What determines the degree to which some event harms a subject? According to the counterfactual comparative account, an event is harmful for a subject to the extent that she would have been overall better off if it had not occurred. Unlike the causation based account, this view nicely accounts for deprivational harms, including the harm of death, and for cases in which events constitute a harm rather than causing it. However, I argue, it ultimately fails, since not every intrinsically bad (...) state that is counterfactually dependent on an event contributes to its degree of harm. So while the causation based account is too restrictive, the counterfactual comparative view is not restrictive enough. In light of this, I suggest an alternative, explanation based account of overall harm, according to which the degree to which some event is harmful for a subject is determined by the degree to which (crudely) the states explained by it are overall more intrinsically bad than intrinsically good for her. (shrink)

The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...) first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection. (shrink)

In this paper, I offer a prolegomenon to the philosophy of harm reduction. I begin with an overview of the philosophical literature on both harm and harm reduction, and a brief summary of harm reduction scholarship outside of philosophy in order to make the case that philosophers have something to contribute to understanding harm reduction, and moreover that engagement with harm reduction would improve philosophical scholarship. I then proceed to survey and assess the nascent and still modest philosophy of harm (...) reduction literature that has begun to emerge. I pay particular attention to two Canadian philosophers who have called for the expansion of harm reduction beyond the realm of so-called “vice”. Finally, I sketch some of the most interesting and important philosophical issues that I think the philosophy of harm reduction must grapple with going forward. (shrink)

Physicians place significant weight on the distinction between acts and omissions. Most believe that autonomous refusals for procedures, such as blood transfusions and resuscitation, ought to be respected, but they feel no similar obligation to accede to requests for treatment that will, in the physician’s opinion, harm the patient (e.g., assisted death). Thus, there is an asymmetry. In this paper, we challenge the strength of this distinction by arguing that the ordering of values should be the same in both cases. (...) The reason for respecting refusals is that, in such cases, autonomy outweighs well-being. We argue that the same should be true in request cases, which means that requests should not be denied only due to the treatment being too harmful in the physician’s opinion. Our strategy is to consider and reject a number of arguments for the asymmetrical view, including an appeal to the doing–allowing distinction and positive and negative rights. The duty to respect refusals is still greater than the duty to grant requests on our view, but, by arguing that the ordering of values is the same in both cases, we show that there is less of a distinction in healthcare between requests and refusals than many currently believe. (shrink)

The nonidentity problem is a deep puzzle challenging the moral intuition that what is bad must be bad for someone. The first part of the paper constructs a new theory of harming, whereas the second part builds on the conclusions of the first to offer a new solution to the NIP. The first part discusses the neglected question of when a burden inflicted in the context of overall benefitting can be discretized as a separate entity—only when it can, is it (...) possible to identify the burden as harm, and only then is it possible to harm in bringing into overall good existence. The second part explains how, in those cases where creating is indeed harming, we can use the logic of concept expansion to construct a concept of wronging that applies to creation cases. (shrink)

Abstract“The wrongness of Albert's action causally explains why Jane judged that his action was wrong”. This type of causal moral explanation has been extensively discussed in the recent metaethical literature. This paper motivates the following claims about this type of moral explanation. First, a typical defence of this type of moral explanation suggested in the literature does not work because it predicts inaccurate modal information. Second, focusing on different aspects of the ways moral judgements are generated provides better chances for (...) the defender of this type of moral explanation. Third, the strategy mentioned in the previous point leads us to the following alternative evaluative explanation: The property of being a harmful action explains a recognisable pattern of moral judgements observed in the relevant empirical studies. One crucial implication the paper alludes to is a localist approach to the debates concerning moral realism: We should consider each moral property's ontological genuineness separately, referring to specific empirical findings that are particularly relevant to the target moral property in question. Such a localist approach can provide solid resources for realists to respond to various anti‐realist challenges, such as an influential evolutionary debunking argument. (shrink)

Charlotte Unruh has recently put forward a hybrid account of what it is to suffer harm – one that combines comparative and non‐comparative elements. We raise two problems for Unruh's account. The first concerns killing and death; the second concerns the causing of temporarily low or high welfare.

