For even if there existed something like a game of life...

For even if there existed something like a game of life,[^37] the skeptic could still ask a reformulated question: “Why should we not alter its rules?” Constitutive rules, are after all not merely to a high degree defeasible, they are also easy to change: at some point in their history virtually all games had rules different from those they have today. Hospitals are, by definition, places where physicians and nurses ought to care for patients.

If there were a hospital in which nurses and physicians systematically harmed their patients, then we would not be content simply to claim that this institution is, by definition, no longer a hospital and leaving it at that. Obviously, we would claim that the physicians and nurses ought to care for their patients, and that this obligation is not merely the result of the constitutive rules governing hospitals and medical professions.

Other sorts of normative claims: that murder is wrong, or that it is appropriate for wrongdoers to apologize, that purely accidental (non-negligent) wrongdoing is not blameworthy, etc., are not only not easily defeated, they are also - and even more conspicuously - not easily changed . Whereas the number of fouls a basketball player can ‘legally’ make in the course of a game can at any time be changed, the prohibition against stabbing his opponents is not likely to change at all. Previous…