The practice whereby terminally ill patients choose to end their own lives painlessly by ingesting a drug prescribed by a physician has commonly been referred to as physician-assisted suicide. There is, however, a strong trend forming that seeks to deny that this act should properly be termed suicide. The purpose of this paper is to examine and reject the view that the term suicide should be abandoned in reference to what has been called physician-assisted suicide. I argue that there are (...) no good conceptual or philosophical reasons to avoid the suicide label. I contend that intending one’s death is essential to the nature of suicide, and this intention is normally required on the part of the terminally ill patient when she knowingly takes a life-ending drug. Additionally, the analysis shows that any plausible strategy that avoids the term suicide is counteracted by the way in which advocates of the practice want to make it legal. (shrink)

Governments and policy-makers have of late displayed renewed attention to behavioural research in an attempt to achieve a range of policy goals, including health promotion. In particular, approaches which could be labelled as ‘nudges’ have gained traction with policy-makers. A range of objections to nudging have been raised in the literature. These include claims that nudges undermine autonomy and liberty, may lead to a decrease in responsibility in decision-making, lack transparency, involve deception, and involve manipulation, potentially occasioning coercion. In this (...) article I focus on claims of coercion, examining nudges within two of the main approaches to coercion—the pressure approach and the more recent enforcement approach. I argue that coercion entails an element of control over the behaviour of agents which is not plausibly displayed by the kinds of serious examples of nudges posited in the literature. (shrink)

ABSTRACT:This article considers the economic case for so-called sweatshop wages and working conditions. My goal is not to defend or reject the economic case for sweatshops. Instead, proceeding from a broadly pluralist understanding of value, I make and defend a number of claims concerning the ethical relevance of economic analysis for values that different agents utilize to evaluate sweatshops. My arguments give special attention to a series of recent articles by Benjamin Powell and Matt Zwolinski, which represent the latest and (...) best defense of the economic case for sweatshops. In the process, I challenge Zwolinski’s “non-worseness claim”, and the idea that opposition to sweatshop wages and working conditions fails to respect that the autonomy of would-be sweatshop workers. Ultimately, I conclude that even if the economic case for sweatshops rests on a solid empirical foundation, agents possess good reason to advocate for better wages and working conditions for sweatshop workers, and to prefer less exploitative or coercive relationships. Sweatshop labor undermines a compelling vision of free markets, according to both Kantian and republican conceptions of freedom, and the relationships formed by those who participate in such markets. (shrink)

ABSTRACT:This article considers the economic case for so-called sweatshop wages and working conditions. My goal is not to defend or reject the economic case for sweatshops. Instead, proceeding from a broadly pluralist understanding of value, I make and defend a number of claims concerning the ethical relevance of economic analysis for values that different agents utilize to evaluate sweatshops. My arguments give special attention to a series of recent articles by Benjamin Powell and Matt Zwolinski, which represent the latest and (...) best defense of the economic case for sweatshops. In the process, I challenge Zwolinski’s “non-worseness claim” (NWC), and the idea that opposition to sweatshop wages and working conditions fails to respect that the autonomy of would-be sweatshop workers. Ultimately, I conclude that even if the economic case for sweatshops rests on a solid empirical foundation, agents possess good reason to advocate for better wages and working conditions for sweatshop workers, and to prefer less exploitative or coercive relationships. Sweatshop labor undermines a compelling vision of free markets, according to both Kantian and republican conceptions of freedom, and the relationships formed by those who participate in such markets. (shrink)

According to an often repeated definition, economics is the science of individual choices and their consequences. The emphasis on choice is often used – implicitly or explicitly – to mark a contrast between markets and the state: While the price mechanism in well-functioning markets preserves freedom of choice and still efficiently coordinates individual actions, the state has to rely to some degree on coercion to coordinate individual actions. Since coercion should not be used arbitrarily, coordination by the state needs to (...) be legitimized by the consent of its citizens. The emphasis in economic theory on freedom of choice in the market sphere suggests that legitimization in the market sphere is “automatic” and that markets can thus avoid the typical legitimization problem of the state. In this paper, I shall question the alleged dichotomy between legitimization in the market and in the state. I shall argue that it is the result of a conflation of choice and consent in economics and show how an independent concept of consent makes the need for legitimization of market transactions visible. Footnotes1 For helpful comments and suggestions I am most grateful to Marc Fleurbaey, Alain Marciano, Herlinde Pauer-Studer, Thomas Pogge, Hans Bernhard Schmid, to seminar or conference participants in Aix-Marseille, Tutzing, Paris, and Amsterdam, and to two anonymous referees. (shrink)