This article provides an account of moral obligations that we have towards present generations, which require us to produce outcomes that are similar to those we would be required to produce if we had moral obligations to future generations. Discharging these duties enables us to secure the kinds of goods for future generations that we intuitively think we ought to provide in the absence of an answer to the non-identity problem. In this sense, the non- identity problem is avoided rather (...) than solved. Nevertheless, a significant upshot of this account is that it provides a basis for practical action in the face of theoretical uncertainty. (shrink)

A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. (...) The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life. (shrink)

It is often said that while we have a strong reason not to create someone who will be badly off, we have no strong reason for creating someone who will be well off. In this paper I argue that this asymmetry is incompatible with a plausible principle of independence of irrelevant alternatives, and that a more general asymmetry between harming and benefiting is difficult to defend. I then argue that, contrary to what many have claimed, it is possible to harm (...) or benefit someone by bringing her into existence. (shrink)

Can an act harm someone—a future someone, someone who does not exist yet but will—if that person would never exist but for that very action? This is one question raised by the non-identity problem. Many would argue that the answer is No: an action harms someone only insofar as it is worse for her, and an action cannot be worse for someone if she would not exist without it. The first part of this paper contends that the plausibility of the (...) ‘no harm’ argument stems from an equivocation. The second half argues for an account of harm that is both causal and contrastive. Finally, the paper contends that the contrastive account disarms the no harm argument and furthermore neutralizes a related argument that has been problematic for some previously proposed solutions to the non-identity problem. (shrink)

What is harm? I offer an account that involves the victim’s either suffering some adverse intrinsic change or being prevented from enjoying some beneficial intrinsic change. No one is harmed, I claim, in virtue of relational changes alone. Thus (excepting for contrived cases), there are neither posthumous harms nor, in life, harms of the undiscovered betrayal, slander, reputation-damaging variety. Further, two widespread moves in the philosophy of death are rejected. First, death and posthumous are not to be assimilated—death does bring (...) about adverse internal change and harms us straightforwardly. Second, Pitcher-type accounts of posthumous harm are criticized—posthumous events can thwart the satisfaction of my interests, but I am not harmed either just when this occurs or, earlier, when I first acquire or invest in those interests. We have other ways of describing what is going on. (shrink)

Some moral theorists argue that being an innocent beneficiary of significant harms inflicted by others may be sufficient to ground special duties to address the hardships suffered by the victims, at least when it is impossible to extract compensation from those who perpetrated the harm. This idea has been applied to climate change in the form of the beneficiary-pays principle. Other philosophers, however, are quite sceptical about beneficiary pays. Our aim in this article is to examine their critiques. We conclude (...) that, while they have made important points, the principle remains worthy of further development and exploration. Our purpose in engaging with these critiques is constructive — we aim to formulate beneficiary pays in ways that would give it a plausible role in allocating the cost of addressing human-induced climate change, while acknowledging that some understandings of the principle would make it unsuitable for this purpose. (shrink)

Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding (...) harm, it is very plausible to consider the policies harmful but much less reasonable to consider those responsible for their health disadvantages a socially salient group. Drawing on the disrespect literature, where social salience is typically not required for something to be discrimination, the policies are a form of discrimination. They are, however, not disrespectful. The upshot of this first assessment of the discrimination objection to luck egalitarianism in health is, thus, that it fails. (shrink)

Jeff McMahan rejects the relevance of desert to the morality of self-defense. In Killing in War he restates his rejection and adds to his reasons. We argue that the reasons are not decisive and that the rejection calls for further attention, which we provide. Although we end up agreeing with McMahan that the limits of morally acceptable self-defense are not determined by anyone’s deserts, we try to show that deserts may have some subsidiary roles in the morality of self-defense. We (...) suggest that recognizing this might help McMahan to answer some unanswered questions to which his own position gives rise. (shrink)

