Many people in desperate need of an organ will die on waiting lists for transplantation or face increased morbidity because of their wait. This circumstance is particularly troubling since many viable organs for transplantation go unused when individuals fail to participate in their local organ donation system. In this paper, I consider whether participating in organ transplantation should be considered a form of a rescue of others from the great harms caused by a shortage in transplantable organs. Specifically, I consider (...) whether cadaver organ transplantation is a case of an easy rescue. If so, participation in cadaver organ transplantation will be a duty rather than a supererogatory act.1 This question is important in illuminating individual duties to participate in organ transplantation. Moreover, as I will argue, it has repercussions for community-wide policies for enrolling individuals in transplantation schemes. -/- In the first section of this paper, I tie cadaver organ transplantation to the duty to rescue others from great harm when it is easy to do so. Given the number of persons who will die or be greatly harmed without transplanted organs, the transfer of organs upon death is seemingly similar to other, classical cases of easy rescue. In the second section, I consider objections to this proposal on the ground that cadaver organ transplantation is structurally dissimilar to classical rescue cases, especially given uncertainty over when and to whom organs will be transplanted, if they are transplanted at all. In the third section, I consider the objection that cadaver organ transplantation is a demanding, rather than easy, rescue. While I grant that cadaver organ transplantation will be demanding for some persons, I argue that there remain many cases where it will be an easy rescue. In the final section, I consider the policy implications of my argument. In particular, I argue that understanding cadaver organ transplantation as a duty should shift the debate over opt-out, opt-in, and mandatory choice procedures for participating in organ transplantation upon death. While different systems will be appropriate for different communities, understanding transplantation as a duty in some cases helps to justify an opt-out system. (shrink)

In this paper, I defend the existence of a moral duty to disobey the law and engage in civil disobedience on the basis of one of the grounds of political obligation—the Samaritan duty. Christopher H. Wellman has recently offered a ‘Samaritan account’ of state legitimacy and political obligation, according to which the state is justified in coercing each citizen in order to rescue all from the perilous circumstances of the state of nature; and each of us is bound to obey (...) the law, as the state demands, because we each have a responsibility to help rescue others when this assistance is not unreasonably costly. Though Wellman recognizes that there can be reasons for disobeying the law and resisting injustice in otherwise legitimate states, he overlooks the possibility that at least some of these reasons could be Samaritan in nature, grounded in the duty to rescue people from peril. As I shall argue, the Samaritan duty supports obligations to disobey the law, when the law prohibits Samaritan rescues, and to engage in civil disobedience, when unjust laws and practices contribute to endangering people. The discussion proceeds as follows. After a brief overview of the Samaritan duty, I articulate my case for Samaritan duties to disobey the law, and duties to engage in civil disobedience when unjust laws, institutions, or practices enable what I call ‘persistent Samaritan perils’. I then examine and respond to several objections to my account: first, that the costs of law-breaking are unreasonable, and thus cannot be morally required; second, that individuals’ particular acts of protest and civil disobedience do not appear to make any difference to the rescue, and thus cannot be required; third, that I stretch the Samaritan duty beyond recognition; and fourth, that the Samaritan duty binds us to help people in need or peril anywhere, not particularly at home. I consider in conclusion the advantages and limits of my account of citizens’ Samaritan duties in the face of injustice. (shrink)

Abstract The article addresses three aspects of the humanitarian intervention doctrine. It argues, first, that the value of sovereignty rests on the justified social processes of the target state ? the horizontal contract. Foreign interventions, even when otherwise justified, must respect the horizontal contract. In contrast, morally objectionable social processes (such as the subjection of women) are not protected by sovereignty (intervention, of course, may be banned for other reasons). In addition, tyrants have no moral protection against interventions directed at (...) them. Second, the article addresses the internal legitimacy of humanitarian intervention. It concludes that the liberal state may only use voluntary soldiers (either the voluntary army or mercenaries) to conduct humanitarian intervention. Conscription for that purpose is not permissible. The article shows that the long-standing criticism of mercenaries stems from a romantic prejudice and is thus unfair. Third, the article makes a distinction between intention (the determination to perform an action) and motive (a further goal that the agent seeks with that action) and shows that only intention is relevant for humanitarian intervention. A justified humanitarian intervention requires the intention to liberate the victims, but not necessarily a good further motive. It shows how mainstream doctrine has impermissibly confused the two concepts. (shrink)

