In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978). Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This (...) model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons. (shrink)

This paper identifies a new source that explains environmental behaviour: the presence of future tense marking in language. We predict that languages that grammatically mark the future affect speakers' intertemporal preferences and thereby reduce their willingness to address environmental problems. We first show that speakers of languages with future tense marking are less likely to adopt environmentally responsible behaviours and to support policies to prevent environmental damage. We then document that this effect holds across countries: future tense marking is an (...) important determinant of climate change policies and global environmental cooperation. The results suggest that there may be deep and surprising obstacles for attempts to address climate change. (shrink)

This paper identifies a new source of differences in religiosity: the type of future tense marking in language. We argue that the rewards and punishments that incentivize religious behaviour are more effective for speakers of languages without inflectional future tense. Consistent with this prediction, we show that speakers of languages without inflectional future tense are more likely to be religious and to take up the short-term costs associated with religiosity. What is likely to drive this behaviour, according to our results, (...) is the relatively greater appeal of the religious rewards to these individuals. Our analysis is based on within-country regressions comparing individuals with identical observable characteristics who speak a different language. (shrink)

In this commentary on Yashar Saghai's article "Salvaging the Concept of Nudge" (JME 2013) I discuss his distinction between a 'prod' (which is 'substantially controlling') and a 'nudge' (which is ‘substantially non-controlling’).