Non-Identity arguments have a pervasive but sometimes counter-intuitive grip on certain key areas in ethics. As a result, there has been limited success in supporting the alternative view that our choices concerning future generations can be considered harmful on any sort of person-affecting principle. However, as the Non-Identity Problem relies overtly on certain metaphysical assumptions, plausible alternatives to these foundations can substantially undermine the Non-Identity argument itself. In this paper, I show how the pervasive force and nature of Non-Identity arguments (...) rely upon a specific adoption of a theory of modality and identity and how adopting an alternative account of modality can be used to reject many conclusions formed through Non-Identity type arguments. By using Lewis’s counterpart-theoretic account to understand ways we might have been, I outline the basis of a modal account of harm that incorporates a person-affecting aspect. This, in turn, has significant implications for ethical decision-making in areas such as reproductive choice and the welfare of future generations. (shrink)

Has the time come to put to bed the concept of a harm threshold when discussing the ethics of reproductive decision making and the legal limits that should be placed upon it? In this commentary, we defend the claim that there exist good moral reasons, despite the conclusions of the non-identity problem, based on the interests of those we might create, to refrain from bringing to birth individuals whose lives are often described in the philosophical literature as ‘less than worth (...) living’. (shrink)

ABSTRACT When does a state of affairs constitute a harm to someone? Comparative accounts say that being worse off constitutes harm. The temporal version of the comparative account is seldom taken seriously, due to apparently fatal counterexamples. I defend the temporal version against these counterexamples, and show that it is in fact more plausible than the prominent counterfactual version of the account. Non-comparative accounts say that being badly off constitutes harm. However, neither the temporal comparative account nor the non-comparative account (...) can correctly classify all harms. I argue that we should combine them into a hybrid account of harm. The hybrid account is extensionally adequate and presents a unified view on the nature of harm. (shrink)

One important test of adequacy for a theory of welfare is completeness. To be complete a theory must cover ill-being as well as well-being. Call this the ill-being test for a theory. The author’s aim in this article is to determine how well equipped the leading theories of welfare are to pass this test. The author reaches three modest conclusions: passing the test is not straightforward for any theory; on the whole, subjective theories do better than objective ones; within the (...) subjective category experiential theories do better than desire theories. (shrink)

I argue that death can be (and sometimes is) bad for cattle because it destroys relationships that are valuable for cattle for their own sake. The argument relies on an analogy between valuable human relationships and relationships cattle form with conspecifics. I suggest that the reasons we have for thinking that certain rich and meaningful human relationships are valuable for their own sake should also lead us to think that certain cattle relationships are valuable for their own sake. And just (...) as death is bad for us when it destroys our valuable relationships, so death is bad for cattle when it destroys their valuable relationships. This argument is important because it pinpoints something that is bad about death for cattle that is overlooked by popular accounts of the badness of death for non-human animals that focus exclusively on the impact of death on lifetime well-being levels. Thus, the argument reveals an overlooked moral cost of some of our farming practices. (shrink)

This article discusses two normative questions raised by cases of colonial settlement. First, is it sometimes wrong to migrate and settle in a previously inhabited land? If so, under what conditions? Second, should settler countries ever take steps to undo wrongful settlement, by enforcing repatriation and return? The article argues that it is wrong to settle in another country in cases where one comes with intent to colonize the population against their will, or one possesses an adequate territorial base somewhere (...) else, lacks an urgent interest in moving, and seeks to settle in a new place under conditions where settlement would severely harm the practices of prior occupants. It also argues for a presumption of repatriation and return in the first generation of wrongful settlement and holds that these remedies may be extended to second and higher generations in some – but not all – cases. (shrink)

IntroductionHarm is a fundamental concept featuring in many normative claims. In the political context, it is sometimes argued that the only justification for state coercion is the prevention of harm to others, or that it is impermissible to forcibly prevent someone harming themselves. In ethics, many philosophers endorse weighty constraints against harming others. Finally, remedial duties in the civil law are usually conceptualised as responses to harm. Given its broad significance, the recent increase in attention to the philosophical foundations of (...) harm is understandable, but there is still no consensus on even the broad outlines of a theory.Most theories of harm are ‘state-based’. They analyse harm with reference to the state in which a victim is placed as a result of some event: to be harmed is to be placed in a bad state. Events usually feature in state-based views as causes of harm, although the harm is not identified with this event or any further event. The event-based view (h. (shrink)

