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  1. Reproductive Embryo Editing: Attending to Justice.Inmaculada de Melo-Martin - forthcoming - Hastings Center Report.
    The use of genome embryo editing tools in reproduction is often touted as a way to ensure the birth of healthy and genetically related children. Many would agree that this is a worthy goal. The purpose of this paper is to argue that, if we are concerned with justice, accepting such goal as morally appropriate commits one to rejecting the development of embryo editing for reproductive purposes. This is so because safer and more effective means exist that can allow many (...)
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  2. Two Conceptions of Solidarity in Health Care.L. Chad Horne - forthcoming - Social Theory and Practice.
    In this paper, I distinguish two conceptions of solidarity, which I call solidarity as beneficence and solidarity as mutual advantage. I argue that only the latter is capable of providing a complete foundation for national universal health care programs. On the mutual advantage account, the rationale for universal insurance is parallel to the rationale for a labor union’s “closed shop” policy. In both cases, mandatory participation is necessary in order to stop individuals free-riding on an ongoing system of mutually advantageous (...)
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  3. How (Not) to Make Trade-Offs Between Health and Other Goods.Antti Kauppinen - forthcoming - Cambridge Quarterly of Healthcare Ethics.
    In the context of a global pandemic, there is good health-based reason for governments to impose various social distancing measures. However, such measures also cause economic and other harms to people at low risk from the virus. In this paper, I examine how to make such trade-offs in a way that is respectfully justifiable to their losers. I argue that existing proposals like using standard QALY (quality-adjusted life-year) valuations or WELLBYs (wellbeing-adjusted life-years) as the currency for trade-offs do not allow (...)
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  4. Why We Should Stop Using Animal-Derived Products on Patients Without Their Consent.Daniel Rodger - forthcoming - Journal of Medical Ethics.
    Medicines and medical devices containing animal-derived ingredients are frequently used on patients without their informed consent, despite a significant proportion of patients wanting to know if an animal-derived product is going to be used in their care. Here, I outline three arguments for why this practice is wrong. Firstly, I argue that using animal-derived medical products on patients without their informed consent undermines respect for their autonomy. Secondly, it risks causing non-trivial psychological harm. Thirdly, it is morally inconsistent to respect (...)
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  5. Global Obligations and the Human Right to Health.Bill Wringe - forthcoming - In Tracy Isaacs, Kendy Hess & Violetta Igneski (eds.), Collective Obligation: Ethics, Ontology and Applications.
    In this paper I attempt to show how an appeal to a particular kind of collective obligation - a collective obligation falling on an unstructured collective consisting of the world’s population as a whole – can be used to undermine recently influential objections to the idea that there is a human right to health which have been put forward by Gopal Sreenivasan and Onora O’Neill. -/- I take this result to be significant both for its own sake and because it (...)
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  6. Responsibility and the Recursion Problem.Ben Davies - 2022 - Ratio 35 (2):112-122.
    A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...)
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  7. Medical AI and Human Dignity: Contrasting Perceptions of Human and Artificially Intelligent (AI) Decision Making in Diagnostic and Medical Resource Allocation Contexts.Paul Formosa, Wendy Rogers, Yannick Griep, Sarah Bankins & Deborah Richards - 2022 - Computers in Human Behaviour 133.
    Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions of being (...)
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  8. COVID-19 Vaccine Refusal and Fair Allocation of Scarce Medical Resources.Govind Persad & Emily A. Largent - 2022 - JAMA Health Forum 3 (4):e220356.
    When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We offer a (...)
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  9. COVID-19 Vaccine Boosters for All Adults: An Optimal U.S. Approach?Ameet Sarpatwari, Ankur Pandya, Emily P. Hyle & Govind Persad - 2022 - Annals of Internal Medicine 175 (2):280–282.
    By 20 October 2021, the U.S. Food and Drug Administration (FDA) had amended its Emergency Use Authorizations for immunocompetent adults who previously received the Pfizer-BioNTech, Moderna, or Johnson & Johnson COVID-19 vaccines. For the 2-dose Pfizer-BioNTech and Moderna vaccines, the FDA permitted a single booster dose for adults aged 65 years or older and adults aged 18 to 64 years at high-risk for severe COVID-19 or at high risk for occupational or institutional COVID-19 exposure. For the single-dose Johnson & Johnson (...)