The way in which consent to sexual interactions is understood in the US is undergoing a transformation. Many universities, sometimes at the behest of lawmakers, are moving to adopt ‘affirmative consent’ policies, which define consent in terms of affirmative behavior that goes beyond mere silence or lack of resistance. Although these policies are a move in the right direction, I argue that their content has not been properly understood. In particular, the circumstances in which nonverbal behavior may communicate consent are (...) more limited than might be apparent. And even though these circumstances can be abstractly identified, it is difficult to give people adequate guidance about when some of them obtain. Moreover, I argue that no matter how the allowance for nonverbal behavior is construed, affirmative consent policies unnecessarily prohibit interactions that people may have reason to engage in. I propose an alternative policy that remedies these problems with the affirmative consent policies that are currently being implemented. And I note that the justification for this alternative policy does not turn on any special features of the university setting. Instead, the account I give suggests grounds for reforming the law as well. (shrink)

Kidney transplantation is the most efficacious and cost-effective treatment for end-stage renal disease. However, the treatment’s accessibility is limited by a chronic shortage of transplantable kidneys, resulting in the death of numerous patients worldwide as they wait for a kidney to become available. Despite the implementation of various measures the disparity between supply and needs continues to grow. This paper begins with a look at the current treatment options, including various sources of transplantable kidneys, for end-stage renal disease. We propose, (...) in accordance with others, the introduction of compensated kidney donation as a means of addressing the current shortage. We briefly outline some of the advantages of this proposal, and then turn to examine several of the ethical arguments usually marshaled against it in a bid to demonstrate that this proposal indeed passes the ethics test. Using available data of public opinions on compensated donation, we illustrate that public support for such a program would be adequate enough that we can realistically eliminate the transplant waiting list if compensation is introduced. We urge a pragmatic approach going forward; altruism in living kidney donation is important, but altruism only is an unsuccessful doctrine. (shrink)

Research Articles Christopher W. Morris, Social Philosophy and Policy, FirstView Article.

ABSTRACT The article begins by contrasting medical and moral views of addiction and how such views influence responsibility and policy analysis. It suggests that since addiction always involves action and action can always be morally evaluated, we must independently decide whether addicts do not meet responsibility criteria rather than begging the question and deciding by the label of ?disease? or ?moral weakness?. It then turns to the criteria for criminal responsibility and shows that the criteria for criminal responsibility, like the (...) criteria for addiction, are all folk psychological. Therefore, any scientific information about addiction must be ?translated? into the law's folk psychological criteria. Distractions about responsibility are then quickly canvassed. Then it addresses the direct relation between addiction and criminal responsibility. It argues that most addicts retain sufficient rational and control capacities at the relevant times to be held responsible, especially for crimes that are not part of the definition of addiction itself. It suggests that there is good reason to excuse or mitigate addicts for the crimes of purchase and possession for personal use. It concludes by briefly considering what contemporary science can contribute to our understanding of addiction and agency. (shrink)

The relationship between law and coercion has been, and still is, a central topic in legal philosophy. Despite this, discussion about it is immersed in confusion. Some philosophers have noticed this, but hardly any work has been done to attempt to solve or even identify the confusions. This paper aims to fill this gap. Here I propose distinctions and qualifications that help us clarify the relationship between law and coercion and avoid confusion. Building on the clarificatory work, I then argue (...) that despite there being several distinct philosophical discussions about the relationship between law and coercion, one of them should be prioritised. (shrink)

The idea that payment for research participation can be coercive appears widespread among research ethics committee members, researchers, and regulatory bodies. Yet analysis of the concept of coercion by philosophers and bioethicists has mostly concluded that payment does not coerce, because coercion necessarily involves threats, not offers. In this article we aim to resolve this disagreement by distinguishing between two distinct but overlapping concepts of coercion. Consent-undermining coercion marks out certain actions as impermissible and certain agreements as unenforceable. By contrast, (...) coercion as subjection indicates a way in which someone’s interests can be partially set back in virtue of being subject to another’s foreign will. While offers of payment do not normally constitute consent-undermining coercion, they do sometimes constitute coercion as subjection. We offer an analysis of coercion as subjection and propose three possible practical responses to worries about the coerciveness of payment. (shrink)