Standard, familiar models portray harms and benefits as symmetrical. Usually, harm is portrayed as involving a worsening of one's situation, and benefits as involving an improvement. Yet morally, the aversion, prevention, and relief of harms seem, at least presumptively, to matter more than the provision, protection, and maintenance of comparable and often greater benefits. Standard models of harms and benefits have difficulty acknowledging this priority, much less explaining it. They also fail to identify harm accurately and reliably. In this paper, (...) I develop these problems, argue that we should reconsider our commitment to the standard models, and then merely gesture at the direction in which we might locate a superior approach, one that better accounts for the moral significance of harm and its relation to autonomy rights. (shrink)

Many legal, social, and medical theorists and practitioners, as well as lay people, seem to be concerned with the harmfulness of discriminative practices. However, the philosophical literature on the moral wrongness of discrimination, with a few exceptions, does not focus on harm. In this paper, I examine, and improve, a recent account of wrongful discrimination, which divides into a definition of group discrimination, and a characterisation of its moral wrong-making feature in terms of harm. The resulting account analyses the wrongness (...) of discrimination in terms of intrapersonal comparisons of the discriminatee’s actual, and relevantly counterfactual, well-being levels. I show that the account faces problems from counterfactuals, which can be traced back specifically to the orthodox - comparative, counterfactual, welfarist - concept of harm. I argue that non-counterfactual and non-comparative harm concepts face problems of their own, and don’t fit easily with our best understanding of discrimination; hence they are unsuitable to replace the orthodox concept here. I then propose a non-orthodox - comparative, counterfactual, hybrid - concept of harm, which relies on counterfactual comparisons of ways of being treated. I suggest how such a concept can help us handle the problems from counterfactuals, at least for my account of discrimination. I also show that there are similar proposals in other harm-related debates. An upshot of the paper is thus to corroborate the case for a non-orthodox, hybrid concept of harm, which seems better able to fulfil its functional roles in a variety of contexts. (shrink)

In recent years, philosophers have proposed a variety of accounts of the nature of harm. In this paper, I consider several of these accounts and argue that they are unsuccessful. I then make a modest case for a different view.

A powerful argument against the counterfactual comparative account of harm is that it cannot distinguish harming from failing to benefit. In reply to this problem, I suggest a new account of harm. The account is a counterfactual comparative one, but it counts as harms only those events that make a person occupy his level of well-being at the world at which the event occurs. This account distinguishes harming from failing to benefit in a way that accommodates our intuitions about the (...) standard problem cases. In laying the groundwork for this account, I also demonstrate that rival accounts of harm are able to distinguish harming from failing to benefit only if, and because, they also appeal to the distinction between making upshots happen and allowing upshots to happen. One important implication of my discussion is that preserving the moral asymmetry between harming and failing to benefit requires a commitment to the existence of a metaphysical and moral distinction between making and allowing. (shrink)

I defend a theory of the way in which death is a harm to the person who dies that fits into a larger, unified account of harm ; and includes an account of the time of death's harmfulness, one that avoids the implications that death is a timeless harm and that people have levels of welfare at times at which they do not exist.

According to the Counterfactual Comparative Account of harm and benefit, an event is overall harmful for a subject to the extent that this subject would have been better off if it had not occurred. In this paper we present a challenge for the Counterfactual Comparative Account. We argue that if physical processes are chancy in the manner suggested by our best physical theories, then CCA faces a dilemma: If it is developed in line with the standard approach to counterfactuals, then (...) it delivers that the value of any event for a subject is indeterminate to the extreme, ranging from terribly harmful to highly beneficial. This problem can only be avoided by developing CCA in line with theories of counterfactuals that allow us to ignore a-typical scenarios. Doing this generates a different problem: when the actual world is itself a-typical we will sometimes get the result that the counterfactual nonoccurrence of an actual benefit is itself a benefit. An account of overall harm bearing either of these two implications is deficient. Given the general aspiration to account for deprivational harms and the dominance of the Counterfactual Comparative Account in this respect, theorists of harm and benefit face a deadlock. (shrink)