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  10. Afro-Communitarianism and the Role of Traditional African Healers in the COVID-19 Pandemic.Luís Cordeiro-Rodrigues & Thaddeus Metz - 2021 - Public Health Ethics 14 (1):59-71.
    The COVID-19 pandemic has brought significant challenges to healthcare systems worldwide, and in Africa, given the lack of resources, they are likely to be even more acute. The usefulness of Traditional African Healers in helping to mitigate the effects of pandemic has been neglected. We argue from an ethical perspective that these healers can and should have an important role in informing and guiding local communities in Africa on how to prevent the spread of COVID-19. Particularly, we argue not only (...)
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  11. There is No Race Problem: Theorizing the Absence of Racial and Ethnic Disparity Data in Scotland After COVID-19.Tommy J. Curry - 2021 - In Scotland After the Virus. Edinburgh, UK: pp. 195-202.
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  12. ‘Personal Health Surveillance’: The Use of mHealth in Healthcare Responsibilisation.Ben Davies - 2021 - Public Health Ethics 14 (3):268-280.
    There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...)
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  13. Priority, Ethical Principle, and Allocation of Scarce Medical Resources. Di Wu - 2021 - Studies in Dialectics of Nature 11 (37):62-68.
    Aiming at the allocation of scarce medical resources, Immanuel and other scholars have put forward a set of influential ethical values and guiding principles. It assigns the priority of resource allocation to those whose lives can be saved and maximized, those who can bring the greatest instrumental value, and those who are the worse off. For other members of society, random selection under the same conditions is adopted. Following the Rawlsian "lexical order, lexicographical" rule, this priority arrangement requires that the (...)
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  14. Love Thy Neighbour? Allocating Vaccines in a World of Competing Obligations.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (12):20-20.
    Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there (...)
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  15. Phantom Premise and a Shape-Shifting Ism: Reply to Hassoun.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (11).
    In ‘Against vaccine nationalism’, Nicole Hassoun misrepresents our argument, distorts our position and ignores crucial distinctions we present in our article, ‘Love thy neighbor? Allocating vaccines in a world of competing obligations’. She has created a strawman that does not resemble our position. In this reply, we address two features of ‘Against vaccine nationalism’. First, we address a phantom premise. Hassoun misattributes to us a thesis, according to which citizen-directed duties are stronger than noncitizen-directed duties. This thesis is a figment (...)
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  16. Continuous Glucose Monitoring as a Matter of Justice.Steven R. Kraaijeveld - 2021 - HEC Forum 33 (4):345-370.
    Type 1 diabetes (T1D) is a chronic illness that requires intensive lifelong management of blood glucose concentrations by means of external insulin administration. There have been substantial developments in the ways of measuring glucose levels, which is crucial to T1D self-management. Recently, continuous glucose monitoring (CGM) has allowed people with T1D to keep track of their blood glucose levels in near real-time. These devices have alarms that warn users about potentially dangerous blood glucose trends, which can often be shared with (...)
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  17. What Does an African Ethic of Social Cohesion Entail for Social Distancing?Thaddeus Metz - 2021 - Developing World Bioethics 21 (1):7-16.
    The most prominent strand of moral thought in the African philosophical tradition is relational and cohesive, roughly demanding that we enter into community with each other. Familiar is the view that being a real person means sharing a way of life with others, perhaps even in their fate. What does such a communal ethic prescribe for the coronavirus pandemic? Might it forbid one from social distancing, at least away from intimates? Or would it entail that social distancing is wrong to (...)
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  18. Difficult Trade-Offs in Response to COVID-19: The Case for Open and Inclusive Decision-Making.Ole Frithjof Norheim, Joelle Abi-Rached, Liam Kofi Bright, Kristine Baeroe, Octavio Ferraz, Siri Gloppen & Alex Voorhoeve - 2021 - Nature Medicine 27:10-13.
    We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.
