
cacy. It may be true that these features of the re-
spective activities also explain why these activities
are happiness-producing. But, to the nonutilitarian,
this may not be to the point. For if one values these
activities in these more direct ways, one may not be
willing to exchange them for others that produce an
equal, or even a greater amount of happiness. From
that point of view, it is not because they produce
happiness that these activities are valuable; it is be-
cause these activities are valuable in more direct
and specific ways that they produce happiness. . . .

The Kantian believes that being morally worthy
consists in always acting from maxims that one
could will to be universal law, and doing this not
out of any pathological desire but out of reverence
for the moral law as such, Or, to take a different for-
mulation of the categorical imperative, the Kantian
believes that moral action consists in treating other
persons always as ends and never as means only.
Presumably, and according to Kant himself, the
Kantian thereby commits himself to some degree of
benevolence as well as to the rules of fair play. But
we surely would not will that every person become
a  moral saint, and treating others as ends hardly
requires bending over backwards to protect and
promote their interests. On one interpretation of
Kantian doctrine, then, moral perfection would be
achieved simply by unerring obedience to a limited set
of side-constraints. On this interpretation, Kantian
theory simply does not yield an ideal conception of
a person of any fullness comparable to that of the
moral saints I have so far been portraying.

On the other hand, Kant does say explicitly that
we have a duty of benevolence, a duty not only to
allow others to pursue their ends, but to take up
their ends as our own. In addition, we have positive

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76 PART 1: PRINCIPLES AND THEORIES

concerned with what kind of life it is in a person’s
interest to lead, but with what kind of interests it
would be good for a person to have, and it need not
be in a person’s interest that he acquire or maintain
objectively good interests. Indeed, the model of the
Loving Saint, whose interests are identified with
the interests of morality, is a model of a person for
whom the dictates of rational self-interest and the
dictates of morality coincide. Yet, I have urged
that we have reason not to aspire to this ideal and
that some of us would have reason to be sorry if our
children aspired to and achieved it.

The moral point of view, we might say, is the
point of view one takes up insofar as one takes the
recognition of the fact that one is just one person
among others equally real and deserving of the good
things in life as a fact with practical consequences,
a fact the recognition of which demands expression
in one’s actions and in the form of one’s practical
deliberations. Competing moral theories offer al-
ternative answers to the question of what the most
correct or the best way to express this fact is. In
doing so, they offer alternative ways to evaluate and
to compare the variety of actions, states of affairs,
and so on that appear good and bad to agents from
other, nonmoral points of view. But it seems that
alternative interpretations of the moral point of view
do not exhaust the ways in which our actions, char-
acters, and their consequences can be comprehen-
sively and objectively evaluated. Let us call the point
of view from which we consider what kinds of lives
are good lives, and what kinds of persons it would
be good for ourselves and others to be, the point of
view of individual perfection.

Since either point of view provides a way of com-
prehensively evaluating a person’s life, each point of
view takes account of, and, in a sense, subsumes the
other. From the moral point of view, the perfection
of an individual life will have some, but limited,
value—for each individual remains, after all, just
one person among others. From the perfectionist
point of view, the moral worth of an individual’s re-
lation to his world will likewise have some, but lim-
ited, value—for, as I have argued, the (perfectionist)
goodness of an individual’s life does not vary pro-
portionally with the degree to which it exemplifies
moral goodness.

dance as well as Fred Astaire, to paint as well as
Picasso, or to solve some outstanding problem in
abstract algebra, and it is hardly what one hopes
to  find lying dominantly behind a father’s action
on  behalf of his son or a lover’s on behalf of her
beloved. . . .

Moral Saints and Moral Philosophy
In pointing out the regrettable features and the nec-
essary absence of some desirable features in a moral
saint, I have not meant to condemn the moral saint
or the person who aspires to become one. Rather,
I have meant to insist that the ideal of moral saint-
hood should not be held as a standard against which
any other ideal must be judged or justified, and that
the posture we take in response to the recognition
that our lives are not as morally good as they might
be need not be defensive.2 It is misleading to insist
that one is permitted to live a life in which the goals,
relationships, activities, and interests that one pur-
sues are not maximally morally good. For our lives
are not so comprehensively subject to the require-
ment that we apply for permission, and our non-
moral reasons for the goals we set ourselves are not
excuses, but may rather be positive, good reasons
which do not exist despite any reasons that might
threaten to outweigh them. In other words, a person
may be perfectly wonderful without being perfectly
moral.

Recognizing this requires a perspective which
contemporary moral philosophy has generally ig-
nored. This perspective yields judgments of a type
that is neither moral nor egoistic. Like moral judg-
ments, judgments about what it would be good for a
person to be are made from a point of view outside
the limits set by the values, interests, and desires
that the person might actually have. And, like moral
judgments, these judgments claim for themselves a
kind of objectivity or a grounding in a perspective
which any rational and perceptive being can take up.
Unlike moral judgments, however, the good with
which these judgments are concerned is not the good
of anyone or any group other than the individual
himself.

Nonetheless, it would be equally misleading to
say that these judgments are made for the sake of
the individual himself. For these judgments are not

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Chapter 2: Bioethics and Moral Theories 77

our values cannot be fully comprehended on the
model of a hierarchical system with morality at
the top.