A popular strategy for meeting over-determination and pre-emption challenges to the comparative counterfactual conception of harm is Derek Parfit’s suggestion, more recently defended by Neil Feit, that a plurality of events harms A if and only if that plurality is the smallest plurality of events such that, if none of them had occurred, A would have been better off. This analysis of ‘harm’ rests on a simple but natural mistake about the relevant counterfactual comparison. Pluralities fulfilling these conditions make no (...) difference to the worse for anyone in the over-determination cases that prompted the need for revising the comparative conception of harm to begin with. We may choose to call them harmful anyway, but then we must abandon the idea that making a difference to the worse for someone is essential to harming. I argue that we should hold on to the difference-making criterion and give up the plural harm principle. I offer an explanation of why Parfit’s and Feit’s plural harm approach seems attractive. Finally, I argue that the consequences of giving up the plural harm principle and holding on to the simple comparative counterfactual analysis of harm are less radical than we may think, in relation to questions about wrongness and responsibility. (shrink)

J. S. Mill’s harm principle rules out, among other things, the criminalization of purely self-regarding conduct. I argue that Aristotle’s ideas, especially his claims about the interpersonal nature of justice and the importance of the “common good,” provide support for this antipaternalistic principle. I consider whether Aristotelians who are also theists can defend paternalistic and moralistic laws on the grounds that private wrongdoing is an injustice against God. I conclude that they cannot. Finally, I argue that antipaternalists have good reasons (...) to reject individualism about the common good. (shrink)

I propose an analysis of harm in terms of causation: harm is when a subject is caused to be worse off. The pay-off from this lies in the details. In particular, importing influential recent work from the causation literature yields a contrastive-counterfactual account. This enables us to incorporate harm's multiple senses into a unified scheme, and to provide that scheme with theoretical ballast. It also enables us to respond effectively to previous criticisms of counterfactual accounts, as well as to sharpen (...) criticisms of rival views. (shrink)

I consider the plausibility of discounting for kinship, the view that a positive rate of pure intergenerational time preference is justifiable in terms of agent-relative moral reasons relating to partiality between generations. I respond to Parfit's objections to discounting for kinship, but then highlight a number of apparent limitations of this approach. I show that these limitations largely fall away when we reflect on social discounting in the context of decisions that concern the global community as a whole, such as (...) those related to global climate change. (shrink)

Jerome Wakefield has argued that a disorder is a harmful dysfunction. This paper develops how Wakefield should construe harmful in his harmful dysfunction analysis. Recently, Neil Feit has argued that classic puzzles involved in analyzing harm render Wakefield’s HDA better off without harm as a necessary condition. Whether or not one conceives of harm as comparative or non-comparative, the concern is that the HDA forces people to classify as mere dysfunction what they know to be a disorder. For instance, one (...) can conceive of cases where simultaneous disorders prevent each other from being, in any traditional sense, actually harmful; in such cases, according to the HDA, neither would be a disorder. I argue that the sense of harm that Wakefield should employ in the HDA is dispositional, similar to the sense of harm used when describing a vile of poison: “Be careful! That’s poison. It’s harmful.” I call this harm in the damage sense. Using this sense of harm enables the HDA to avoid Feit’s arguments, and thus it should be preferred to other senses when analyzing harmful dysfunction. (shrink)

When discussing exploitation, we often say things like this, “sweatshop laborers have terrible working conditions and are paid almost nothing, but they are better off with that labor than with no labor.” Similarly, in describing the Non-Identity Problem, Derek Parfit points out: we cannot say that the individuals born in future generations are worse off because of our destructive environmental policies because the particular people living in those future generations wouldn’t even exist if it were not for these destructive policies. (...) How can we explain these cases, exploitation and environmental destruction, as ones of wrongdoing when the victims in both cases are no worse off than they would have otherwise been? This paper investigates the link between these two moral puzzles and ultimately uses one to solve the other: an exploitation solution to the Non-Identity Problem. (shrink)

