Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.

The paper examines two backward-looking principles about how the costs of mitigating and adapting to climate change should be distributed. According to the polluter pays principle, such costs should be borne by those who caused climate change. According to the beneficiary pays principle, they should be borne by those who have benefited from the activities causing climate change, regardless of whether they took part in such activities or not. The paper unpacks both principles, considers their main problems and contends that, (...) when properly combined, they can address such problems. (shrink)

Having an adequate and extensively recognized resource governance system is essential for the conservation and sustainable use of crop genetic resources in a highly populated planet. Despite the widely accepted importance of agrobiodiversity for future plant breeding and thus food security, there is still pervasive disagreement at the individual level on who should own genetic resources. The aim of the article is to provide conceptual clarification on the following concepts and their relation to agrobiodiversity stewardship: open access, commons, private property, (...) state property and common heritage of humankind. After presenting each property regime, we will examine whether and how these incentivize the conservation, improvement and sharing of crop genetic resources, and conclude by defending a mixed property regime. (shrink)

Some of the most pressing contemporary social problems result from the amalgamation of a mass of actions that are not intentionally coordinated. Although these essentially aggregative harms are foreseeable, it is unclear what moral duties individuals have with regards to them. This paper offers a new analysis of these problems and uses a nonideal contractualist approach to argue in favour of two kinds of duties for individuals. Collectivization duties that require individuals to act responsively with a view to ensuring that (...) there are effective governance agents that reliably, fairly, and efficiently prevent these outcomes in the long-term and duties of restraint that require individuals to avoid action of a kind that is likely to come together with other actions to cause serious EAH in the immediate future when restraint with regards to actions of this kind could help prevent the outcome from occurring. (shrink)

The use of opaque, uninterpretable artificial intelligence systems in health care can be medically beneficial, but it is often viewed as potentially morally problematic on account of this opacity—because the systems are black boxes. Alex John London has recently argued that opacity is not generally problematic, given that many standard therapies are explanatorily opaque and that we can rely on statistical validation of the systems in deciding whether to implement them. But is statistical validation sufficient to justify implementation of these (...) AI systems in health care, or is it merely one of the necessary criteria? I argue that accountability, which holds an important role in preserving the patient‐physician trust that allows the institution of medicine to function, contributes further to an account of AI system justification. Hence, I endorse the vanishing accountability principle: accountability in medicine, in addition to statistical validation, must be preserved. AI systems that introduce problematic gaps in accountability should not be implemented. (shrink)

Women are under-represented in surgery, especially in leadership and academic roles, and face a gender pay gap. There has been little work on the role of implicit biases in women’s under-representation in surgery. Nor has the impact of epistemic injustice, whereby stereotyping influences knowledge or credibility judgements, been explored. This article reports findings of a qualitative in-depth interview study with women surgeons that investigates gender biases in surgery, including subtle types of bias. The study was conducted with 46 women surgeons (...) and trainees of the Royal Australasian College of Surgeons. Maximum variance sampling strategies ensured a comprehensive set of perspectives. Data were analysed using iterative thematic analysis to document and classify forms of gender bias experienced by the participants, including implicit bias and epistemic injustice. It found four types of bias affecting women surgeons: workplace factors such as access to parental leave and role models; epistemic injustices—unfair assessments of women surgeons’ credibility by patients and colleagues; stereotyped expectations that they will carry out more of surgery’s carework, such as meeting the emotional needs of patients and objectification. Implicit biases arose in each category. Given that many of the biases identified in this study are small, are harmless on their own and are not necessarily under anyone’s conscious control, important questions arise regarding how they cause harm and how to address them. I draw on theoretical work on cumulative harm to answer these questions. (shrink)

This paper draws on the emerging field of innovation ethics to complement the more established field of responsible innovation by focusing on key ethical issues raised by technological innovations. One key limitation of influential frameworks of RI is that they tend to neglect some key ethical issues raised by innovation, as well as major normative dimensions of the notion of responsibility. We explain how IE could enrich RI by stressing the more important role that ethical analysis should play in RI. (...) We focus on two transversal issues of IE: the issue of redrawing conceptual boundaries, especially the topic of the artificialization of the world, and the issue of responsibility, especially the notion of total responsibility. We address these two issues from the thematic perspective of IE, thereby generating lessons learnt for RI. These two examples are taken as illustrations and blueprint of the dialogue that should take place between the two fields. (shrink)