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  19. Improving the Ethical Review of Health Policy and Systems Research: Some Suggestions.Govind Persad - 2021 - Journal of Law, Medicine and Ethics 49 (1):123-125.
    Consistent and well-designed frameworks for ethical oversight enable socially valuable research while forestalling harmful or poorly designed studies. I suggest some alterations that might strengthen the valuable checklist Rattani & Hyder propose for the ethical review of health policy and systems research (HPSR), or prompt future work in the area.
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  20. Against Exclusive Survivalism: Preventing Lost Life and Protecting the Disadvantaged in Resource Allocation.Govind Persad - 2021 - Hastings Center Report 51 (5):47-51.
    When life-saving medical resources are scarce and not everyone can be saved, is the only relevant goal saving the most lives? Or can other factors be considered, at least as tiebreakers, such as how early in life the people we don't save will die or how much future life they are likely to lose? This commentary defends a multiprinciple allocation approach that considers objectives in addition to saving more lives, including preventing early death and preventing harm in the form of (...)
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  21. Ethical Considerations of Offering Benefits to COVID-19 Vaccine Recipients.Govind Persad & Ezekiel J. Emanuel - 2021 - JAMA 326 (3):221-222.
    We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.
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  22. Off-Label Prescription of COVID-19 Vaccines in Children: Clinical, Ethical, and Legal Issues.Govind Persad, Holly Fernandez Lynch & Patricia J. Zettler - 2021 - Pediatrics 2021:e2021054578.
    We argue that the universal recommendations against “off-label” pediatric use of approved COVID-19 issued by the FDA, CDC, and AAP are overbroad. Especially for higher-risk children, vaccination can be ethically justified even before FDA authorization or approval – and similar reasoning is relevant for even younger patients. Legal risks can also be managed, although the FDA, CDC, and Department of Health and Human Services (HHS) should move quickly to provide clarity.
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  23. Conditioning Principles: On Bioethics and The Problem of Ableism.Joel Michael Reynolds - 2021 - In Elizabeth Victor & Laura K. Guidry-Grimes (eds.), Applying Nonideal Theory to Bioethics: Living and Dying in a Nonideal World. Springer. pp. 99-118.
    This paper has two goals. The first is to argue that the field of bioethics in general and the literature on ideal vs. nonideal theory in particular has underemphasized a primary problem for normative theorizing: the role of conditioning principles. I define these as principles that implicitly or explicitly ground, limit, or otherwise determine the construction and function of other principles, and, as a result, profoundly impact concept formation, perception, judgment, and action, et al. The second is to demonstrate that (...)
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  24. The Complex Relationship Between Disability Discrimination and Frailty Scoring.Joel Michael Reynolds, Charles E. Binkley & Andrew Shuman - 2021 - American Journal of Bioethics 21 (11):74-76.
    In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...)
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  25. The ”Foreign” Virus? Justifying Norway’s Border Closure.Magnus Skytterholm Egan & Attila Tanyi - 2021 - Etikk I Praksis - Nordic Journal of Applied Ethics 15 (2):29-47.
    In response to the Covid pandemic the Norwegian government put in place the strictest border closures in Norwegian modern history, restricting entry to most foreign nationals. The Prime Minister, Erna Solberg, justified these restrictions with reference to the rise of new Covid variants, and the need to limit visitors to Norway as much as possible. In this paper we critically examine both the justification given for the border closure, and explore the possible adverse effects this closure might bring about. We (...)
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  26. Aligning Patient’s Ideas of a Good Life with Medically Indicated Therapies in Geriatric Rehabilitation Using Smart Sensors.Cristian Timmermann, Frank Ursin, Christopher Predel & Florian Steger - 2021 - Sensors 21 (24):8479.
    New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a (...)
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  27. Assessing the Wellbeing Impacts of the COVID-19 Pandemic and Three Policy Types: Suppression, Control, and Uncontrolled Spread.Matthew D. Adler, Richard Bradley, Maddalena Ferranna, Marc Fleurbaey, James Hammitt & Alex Voorhoeve - 2020 - Thinktank 20 Policy Briefs for the G20 Meeting in Saudi Arabia 2020.