Discussions of the non-identity problem presuppose a widely shared intuition that actions or policies that change who comes into existence don't, thereby, become morally unproblematic. We hypothesize that this intuition isn’t generally shared by the public, which could have widespread implications concerning how to generate support for large-scale, identity-affecting policies relating to matters like climate change. To test this, we ran a version of the well-known dictator game designed to mimic the public's behavior over identity-affecting choices. We found the public (...) does seem to behave more selfishly when making identity-affecting choices, which should be concerning. We further hypothesized that one possible mechanism is the notion of harm the public uses in their decision-making and find that substantial portions of the population seem to each employ distinct notions of harm in their normative thinking. These findings raise puzzling features about the public’s normative thinking that call out for further empirical examination. (shrink)

In the literature about harm, the counterfactual comparative account has emerged as a main contender. According to it, an event constitutes a harm for someone iff the person is worse off than they would otherwise have been as a result. But the counterfactual comparative account faces significant challenges, one of the most serious of which stems from examples involving non-harmful omitted actions or non-occurring events, which it tends to misclassify as harms: for example, Robin is worse off when Batman does (...) not give him a new set of golf clubs, but Batman has not harmed him. In this article, I will clearly state the counterfactual comparative account; state and explain this objection to the account; canvass several unsatisfactory responses; and attempt to show how the account can overcome the objection. This solution involves distinguishing between principles concerning the existence of harm and principles concerning attributions of responsibility for harm. (shrink)

Contemporary tort theory is dominated by a debate between legal economists and corrective-justice theorists. Legal economists suppose that tortfeasors and tortious wrongs are false targets for cheapest cost-avoiders and avoidable future losses. Corrective-justice theorists argue powerfully that the economic account of tort as search for cheapest cost-avoiders with respect to future accidents does not capture the most fundamental fact about tort adjudication, namely, that the reason we hold defendants liable in tort is that they have wronged their victims and should (...) therefore repair the harm they have done. Deterring cheapest cost-avoiders from committing future harms no more justifies imposing liability in tort than deterring future crime justifies hanging the innocent. This is a powerful critique of the economic theory of tort, but it overshoots the mark. As an account of tort law, corrective justice puts the cart before the horse Tort is a law of wrongs, not just a law of redress for wrongs. Repairing harm wrongly done is the next best way of complying with an obligation not to do harm wrongly in the first place. Rights and remedies form a unity in which rights have priority. Corrective justice is thus an essential but subordinate aspect of tort. This paper develops this line of criticism of corrective-justice theory and offers an alternative account of tort that places primary norms of harm avoidance and respect for rights at its center. On this conception, tort isa law of wrongs, but its distinctiveness lies in the content and character of the wrongs with which it is concerned. At its core, tort is concerned with protecting essential conditions of individual agency. (shrink)

This article considers how legislators should respond to evidence that identifies a common and widely accepted parental practice as a potential source of harm to children, using domestic exposure to environmental tobacco smoke as a test case. It is claimed that children are parties to the Harm Principle, and that the State has an obligation to protect children from exposure to harm. Parental prerogative is limited by the need to avoid harming children. That said, there is considerable uncertainty about what (...) is harmful to children. Several sources of uncertainty, both empirical and conceptual, are explored, in order to demonstrate the complexity of the task legislators face. Seven considerations that are relevant to decisions about legislation of harmful parental practices are outlined, and these considerations are then employed to assess the case in favour of legislating to prohibit the exposure of children to environmental tobacco smoke in domestic settings. (shrink)

Baselines are commonly used to enable harm identification. The temporal, the counterfactual and the duty-based normative baselines are the most prominent. Each of these captures an aspect of common conceptions of what it is to harm and be harmed. However, each baseline also fails to deliver workable identifications of harm when presented with certain types of case. Problematic cases are found readily in childhood, a venue in which harm identification is often called for. Without a reliable means of identifying harm (...) in childhood, harm cannot properly play a central role in normative assessments of parental practices and state intervention. This paper presents childhood cases in which the prominent baselines fail and offers an alternative: the interest-based normative baseline. Should the interest-based normative baseline replace its rivals and reign supreme? I argue not, presenting a case for maintaining a suite of baselines for use in varying contexts. (shrink)