Cardiovascular disease is the leading cause of death of women in the United States, yet cardiovascular research is disproportionately conducted using male human subjects and male animal models. This article deploys Katrina Hutchison’s (2019) analysis of gender disparity in clinical trials as a moral aggregation problem to address the problem of underrepresentation of women in cardiovascular research. I identify cost concerns, convenience, pregnancy, and negligence as potential reasons for the underrepresentation of women in CVD research. Finally, I suggest that multilevel (...) strategies will be needed to eliminate sex disparity in CVD research and improve patient care. (shrink)

In this article, I describe how gender bias can affect the design, testing, clinical trials, regulatory approval, and clinical use of implantable devices. I argue that bad outcomes experienced by women patients are a cumulative consequence of small biases and inattention at various points of the design, testing, and regulatory process. However, specific instances of inattention and bias can be difficult to identify, and risks are difficult to predict. This means that even if systematic gender bias in implant design is (...) an ethical issue, it is one with no clearly blameworthy player. From a practical perspective, there is no single obvious point at which to intervene. Philosophers working in other areas have explored structurally similar moral problems—sometimes referred to as “moral aggregation problems”—such as the type of environmental harm caused by small actions of many players. I describe key features of these type of problems and strategies to address them. I then draw on these to suggest an approach to gender bias in medical implant design and use. (shrink)

Cardiovascular disease is the leading cause of death of women in the United States, yet cardiovascular research is disproportionately conducted using male human subjects and male animal models. This article deploys Katrina Hutchison’s (2019) analysis of gender disparity in clinical trials as a moral aggregation problem to address the problem of underrepresentation of women in cardiovascular research. I identify cost concerns, convenience, pregnancy, and negligence as potential reasons for the underrepresentation of women in CVD research. Finally, I suggest that multilevel (...) strategies will be needed to eliminate sex disparity in CVD research and improve patient care. (shrink)

In Justice and Reconciliation in World Politics Catherine Lu endorses the idea that those who contribute to the reproduction of structural injustice have responsibilities to address that injustice. However, in the book, Lu does not explore the grounds and justification for recognising such a responsibility. In order to address this deficit, this paper proposes that those likely to contribute to the reproduction of structural injustice, in the future, have precautionary duties, in the present, that require them to take action aimed (...) at preventing their future contribution. It is proposed that these ‘collectivization duties’ require them to act responsively with a view to forming a collective that can end the structural injustice in question. This account recommends a collective-action solution alongside recognising that each socially connected agent is obliged to act. However, it does not entail that amorphous groups bear responsibilities and is appropriate in its attribution of blame, thus avoiding both Nussbaum’s critique of perpetually forward-looking accounts and the ‘agency objection’. (shrink)

Let me first thank Samantha Brennan, Carolyn McLeod and Brandi Braud Scully for their detailed and constructive commentaries. In this brief response I wish to highlight and engage with three main points they raise. First, I will address McLeod’s argument that female surgeons are not merely harmed, but also wronged by the forms of bias found in the study. Second, I will discuss a concern voiced by both Scully and Brennan that my emphasis on small and implicit biases fails to (...) acknowledge the ongoing, significant problem of explicit bias. Third, and finally, I will engage with Brennan’s argument that institutional responses are the best way of addressing cumulative harms caused by microinequities. These concerns all connect with the difficult question of responsibility, a feature I draw out below. Carolyn McLeod argues that female surgeons’ interests in receiving equal treatment and opportunity are morally significant interests. As such, when these interests are set back by cumulative small biases the female surgeons are morally wronged. Moreover, she says, ‘it’s also hard to see how setting them back in this context could possibly be justified.’ McLeod is right to press me on this issue. In the article I have skirted around …. (shrink)

Medical devices with built-in bias can both result from, and contribute to, harmful systemic racial oppression—a point that Liao and Carbonell (2023) argue convincingly in the target article of thi...