This article analyses the paternalistic justification of the world’s first mandatory tobacco plain packaging policy, which came into force in Australia in 2012. The policy is setting international precedence, with a range of developed and developing countries planning and implementing similar policies. Understanding the paternalistic dimension of the policy is therefore of imminent international importance. The policy meets important ethical benchmarks such as respect for citizens’ self-interests and protection of others against harm. However, plain packaging faces a number of ethical (...) challenges: the policy is a controversial type of paternalism; it runs partially against the harm principle; and it fails to meet key operational criteria. (shrink)

There is a large literature exploring the concept of ‘health promotion’. However, the meaning of the term remains unclear and contested. This is for at least two reasons. First, any definition of ‘health promotion’ is going to have to outline and defend an account of the notoriously controversial concept of ‘health’, and then suggest how (and why) we should promote it. Second, health promotion clearly has some overlap with ‘public health’, but it is far from clear how they are related. (...) Is health promotion part of public health or is health promotion a radically different type of activity from public health? Answering this question requires engaging with tricky professional as well as contentious conceptual issues. Some advocates of health promotion talk as though public health is problematic: seen as medical, physiological in focus and reductionist in approach, whereas health promotion, on this view, is focused on the whole person in a social environment. However, to an outsider this looks more like an attempt to artificially (and rather crudely) define and protect professional boundaries, rather than a contribution to conceptual analysis. There seems no good reason why public health cannot take into account the role of social, political, economic and cultural factors and their impact on health. Indeed, much work in public health does precisely this, and uses a wide range of methodologies drawn from non-medical disciplines such as geography, sociology and psychology, not just epidemiology. It seems much more sensible to see health promotion as being one vitally important aspect of the work of public health, rather than something markedly distinct. We will assume here that this is the case and focus instead on the first issue: what is health promotion? (shrink)

This thesis is an attempt to constructively interpret and critically evaluate the liberal doctrine that we may not limit a person’s liberty for her own good, and to discuss its implications and alternatives in some concrete areas of public health policy. The thesis starts theoretical and goes ever more practical. The first paper is devoted to positive interpretation of anti-paternalism with special focus on the reason component – personal good. A novel generic definition of paternalism is proposed, intended to capture, (...) in a generous fashion, the object of traditional liberal resistance to paternalism – the invocation of personal good reasons for limiting of or interfering with a person’s liberty. In the second paper, the normative aspect of this resistance is given a somewhat technical interpretation in terms of invalidation of reasons – the blocking of reasons from influencing the moral status of actions according to their strength. It is then argued that normative anti-paternalism so understood is unreasonable, on three grounds: 1) Since the doctrine only applies to sufficiently voluntary action, voluntariness determines validity of reasons, which is unwarranted and leads to wrong answers to moral questions. 2) Since voluntariness comes in degrees, a threshold must be set where personal good reasons are invalidated, leading to peculiar jumps in the justifiability of actions. 3) Anti-paternalism imposes an untenable and unhelpful distinction between the value of respecting choices that are sufficiently voluntary and choices that are not. The third paper adds to this critique the fourth argument that none of the action types typically proposed to specify the action component of paternalism is such that performing an action of that type out of benevolence is essentially morally problematic. The fourth paper ignores the critique in the second and third papers and proposes, in an anti-paternalistic spirit, a series of rules for the justification of option-restricting policies aimed at groups where some members consent to the policy and some do not. Such policies present the liberal with a dilemma where the value of not restricting people’s options without their consent conflicts with the value of allowing people to shape their lives according to their own wishes. The fifth paper applies the understanding of anti-paternalism developed in the earlier papers to product safety regulation, as an example of a public health policy area. The sixth paper explores in more detail a specific public health policy, namely that of mandatory alcohol interlocks in all cars, proposed by the former Swedish government and supported by the Swedish National Road Administration. The policy is evaluated for cost-effectiveness, for possible diffusion of individual responsibility, and for paternalistic treatment of drivers. The seventh paper argues for a liberal policy in the area of dissemination of information about uncertain threats to public health. The argument against paternalism is based on common sense consequentialist considerations, avoiding any appeal to the normative anti-paternalism rejected earlier in the thesis. (shrink)

The paper has two goals. The first is presenting the main results of the recent report Ethics of Connected and Automated Vehicles: recommendations on road safety, privacy, fairness, explainability and responsibility written by the Horizon 2020 European Commission Expert Group to advise on specific ethical issues raised by driverless mobility, of which the author of this paper has been member and rapporteur. The second is presenting some broader ethical and philosophical implications of these recommendations, and using these to contribute to (...) the establishment of Ethics of Transportation as an independent branch of applied ethics. The recent debate on the ethics of Connected and Automated Vehicles presents a paradox and an opportunity. The paradox is the presence of a flourishing debate on the ethics of one very specific transportation technology without ethics of transportation being in itself a well-established academic discipline. The opportunity is that now that a spotlight has been switched on the ethical dimensions of CAVs it may be easier to establish a broader debate on ethics of transportation. While the 20 recommendations of the EU report are grouped in three macro-areas: road safety, data ethics, and responsibility, in this paper they will be grouped according to eight philosophical themes: Responsible Innovation, road justice, road safety, freedom, human control, privacy, data fairness, responsibility. These are proposed as the first topics for a new ethics of transportation. (shrink)

More than 1.2 million people are killed annually in road crashes all over the world, and still it seems that philosophers and, perhaps more importantly, professional ethicists have not devoted thought to the many moral issues that road traffic was bound to create. This article tries to understand why road ethics is all but ignored by philosophers and ethicists, and makes a plea for a change. By exploring ethically the traffic safety problem of speeding it will be shown that ethical (...) analysis is not only appropriate but mandatory. (shrink)

The philosophical–ethical literature and the public debate on autonomous vehicles have been obsessed with ethical issues related to crashing. In this article, these discussions, including more empirical investigations, will be critically assessed. It is argued that a related and more pressing issue is questions concerning safety. For example, what should we require from autonomous vehicles when it comes to safety? What do we mean by ‘safety’? How do we measure it? In response to these questions, the article will present a (...) foundation for a continued discussion on these issues and an argument for why discussions about safety should be prioritized over ethical concerns related to crashing. (shrink)

In this paper, we discuss the ethics of automated driving. More specifically, we discuss responsible human-robot coordination within mixed traffic: i.e. traffic involving both automated cars and conventional human-driven cars. We do three main things. First, we explain key differences in robotic and human agency and expectation-forming mechanisms that are likely to give rise to compatibility-problems in mixed traffic, which may lead to crashes and accidents. Second, we identify three possible solution-strategies for achieving better human-robot coordination within mixed traffic. Third, (...) we identify important ethical challenges raised by each of these three possible strategies for achieving optimized human-robot cordination in this domain. Among other things, we argue that we should not just explore ways of making robotic driving more like human driving. Rather, we ought also to take seriously potential ways of making human driving more like robotic driving. Nor should we assume that complete automation is always the ideal to aim for; in some traffic-situations, the best results may be achieved through human-robot collaboration. Ultimately, our main aim in this paper is to argue that the new field of the ethics of automated driving needs take seriously the ethics of mixed traffic and responsible human-robot coordination. (shrink)