Because harm is an important notion in ethics, it’s worth investigating what it amounts to. The counterfactual comparative account of harm, commonly thought to be the most promising account of harm, analyzes harm by comparing what actually happened with what would have happened in some counterfactual situation. But it faces the preemption problem, a problem so serious that it has driven some to suggest we abandon the counterfactual comparative account and maybe even abandon the notion of harm altogether. This paper (...) defends a version of the counterfactual comparative account that solves the preemption problem, a version called the “worse than nothing account.” It says that you harm someone just in case you leave them worse off than if you’d done nothing at all. (shrink)

Harm is one of the central concepts of ethics so it would be good to offer an account of it. Many accounts appeal to a baseline: they say that you harm someone if you leave them worse off than in the baseline case. In this paper, I draw some lessons regarding what counts as an appropriate baseline and explore what these general lessons reveal about the nature of harm. In the process of so doing, I argue that a certain rarely-discussed (...) account of harm -- the worse than nothing account of harm -- does a particularly good job at identifying a baseline. This account says you harm someone if you leave them worse off than if you had done nothing to them. (shrink)

Decisions on which new health technologies to provide are controversial because of the scarcity of healthcare resources, the competing demands of payers, providers and patients and the uncertainty of the evidence base. Given this, additional information about new health technologies is often considered valuable. One response is to make access to a new health technology conditional on further research. Access can be restricted to patients who participate in a research study, such as a randomised controlled trial; alternatively, a new treatment (...) can be made generally available, but only on condition that further evidence is collected (eg, on long-term outcomes and adverse events, in patient registries). The National Institute for Health and Clinical Excellence (NICE), which provides guidance on which new health technologies to make available under the UK's NHS, for example, has made some research conditional recommendations, and the current interest in such options suggests that they are likely to become more prevalent in the future. This paper identifies and discusses the main ethical issues created by this distinctive range of recommendations. We argue that decisions to put research conditions on access to new technologies are compatible with widely accepted values, principles and practices relevant to resource allocation. However, there are important features of these distinctive judgements that must be taken into account by resource allocation decision-making bodies and research ethics committees, and that require new sorts of empirical data. (shrink)

The paper explores how harm must be understood if intuitively attractive deontological principles concerning the infliction and prevention of harm are to be vindicated. It focuses especially upon how harm must be understood if it is to be plausible that preventing people from undergoing harm takes priority over improving the conditions of badly-off people who have not suffered harm.

Most punishment theorists seem to accept the following claim: punishment is intended to harm the punishee. A significant minority of punishment theorists reject the claim, though. I defend the claim from objections, focusing mostly on recent objections that haven’t gotten much attention. My objective is to reinforce the already strong case for the intentions claim. I first clarify what advocates of the intentions claim mean by it and state the standard argument for it. Then I critically discuss a wide variety (...) of objections to the claim and to the standard argument for it. (shrink)

The Counterfactual Comparative Account of Harm says that an event is overall harmful for someone if and only if it makes her worse off than she otherwise would have been. I defend this account from two common objections.

The problem of justified harm is the problem of explaining why it is permissible to inflict harm for the sake of future benefits in some cases but not in others. In this paper I first motivate the problem by comparing a case in which a lifeguard breaks a swimmer’s arm in order to save her life to a case in which Nazis imprison a man who later grows wiser as a result of the experience. I consider other philosophers’ attempts to (...) explain why the lifeguard’s action was permissible but the Nazis’ action was not. After arguing that principles having to do with consent, expected utility, and the types of harms and benefits at issue do not fully solve the problem, I argue for a causal solution to the problem. The causal solution includes both a causal account of harming and a distinction between causes and mere conditions. It then distinguishes between the lifeguard and Nazi cases with following principle: A harmful action that causes greater benefits can sometimes be justified by those benefits, but a harmful action that does not cause greater benefits cannot be justified by any subsequent benefits that the action, itself, does not cause. (shrink)

According to various “harm-based” approaches to the non-identity problem, an action that brings a particular child into existence can also harm that child, even if his or her life is worth living. In the third chapter of The Non-Identity Problem and the Ethics of Future People, David Boonin surveys a variety of harm-based approaches and argues that none of them are successful. In this paper I argue that his objections to these various approaches do not impugn a harm-based approach that (...) Boonin does not consider, an approach I call the “existence solution to the non-identity problem.” I also argue that the existence solution is more plausible than Boonin’s own proposed solution. (shrink)