Between moral theories and medical reality: a conversation with Torbjörn Tännsjö on the ethics of life, death, and justice

Abstract

This interview explores the relationship between moral theory and medical reality through an in-depth conversation with Torbjörn Tännsjö, one of the most influential contemporary utilitarian philosophers. Moving between normative ethics and concrete bioethical challenges, the dialogue addresses healthcare priority setting, triage in pandemics and war, euthanasia, disability, distributive justice, and global existential threats. Central attention is given to Tännsjö’s methodological approach – described as “applied ethics turned upside down” – which relies on considered moral intuitions tested through crucial thought experiments and subjected to cognitive psychotherapy. The interview examines the practical relevance and limits of philosophical abstraction in real clinical contexts, particularly under conditions of scarcity, uncertainty, and moral distress. Special emphasis is placed on overlapping consensus among competing moral theories, the role of counterfactual reasoning in utilitarianism, and the ethical implications of aging, mental illness, and end-of-life decisions. Situating these discussions against the background of the COVID-19 pandemic and russia’s full-scale war against Ukraine, the conversation highlights how extreme circumstances expose latent ethical assumptions embedded in healthcare systems. The interview concludes by reflecting on the place of bioethics as applied ethics, its educational mission, and its capacity to inform morally responsible decision-making without claiming privileged principles of its own.