In this article, I examine what Kant’s Formula of Universal Law requires of an individual agent in situations of great need, e.g.: if you can easily help a drowning child, or if you know of a famine situation in another country. I first explain why I do not simply apply the standard interpretation of how one can derive concrete duties from Kant’s Universal Law formulation of the Categorical Imperative. I then glean an alternative procedure from Kant’s texts and give the (...) reasons for using that interpretation. Finally, I apply the alternative procedure to situations of great need. – According to the interpretation I glean from Kant’s texts, one (i) should not make an exception to (ii) laws that we believe to be objectively necessary, whereby we derive these rules from (iii) universal ends of humankind. Since we take survival as one of the universal ends of mankind, we deem helping someone whose life is in danger as objectively necessary (to achieve the end). The formal Categorical Imperative demands that one does not make an exception to this rule. Applying this interpretation to cases of great need depends on at least three factors: (i) how urgent the need is, (ii) how great the costs are to the one who helps, and (iii) how many people can help. But at one extreme, where you are the only one who can easily save an innocent person’s life, the Kantian procedure generates a strict duty to help the other in need. (shrink)

Although rapid genomic sequencing (RGS) is improving care for critically ill children with rare disease, it also raises important ethical questions that need to be explored as its use becomes more widespread. Two such questions relate to the degree of consent that should be required for RGS to proceed and whether it might ever be appropriate to override parents’ decisions not to allow RGS to be performed in their critically ill child. To explore these questions, we first examine the legal (...) frameworks on securing consent for genomic sequencing and how they apply to the specific context of RGS for critically ill children. We then use a tool from clinical ethics, the Zone of Parental Discretion, to explore two case studies and identify under which circumstances it might be appropriate for parental refusal of RGS to be overridden. We argue that RGS may be a context where, in addition to assessing the complexity of the test offered, it is ethically appropriate to consider an effect on patient outcomes when deciding the degree of consent required. We also suggest that there are some contexts where it may be ethically justified to perform RGS, even when it is actively against the wishes of the parents. More work is needed to examine exactly how ‘time-sensitive’ exceptions to current guidance on consent for genomic sequencing could be formulated and operationalised for RGS for critically ill-children. (shrink)

This article argues that whilst the idea of whistleblowing as a positive duty to do good or to prevent harm may be defendable, legislating that duty is not feasible. We develop our argument by identifying rights and duties involved in whistleblowing as two clusters: one of justice and one of benevolence. Legislative arguments have evolved to cover the justice issues and the tendency exists of extending rights and duties into the realm of benevolence. This article considers the problematic assumptions and (...) implications of whistleblowing as a positive duty, by examining the extent to which the Good Samaritan argument holds with regard to whistleblowing. We argue that three criteria necessary for whistleblowing as a legally enforceable positive duty are not met, namely that we need to be able to (1) specify who should know what, (2) minimize the risk to the whistleblower and (3) adequately deal with mistaken concerns being raised. (shrink)

This article proposes a novel defense of vaccine mandates: such policies are justifiable because they protect the capabilities of individuals who cannot cultivate individual immunity against infection. We begin by considering a nearby argument that has recently enjoyed popularity, which claims individuals have an enforceable obligation to get vaccinated because they have benefited from community protection (often referred to as ‘herd immunity’), and thus they ought to do their fair share in sustaining that public good by getting vaccinated. We object, (...) however, that this kind of argument misstates the ethical basis for vaccine mandates because community protection primarily protects unvaccinated people. We contend that the duty to vaccinate is not fundamentally an obligation to make a fair contribution to a public good from which vaccinated people benefit, but a duty to protect the wellbeing of otherwise vulnerable third parties. We flesh out our view by drawing on Martha Nussbaum's capabilities approach. (shrink)

How should we understand the categorical distinction Aristotle draws between praxis and poesis? If this distinction gains its meaning only in a specific social and cultural context, what does this tell us about another famous Aristotelian distinction, namely, the distinction he draws between two types of justice: corrective and distributive? In particular, what is the orienting role of this distinction (and what should we make of this) in accounts of justice based on Kantian right and accounts based on Rawls’ principles (...) of justice? (shrink)

What, if anything, is wrong with price gouging? Its defenders argue that it increases supply of scarce necessities; critics argue that it is exploitative, inequitable and vicious. In this paper, I argue for its moral wrongness and legal prohibition, without relying on charges of exploitation, inequity or poor character. What is fundamentally wrong with price gouging is that it violates a duty of easy rescue. While legal enforcement of such duties is controversial, a special case can be made for their (...) legal enforcement in this context. This account distinguishes, morally, price gouging by corporations from that of individual entrepreneurs. (shrink)