There is something for everyone in Frances Kamm's Bioethical Prescriptions:1 from the abstract and methodological (chapters 25–27), which will be of interest to those working in ethical theory and metaethics, to the highly applied and detailed oriented (eg, chapter 14), which will be of interest to doctors, nurses and hospital administrators.1 She tackles ethical issues arising at the beginning of life (chapters 9–13) and end of life (chapters 1–8), and discusses a wide range of concerns about enhancement (chapters 15 and 17) and resource distribution (chapters 18–23). Some chapters combine and condense previously published articles (eg, chapter 16 is a composite of five previous publications), and all the chapters have been rewritten in a way that make reference to other relevant chapters. Encountering Kamm's bioethical work in a single collection allows one to better understand how her views on disparate topics are connected; for instance, I gained a deeper appreciation of her underlying account of entitlement and harm by seeing the topic arise in the context of creation, abortion, enhancement and the non-identity problem.

In the limited space I have here, I will focus on the phenomenon of philosophers taking on roles outside of academia, which Kamm discusses in chapter 24, ‘The philosopher as insider and outsider: how to advise, compromise, and criticize’. Increasingly philosophers are providing their expertise to those outside of academia, and Kamm discusses various conflicts that can arise for philosophers who serve as advisors on governmental commissions. One goal many philosophers have in joining such commissions is (a) to promote the public good (p. 527), but this can come into conflict with (b) the goals and norms governing one as a philosopher, as well as with (c) the goals and norms governing philosophers qua advisors to the governmental commissions, which Kamm helpfully sketches on pp. 527, 530 and 535. Kamm's view is that (c) has precedence, up to a point, over (a) and (b) (pp. 530, 531, 533, 535). Questions that arose for me while reading this chapter were (1) what are the norms constitutive of being a philosopher; (2) how do the norms constitutive of other roles (see below) philosophers enter into differ from that of advisors to commissioners; and (3) when and why do some of the norms and goals outlined by Kamm take precedence over others?

(1). It would be useful to have a more nuanced understanding of norms governing one qua philosopher that extends beyond pursuing the truth and challenging assumptions (p. 528). Consider, for example, the long-standing complaints of feminist philosophers, along with other marginalised philosophical voices and perspectives, to have their work taken seriously by mainstream philosophers. Clearly these philosophers are challenging philosophy as it is actually practiced, but should we also see their complaints as relying on norms governing philosophical activity, and so criticising philosophy from within, so to speak, or as arguing for a reshaping of those norms? And if the latter, what are the appropriate norms for guiding that reshaping process?

(2). There is a growing range of non-academic roles that philosophers now occupy. Here is an incomplete list: they (i) offer consulting services to doctors, nurses, hospital administrators and human subject researchers; (ii) create curriculumⁱ and educate teachers and students at the secondary level and (iii) write columns in the newspaper (eg, the New York Times’ ‘The Stone’ weekly column) and participate in radio programmes (eg, Philosophy Talk with John Perry and Ken Taylor). Kamm claims that philosophers advising commissioners must be ‘educators-on-call’ (p. 532, 534), because one of the goals of a commission is help commissioners ‘become better informed about the issue’ (p. 530) and to create reports that include the reasoning against and in support of their conclusions (p. 530). But perhaps this plays a lesser role when one is an ethicist on call at a hospital. Just as lawyers in a medical crisis are primarily responsible for guiding the hospital to the best legal bottom line, and less responsible for educating the hospital on the finer points of law, so too, a philosopher's duty might be primarily to guide them to (what the philosophers sees as) the correct moral conclusion and the reasons for it, rather than educating them about objections and alternative positions in the philosophical literature. This is in great contrast to those participating in a radio programme. It seems worth exploring not only how the norms differ as the roles changes, but also which of those norms might be more or less dominant in a give role.

(3). Why think that (c) the goals and norms governing philosophers qua advisors has precedence over (a) promoting the public good, when they come into conflict? If an activity, such as philosophically advising, is intrinsically valuable, it doesn't follow it is unconditionally valuable, that is, good to do under any conditions, such as when the results would be bad for others.ⁱⁱ 3 So if providing reasons for the correct conclusion would lead the commissioners away from, rather than towards, the correct conclusion,ⁱⁱⁱ thereby setting a precedent that would lead others to suffer, then perhaps philosophers should not ‘have to tolerate this result’ (p. 533, see also p. 531).

In Kamm's favour one might appeal to Rawls’ examples of roles and practices where the norms constitutive of a role/practice take precedence over the goal in taking on the role/practice.^iv 4 For example, one might take on the role of a baseball player for the purpose of having fun, but once in that role one must abide by the rules of baseball playing even if doing so isn't fun. However, the norms constitutive of baseball do not involve having fun, whereas the norms of making bioethical decisions do require considering the good of others. To reason ethically is to aim at a conclusion of what it is good to do, and how others will be impacted is part of what one must consider before arriving at that decision.

As philosophers come to be more interested in, and encouraged to participate in realms outside of academia, the questions that arise in (1)–(3) will become more pressing and Kamm has led the way in opening up this new area for further exploration.