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Without focusing on the details of specific health systems, this chapter considers what we owe each other with regard to promoting and restoring health and what this means for the balance between prevention and treatment. I argue that we have robust obligations both with regard to prevention and treatment, though the specifics of what is owed depend on decisions about how to fit a reasonable array of such services within resource limits. Among our preventive obligations are interventions that provide incentives for adopting health regarding behaviors, though these are harder to justify on some accounts of justice than others. For example, luck egalitarianism provides no justification for such incentives, though a Rawlsian account does. The chapter concludes by considering whether the fact that risk is more concentrated in some people than others, say in identified victims rather than statistical ones, is morally relevant to giving them some priority. I claim that concentration of risk is morally relevant under some conditions and that this may favor identified over statistical victims to the extent that risk concentration is the relevant contrast between them.

This paper follows a path that takes us from utilitarianism to particularism. Utilitarianism is the leading one-principle theory; its falsehood is here simply asserted. W. D. Ross’s theory of prima facie duty is offered as the strongest many-principle theory. Ross’s two accounts of his notion of a prima facie duty are considered and criticized. But the real criticism of his view is that being a prima facie duty is a context-sensitive notion, since a feature that is a prima facie duty-making feature in one case may be prevented from playing that role in another. Since the strongest many-principle theory is therefore false, the only conclusion is a no-principle theory: a theory that allows moral reasons but does not suppose that they behave in the regular way required for there to be moral principles—namely, moral particularism.

This paper examines the rationale for the standard practice in ethics of arguing from imaginary cases to real ones. Challengeable aspects of this practice are exposed. One question is whether an imaginary case is being taken to establish a Rossian prima facie duty or a duty proper. Another is whether, once we have established the correct account of an imaginary case, we can be sure that another case similar to the first in all respects relevant to our account of the first must be given the same account, irrespective of other differences. A generalist will try to extract principles from the imaginary case and apply them to the real case. This paper argues that this is hopeless. Is particularism in a better situation? A possible line is that what the imaginary case reveals is the importance that certain features can have and may have in the real case before us. No more can be expected.

This chapter explains the distinctions that are of moral relevance in discussions of suicide, physician-assisted suicide, termination of treatment, and euthanasia. These include the distinctions between intending and foreseeing; active and passive suicide and euthanasia; killing and letting die; voluntary and involuntary suicide and euthanasia; and the permissibility or impermissibility of conduct.

This comment asks us to imagine that we have discovered a principle that completely matches our intuitions about the various actions that might be performed in all the different versions of the trolley problem. Would that constitute a solution to the problem of providing a plausible principle to cover these various cases? Not necessarily, since the principle might turn on distinctions that have no obvious moral significance, and we might be unable to provide the principle with a compelling and plausible rationale. It argues that this might well be the situation we find ourselves in with regard to the book’s proposed solution to the trolley problem: even if the principle does match our intuitions in how it sorts the cases, it is difficult to see why the distinctions on which it turns should matter, and appearances to the contrary notwithstanding, this comment believes the book has not provided the principle with a plausible account or rationale.