    The COVID-19 crisis has forced a difficult trade-off between limiting the health impacts of the virus and maintaining economic activity. Welfare economics offers tools to conceptualize this trade-off so that policy-makers and the public can see clearly what is at stake. We review four such tools: the Value of Statistical Life (VSL); the Value of Statistical Life Years (VSLYs); Quality-Adjusted Life-Years (QALYs); and social welfare analysis, and argue that the latter are superior. We also discuss how to choose policies that (...)
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  28. COVID-19 and Mental Health: Government Response and Appropriate Measures.Genevieve Bandares-Paulino & Randy A. Tudy - 2020 - Eubios Journal of Asian and International Bioethics 30 (7):378-382.
    As governments around the world imposed lockdowns or stay-at-home measures, people began to feel the stress as time dragged on. There were already reports on some individuals committing suicide. How do governments respond to such a phenomenon? Our main focus is the Philippine government and how it responded to the COVID-19 pandemic. In this paper, we argue that the problem with COVID-19 went forth just dealing with physical health. First, people suffer not just from being infected but the psychological stress (...)
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  29. Pandemic Ethics: 8 Big Questions of COVID-19.Ben Bramble - 2020 - Sydney: Bartleby Books.
    A clear and provocative introduction to the ethics of COVID-19, suitable for university-level students, academics, and policymakers, as well as the general reader. It is also an original contribution to the emerging literature on this important topic. The author has made it available Open Access, so that it can be downloaded and read for free by all those who are interested in these issues. Key features include: -/- A neat organisation of the ethical issues raised by the pandemic. An exploration (...)
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  30. Ethical Allocation of Remdesivir.Parker Crutchfield, Tyler S. Gibb, Michael J. Redinger & William Fales - 2020 - American Journal of Bioethics 20 (7):84-86.
    As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...)
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  31. From Sufficient Health to Sufficient Responsibility.Ben Davies & Julian Savulescu - 2020 - Journal of Bioethical Inquiry 17 (3):423-433.
    The idea of using responsibility in the allocation of healthcare resources has been criticized for, among other things, too readily abandoning people who are responsible for being very badly off. One response to this problem is that while responsibility can play a role in resource allocation, it cannot do so if it will leave those who are responsible below a “sufficiency” threshold. This paper considers first whether a view can be both distinctively sufficientarian and allow responsibility to play a role (...)
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  32. Public Health and Precarity.Michael D. Doan & Ami Harbin - 2020 - International Journal of Feminist Approaches to Bioethics 13 (2):108-130.
    One branch of bioethics assumes that mainly agents of the state are responsible for public health. Following Susan Sherwin’s relational ethics, we suggest moving away from a “state-centered” approach toward a more thoroughly relational approach. Indeed, certain agents must be reconstituted in and through shifting relations with others, complicating discussions of responsibility for public health. Drawing on two case studies—the health politics and activism of the Black Panther Party and the work of the Common Ground Collective in post-Katrina New Orleans—we (...)
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  33. Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care.Laura Guidry-Grimes, Katie Savin, Joseph A. Stramondo, Joel Michael Reynolds, Marina Tsaplina, Teresa Blankmeyer Burke, Angela Ballantyne, Eva Feder Kittay, Devan Stahl, Jackie Leach Scully, Rosemarie Garland-Thomson, Anita Tarzian, Doron Dorfman & Joseph J. Fins - 2020 - Hastings Center Report 50 (3):28-32.
    In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...)
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  34. Egalitarian Provision of Necessary Medical Treatment.Robert C. Hughes - 2020 - The Journal of Ethics 24 (1):55-78.
    Considerations of autonomy and independence, properly understood, support strictly egalitarian provision of necessary medical treatment. If the financially better-off can purchase access to necessary medical treatments that the financially less well-off cannot purchase without help, then their discretionary power to give or to withhold monetary gifts indirectly gives them the power to make life-and-death or sickness-and-health decisions for others. To prevent private citizens from having this objectionable form of power, government must ensure that citizens’ finances do not affect their access (...)
