In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen’s mature position he defends the idea that people should be compensated for “brute luck”, i.e. the outcome of actions that it would be unreasonable to expect them to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too (...) wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck egalitarianism taking into account the moral requirement of meeting everyone’s basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism handles well health distributions above a threshold of basic needs. Secondly, his way of avoiding Elizabeth Anderson’s abandonment objection is theoretically problematic. Finally, I argue that luck egalitarianism in general fails to acknowledge the moral foundation of health and health care as a basic human entitlement. Thus I conclude that luck egalitarianism fails to take health needs seriously and that it cannot therefore uphold justice in health. (shrink)

This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view—defended by Elizabeth Fenton and Loren Lomasky, among others—is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else nearby. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else nearby.

This article considers the sort of diversity in perspective appropriate for a presidential commission on bioethics, and by implication, high-level governmental commissions on ethics more generally. It takes as its point of comparison the respective reports on human cloning produced by the National Bioethics Advisory Commission, appointed by President Bill Clinton, and George W. Bush's President's Council on Bioethics, under the leadership of its original chair, Leon Kass. I argue that the Clinton Commission Report exemplifies forensic diversity (the type of (...) diversity between contesting parties in a legal case), while the Kass Council Report exemplifies academic diversity (the diversity found in a medieval disputatio). Drawing upon Thomas Aquinas, I argue that the type of diversity most appropriate for such advisory bodies is deliberative diversity, which facilitates the President's process of taking counsel. After considering their respective charges, I suggest that neither the Clinton Commission nor the Kass Council possessed an adequate degree of deliberative diversity for their respective tasks. (shrink)

Human papillomavirus (HPV) infection is the world’s most common sexually transmitted infection. It is a prerequisite for cervical cancer, the second most common cause of death in cancer among women worldwide, and is also believed to cause other anogenital and head and neck cancers. Vaccines that protect against the most common cancer-causing HPV types have recently become available, and different countries have taken different approaches to implementing vaccination. This paper examines the ethics of alternative HPV vaccination strategies. It devotes particular (...) attention to the major arguments for and against one strategy: voluntary, publicly funded vaccination for all adolescent boys and girls. This approach seems attractive because it would protect more people against cervical cancer and other HPV-related cancers than less inclusive alternatives, without the sacrifice of autonomy that a comparably broad compulsory programme would require. Also, the herd immunity that it would likely generate would protect those who remain unvaccinated, a major advantage from a justice perspective. However, there is a possibility that a HPV vaccination programme targeting all adolescents of both sexes is not considered sufficiently cost-effective. Also, it might pose more difficulties for achieving informed consent than comparable vaccination programmes against other diseases. Ultimately, society’s choice of HPV vaccination strategy requires careful consideration not only of the values at stake but also of available and emerging scientific evidence. (shrink)

In this paper, I critique one aspect of Simester and von Hirsch’s, Crimes, Harms, and Wrongs—their recognition of harm and offence principles, but failure to construct a paternalistic principle, despite their willingness to countenance some small measure of criminal paternalism. Construction of such a principle would have clarified the problems of as well as the limits to criminalising paternalism.

JOHNSTONE M‐J. Nursing Inquiry 2012; 19: 107–115 [Epub ahead of print]Academic freedom and the obligation to ensure morally responsible scholarship in nursingAcademic freedom is generally regarded as being of critical importance to the development, improved understanding, and dissemination of new knowledge in a field. Although of obvious importance to the discipline of nursing, the nature, extent and value of academic freedom and the controversies surrounding it have rarely been considered in the nursing literature. It is a key aim of this (...) paper to redress this oversight by providing a brief examination of: (i) the principle of academic freedom; (ii) the distinction between academic freedom, freedom of speech, and the academic freedom to publish; (iii) the problem of ideological judgments being dressed up as scientific or discipline judgments to supports ‘bad’ conclusions; and (iv) the standards that might otherwise be appealed to for determining whether maverick manuscripts supporting morally abhorrent conclusions should be accepted for publication. It is suggested that the tenets of academic freedom require robust international debate, with due attention being given to such issues as the development of an international declaration on academic freedom to publish in nursing, how to ensure a robust rebuttal system in nursing journals to counter specious scholarship, and how to better promote the letters pages of nursing journals as a venue for facilitating debate on controversial issues. (shrink)

Liberalism faces a tension between its commitment to minimal interference with individual liberty and the urgent need for strong collective action on global climate change. This paper attempts to resolve that tension. It does so on the one hand by defending an expanded model of collective moral responsibility, according to which a set of individuals can be responsible, qua ?putative group?, for harm resulting from the predictable aggregation of their individual acts. On the other, it defends a collectivized version of (...) the harm principle. The claim is that the collectivized principle pushes the burden of argument, against coercively enforced measures to curtail climate change and compensate its victims, onto the global elite collectively responsible for environmental harms. Some such potential arguments are briefly considered and rejected. (shrink)

Three types of objections have been raised against sweatshops. According to their critics, sweatshops are (1) exploitative, (2) coercive, and (3) harmful to workers. In “The Ethical and Economic Case Against Sweatshop Labor: A Critical Assessment,” Powell and Zwolinski critique all three objections and thereby offer what is arguably the most powerful defense of sweatshops in the philosophical literature to date. This article demonstrates that, whether or not unregulated sweatshops are exploitative or coercive, they are, pace Powell and Zwolinski, harmful (...) to workers. (shrink)