The philosophical temperament will naturally
incline, at this point, toward asking, “What, then, is
at the top—or, if there is no top, how are we to
decide when and how much to be moral?” In other
words, there is a temptation to seek a metamoral—
though not, in the standard sense, metaethical—
theory that will give us principles, or, at least,
informal directives on the basis of which we can
develop and evaluate more comprehensive personal
ideals. Perhaps a theory that distinguishes among
the various roles a person is expected to play within
a life—as professional, as citizen, as friend, and so
on—might give us some rules that would offer us, if
nothing else, a better framework in which to think
about and discuss these questions. I am pessimistic,
however, about the chances of such a theory to yield
substantial and satisfying results. For I do not see
how a metamoral theory could be constructed which
would not be subject to considerations parallel to
those which seem inherently to limit the appro-
priateness of regarding moral theories as ultimate
comprehensive guides for action.

This suggests that, at some point, both in our
philosophizing and in our lives, we must be willing
to raise normative questions from a perspective that
is unattached to a commitment to any particular
well-ordered system of values. It must be admitted
that, in doing so, we run the risk of finding norma-
tive answers that diverge from the answers given by
whatever moral theory one accepts. This, I take it, is
the grain of truth in G. E. Moore’s “open question”
argument. In the background of this paper, then,
there lurks a commitment to what seems to me to
be a healthy form of intuitionism. It is a form of in-
tuitionism which is not intended to take the place
of more rigorous, systematically developed, moral
theories—rather, it is intended to put these more
rigorous and systematic moral theories in their place.

notes
1. Immanuel Kant, The Doctrine of Virtue, Mary J. Gregor,
trans. (New York: Harper & Row, 1964), p. 71.
2. George Orwell makes a similar point in “Reflections
on Gandhi,” in A Collection of Essays by George Orwell

It may not be the case that the perfectionist point
of view is like the moral point of view in being a
point of view we are ever obliged to take up and ex-
press in our actions. Nonetheless, it provides us with
reasons that are independent of moral reasons for
wanting ourselves and others to develop our char-
acters and live our lives in certain ways. When we take
up this point of view and ask how much it would be
good for an individual to act from the moral point
of view, we do not find an obvious answer.3

The considerations of this paper suggest, at any
rate, that the answer is not “as much as possible.”
This has implications both for the continued de-
velopment of moral theories and for the develop-
ment of metamoral views and for our conception of
moral philosophy more generally. From the moral
point of view, we have reasons to want people to live
lives that seem good from outside that point of view.
If, as I have argued, this means that we have reason
to want people to live lives that are not morally per-
fect, then any plausible moral theory must make
use of some conception of supererogation.4

If moral philosophers are to address themselves
at the most basic level to the question of how people
should live, however, they must do more than adjust
the content of their moral theories in ways that
leave room for the affirmation of nonmoral values.
They must examine explicitly the range and nature
of these nonmoral values, and, in light of this ex-
amination, they must ask how the acceptance of a
moral theory is to be understood and acted upon.
For the claims of this paper do not so much conflict
with the content of any particular currently popular
moral theory as they call into question a metamoral
assumption that implicitly surrounds discussions
of moral theory more generally. Specifically, they
call into question the assumption that it is always
better to be morally better.

The role morality plays in the development of
our characters and the shape of our practical delib-
erations need be neither that of a universal medium
into which all other values must be translated nor
that of an ever-present filter through which all other
values must pass. This is not to say that moral value
should not be an important, even the most impor-
tant, kind of value we attend to in evaluating and
improving ourselves and our world. It is to say that

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78 PART 1: PRINCIPLES AND THEORIES

4. The variety of forms that a conception of supererogation
might take, however, has not generally been noticed. Moral
theories that make use of this notion typically do so by
identifying some specific set of principles as universal
moral requirements and supplement this list with a further
set of directives which it is morally praiseworthy but not
required for an agent to follow. [See, e.g., Charles Fried,
Right and Wrong (Cambridge, Mass.: Harvard, 1979).]
But it is possible that the ability to live a morally blameless
life cannot be so easily or definitely secured as this type
of theory would suggest. The fact that there are some situa-
tions in which an agent is morally required to do something
and other situations in which it would be good but not
required for an agent to do something does not imply that
there are specific principles such that, in any situation,
an agent is required to act in accordance with these
principles and other specific principles such that, in any
situation, it would be good but not required for an agent
to act in accordance with those principles.

(New York: Harcourt Brace Jovanovich, 1945), p. 176:
“sainthood is . . . a thing that human beings must avoid . . .
It is too readily assumed that . . . the ordinary man only
rejects it because it is too difficult; in other words, that the
average human being is a failed saint. It is doubtful whether
this is true. Many people genuinely do not wish to be saints,
and it is probable that some who achieve or aspire to saint-
hood have never felt much temptation to be human beings.”
3. A similar view, which has strongly influenced mine, is
expressed by Thomas Nagel in “The Fragmentation of
Value,” in Mortal Questions (New York: Cambridge, 1979),
pp. 128–141. Nagel focuses on the difficulties such appar-
ently incommensurable points of view create for specific,
isolable practical decisions that must be made both by
individuals and by societies. In focusing on the way in
which these points of view figure into the development of
individual personal ideals, the questions with which I am
concerned are more likely to lurk in the background of any
individual’s life.

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