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  35. First Come, First Served?Tyler M. John & Joseph Millum - 2020 - Ethics 130 (2):179-207.
    Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...)
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  36. The Case for Valuing Non-Health and Indirect Benefits.Govind Persad & Jessica du Toit - 2020 - In Ole F. Norheim, Ezekiel J. Emanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. New York, NY, USA: pp. 207-222.
    Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...)
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  37. Age Change in Healthcare Settings: A Reply to Lippert-Rasmussen and Petersen.Joona Räsänen - 2020 - Journal of Medical Ethics 46 (9):636-637.
    Lippert-Rasmussen and Petersen discuss my ‘Moral case for legal age change’ in their article ‘Age change, official age and fairness in health’. They argue that in important healthcare settings (such as distributing vital organs for dying patients), the state should treat people on the basis of their chronological age because chronological age is a better proxy for what matters from the point of view of justice than adjusted official age. While adjusted legal age should not be used in deciding who (...)
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  38. Understanding Autonomy: An Urgent Intervention.Samuel Reis-Dennis - 2020 - Journal of Law and the Biosciences 1 (7).
    In this paper, I argue that the principle of respect for autonomy can serve as the basis for laws that significantly limit conduct, including orders mandating isolation and quarantine. This thesis is fundamentally at odds with an overwhelming consensus in contemporary bioethics that the principle of respect for autonomy, while important in everyday clinical encounters, must be 'curtailed', 'constrained', or 'overridden' by other principles in times of crisis. I contend that bioethicists have embraced an indefensibly 'thin' notion of autonomy that (...)
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  39. Cultural Gaslighting.Elena Ruíz - 2020 - Hypatia 35 (4):687-713.
    This essay frames systemic patterns of mental abuse against women of color and Indigenous women on Turtle Island (North America) in terms of larger design-of-distribution strategies in settler colonial societies, as these societies use various forms of social power to distribute, reproduce, and automate social inequalities (including public health precarities and mortality disadvantages) that skew socio-economic gain continuously toward white settler populations and their descendants. It departs from traditional studies in gender-based violence research that frame mental abuses such as gaslighting--commonly (...)
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  40. Healthy Nails Versus Long Lives: An Analysis of a Dutch Priority Setting Proposal.Alex Voorhoeve - 2020 - In Nir Eyal, Samia A. Hurst, Christopher Murray, S. Andrew Schroeder & Daniel Wikler (eds.), Measuring the Global Burden of Disease: Philosophical Dimensions. New York, NY, USA: pp. 273-292.
    How should governments balance saving people from very large individual disease burdens (such as an early death) against saving them from middling burdens (such as erectile dysfunction) and minor burdens (such as nail fungus)? This chapter considers this question through an analysis of a priority-setting proposal in the Netherlands, on which avoiding a multitude of middling burdens takes priority over saving one person from early death, but no number of very small burdens can take priority over avoiding one death. It (...)
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  41. Setting Priorities Fairly in Response to Covid-19: Identifying Overlapping Consensus and Reasonable Disagreement.David Wasserman, Govind Persad & Joseph Millum - 2020 - Journal of Law and the Biosciences 1 (1):doi:10.1093/jlb/lsaa044.
    Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of first-come, (...)
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  42. The Fifth Face of Fair Subject Selection: Population Grouping.Tomasz Żuradzki - 2020 - American Journal of Bioethics 20 (2):41-43.
    The article by MacKay and Saylor (2020) claims that the principle of fair subject selection yields conflicting imperatives (e.g. in the case of pregnant women) and should be understood as “a bundle of four distinct sub-principles” (i.e. fair inclusion, burden sharing, opportunity, distribution of third-party risks), each having conflicting normative recommendations (MacKay and Saylor 2020). The authors also offer guidance as to how we should navigate between subprinciples that may conflict with each other. The problem is a crucial one since (...)
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  43. Bursting Bubbles? QALYs and Discrimination.Ben Davies - 2019 - Utilitas 31 (2):191-202.
    The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it (...)
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  44. Medical Overtesting and Racial Distrust.Luke Golemon - 2019 - Kennedy Institute of Ethics Journal 29 (3):273-303.
