In an earlier paper entitled _Harm is all you need?_, I used an analysis of English law to claim that the harm threshold was an unsuitable mediator of the best interests test when deciding if parental decisions should be overruled. In this paper I respond to a number of commentaries of that paper, and extend my discussion to consider the claim that the harm threshold gives appropriate normative weight to the interests of parents. While I accept that parents have some (...) rights over their children, I argue these are dependent on parents’ duties to benefit their children. While many such benefits are understood pluralistically, and are thus within parents’ ambit to decide, I claim that health benefits are ordinally different, because they play a foundational role in the flourishing of an individual. In the light of this, clinicians have the moral authority to override parental refusals, although in some cases abstaining from exercising this authority may be a pragmatic way to maintain parental engagement and ensure our ability to benefit the child in future. (shrink)

Much of the sustained attention on pandemic preparedness has focused on the ethical justification for plans for the “crisis” phase of a surge when, despite augmentation efforts, the demand for life...

Reflective equilibrium is overdue a twenty-first century update. Despite its apparent popularity, there is scant evidence that theorists ever thoroughly implement the method, and fewer still openly and transparently publish their attempts to do so in print—stymying its supposed justificatory value. This paper proposes digitising reflective equilibrium as a solution. Inspired by the global open science movement, it advocates for coupling a novel, digital implementation of the equilibrating process with new publication norms that can capitalise on the inherent reproducibility of (...) digital data. The argument is structured around three main claims: that digitising will make it easier to (a) methodically construct, (b) widely disseminate, and (c) thoroughly critique reflective equilibria. Practical guidance is also provided throughout. Altogether, it is argued that digitisation will not only help theorists to better realise reflective equilibrium’s latent theoretical potential, but also greatly extend its value as a justificatory device in contemporary academic discourses. (shrink)

Empirical studies on people's moral attitudes regarding ethically challenging topics contribute greatly to research in medical ethics. However, it is not always clear in which ways this research adds to medical ethics as a normative discipline. In this article, we aim to provide a systematic account of the different ways in which attitudinal research can be used for normative reflection. In the first part, we discuss whether ethical judgements can be based on empirical work alone and we develop a sceptical (...) position regarding this point, taking into account theoretical, methodological and pragmatic considerations. As empirical data should not be taken as a direct source for normative justification, we then delineate different ways in which attitudes research can be combined with theoretical accounts of normative justification in the second part of the article. Firstly, the combination of attitudes research with normative-ethical theories is analysed with respect to three different aspects: The extent of empirical data which is needed, the question of which kind of data is required and the ways in which the empirical data are processed within the framework of an ethical theory. Secondly, two further functions of attitudes research are displayed which lie outside the traditional focus of ethical theories: the exploratory function of detecting and characterising new ethical problems, and the field of ‘moral pragmatics’. The article concludes with a methodological outlook and suggestions for the concrete practice of attitudinal research in medical ethics. (shrink)

Carson Strong has recently argued that wide reflective equilibrium (WRE) is an unacceptable method of justification in bioethics. In its place, Strong recommends a methodology in which certain foundational moral judgments play a central role in the justification of moral beliefs, and coherence plays a limited justificatory role in that the rest of our judgments are made to cohere with these foundational judgments. In this paper, I argue that Strong’s chief criticisms of WRE are unsuccessful and that his proposed alternative (...) is in fact just another version of WRE. In the course of doing so, I specify which theses are central to WRE and which are not, and thus, provide a response to an additional objection, advanced by Peter Singer, that WRE is vacuous. I conclude by arguing that there may be better prospects for advancing the debate regarding methodology in bioethics if we focus on restricted epistemic and methodological theses rather than broad approaches, such as WRE, that come in many different varieties. (shrink)

I address the worry that reflective equilibrium is too weak as an account of justification because it fails to let differing views converge. I take up informal aspects of convergence and operationalise them in a formal model of reflective equilibrium. This allows for exploration by the means of computer simulation. Findings show that the formal model does not yield unique outputs, but still boosts agreement. I conclude from this that reflective equilibrium is best seen as a pluralist account of justification (...) that cannot be accused of resulting in an “anything goes” relativism. (shrink)