    The phenomenon of medical overtesting in general, and specifically in the emergency room, is well-known and regarded as harmful to both the patient and the healthcare system. Although the implications of this problem raise myriad ethical concerns, this paper explores the extent to which overtesting might mitigate race-based health inequalities. Given that medical malpractice and error greatly increase when the patients belong to a racial minority, it is no surprise that the mortality rate similarly increases in proportion to white patients. (...)
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  45. Medical Overtesting and Racial Distrust.Luke Golemon - 2019 - In Fritz Allhoff & Sandra Borden (eds.), Ethics and Error in Medicine. New York, NY, USA: pp. 121-147.
    Reprinted with modification and permission from Kennedy Institute of Ethics Journal. The phenomenon of medical overtesting in general, and specifically in the emergency room, is well-known and regarded as harmful to both the patient and the healthcare system. Although the implications of this problem raise myriad ethical concerns, this chapter explores the extent to which overtesting might mitigate race-based health inequalities. Given that medical malpractice and error greatly increase when the patients belong to a racial minority, it is no surprise (...)
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  46. Medical Crowdfunding, Political Marginalization, and Government Responsiveness: A Reply to Larry Temkin.Alida Liberman - 2019 - Journal of Practical Ethics 7 (1):40-48.
    Larry Temkin draws on the work of Angus Deaton to argue that countries with poor governance sometimes rely on charitable giving and foreign aid in ways that enable them to avoid relying on their own citizens; this can cause them to be unresponsive to their citizens’ needs and thus prevent the long-term alleviation of poverty and other social problems. I argue that the implications of this “lack of government responsiveness argument” (or LOGRA) are both broader and narrower than they might (...)
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  47. Have Reforms Reconciled Health Rights Litigation and Priority Setting in Costa Rica?Alessandro Luciano & Alex Voorhoeve - 2019 - Health and Human Rights 21 (2):283-293.
    The experience of Costa Rica highlights the potential for conflicts between the right to health and fair priority setting. For example, one study found that most favorable rulings by the Costa Rican constitutional court concerning claims for medications under the right to health were either for experimental treatments or for medicines that should have low priority based on health gain per unit of expenditure and severity of disease. In order to better align rulings with priority setting criteria, in 2014, the (...)
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  48. Putting a Number on the Harm of Death.Joseph Millum - 2019 - In Espen Gamlund & Carl Tollef Solberg (eds.), Saving People from the Harm of Death. Oxford University Press. pp. 61-75.
    Donors to global health programs and policymakers within national health systems have to make difficult decisions about how to allocate scarce health care resources. Principled ways to make these decisions all make some use of summary measures of health, which provide a common measure of the value (or disvalue) of morbidity and mortality. They thereby allow comparisons between health interventions with different effects on the patterns of death and ill health within a population. The construction of a summary measure of (...)
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  49. Will More Organs Save More Lives? Cost‐Effectiveness and the Ethics of Expanding Organ Procurement.Govind Persad - 2019 - Bioethics 33 (6):684-690.
    The assumption that procuring more organs will save more lives has inspired increasingly forceful calls to increase organ procurement. This project, in contrast, directly questions the premise that more organ transplantation means more lives saved. Its argument begins with the fact that resources are limited and medical procedures have opportunity costs. Because many other lifesaving interventions are more cost‐effective than transplantation and compete with transplantation for a limited budget, spending on organ transplantation consumes resources that could have been used to (...)
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  50. Justice and Public Health.Govind Persad - 2019 - In Anna Mastroianni, Jeff Kahn & Nancy Kass (eds.), Oxford Handbook of Public Health Ethics. New York, NY, USA: pp. ch. 4.
    This chapter discusses how justice applies to public health. It begins by outlining three different metrics employed in discussions of justice: resources, capabilities, and welfare. It then discusses different accounts of justice in distribution, reviewing utilitarianism, egalitarianism, prioritarianism, and sufficientarianism, as well as desert-based theories, and applies these distributive approaches to public health examples. Next, it examines the interplay between distributive justice and individual rights, such as religious rights, property rights, and rights against discrimination, by discussing examples such as mandatory (...)
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