Coercion by the recipient of consent renders that consent invalid. But what about when the coercive force comes from a third party, not from the person to whom consent would be proffered? In this paper I analyze how threats from a third party affect consent. I argue that, as with other cases of coercion, we should distinguish threats that render consent invalid from threats whose force is too weak to invalidate consent and threats that are legitimate. Illegitimate controlling third party (...) threats render consent invalid just as they do in two party cases. However, knowing that the consent is invalid is not sufficient to tell the recipient of consent what she may or should do. I argue that when presented with a token of consent from someone whom she thinks is experiencing an illegitimate controlling threat, the recipient may act on that token if and only if doing so represents a reasonable joint decision for her and the victim of coercion. The appropriate action for someone faced with third party coercion therefore depends on the other options open to her and those open to the victim of coercion. (shrink)

Philosophy and Phenomenological Research, EarlyView. Despite the acknowledgement of the moral significance of consent there is still much work to be done in determining which specific sexual encounters count as unproblematically consensual. This paper focuses on the impact of deception. It takes up the specific case of deception about one's self. It may seem obvious that one ought not to lie to a sexual partner about who one is, but determining which features of oneself are most relevant, as well as (...) the lies which it follows would be impermissible to tell, is complicated. It is argued here that deception about one's morally valenced character traits, those we think of as virtues and vices, are particularly problematic. This is true regardless of whether knowing the truth about those traits would have made a difference to one's partner's consent. Attention is then drawn to a range of types of lies that one ought not to tell. (shrink)

The problem of standard of care in clinical research concerns the level of treatment that investigators must provide to subjects in clinical trials. Commentators often formulate answers to this problem by appealing to two distinct types of obligations: professional obligations and natural duties. In this article, I investigate whether investigators also possess institutional obligations that are directly relevant to the problem of standard of care, that is, those obligations a person has because she occupies a particular institutional role. I examine (...) two types of institutional contexts: (1) public research agencies – agencies or departments of states that fund or conduct clinical research in the public interest; and (2) private-for-profit corporations. I argue that investigators who are employed or have their research sponsored by the former have a distinctive institutional obligation to conduct their research in a way that is consistent with the state's duty of distributive justice to provide its citizens with access to basic health care, and its duty to aid citizens of lower income countries. By contrast, I argue that investigators who are employed or have their research sponsored by private-for-profit corporations do not possess this obligation nor any other institutional obligation that is directly relevant to the ethics of RCTs. My account of the institutional obligations of investigators aims to contribute to the development of a reasonable, distributive justice-based account of standard of care. (shrink)

Clients may feel trapped into sharing their private digital data with insurance companies to get a desired insurance product or premium. However, private insurance must collect some data to offer products and premiums appropriate to the client’s level of risk. This situation creates tension between the value of privacy and common insurance business practice. We argue for three main claims: first, coercion to share private data with insurers is pro tanto wrong because it violates the autonomous choice of a privacy-valuing (...) client. Second, we maintain that irrespective of being coerced, the choice of accepting digital surveillance by insurers makes it harder for the client to protect his or her autonomy. The violation of autonomy also makes coercing customers into digital surveillance pro tanto morally wrong. Third, having identified an economically plausible process involving no direct coercion by insurers, leading to the adoption of digital surveillance, we argue that such an outcome generates further threats against autonomy. This threat provides individuals with a pro tanto reason to prevent this process. We highlight the freedom dilemma faced by regulators who aim to prevent this outcome by constraining market freedoms and argue for the need for further moral and empirical research on this question. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 19-20, August 2011.

Advances in immunotherapy pave the way for vaccines that target not only infections, but also unhealthy behaviors such as smoking. A nicotine vaccine that eliminates the pleasure associated with smoking could potentially be used to prevent children from adopting this addictive and dangerous behavior. This paper offers an ethical analysis of such vaccines. We argue that it would be permissible for parents to give their child a nicotine vaccine if the following conditions are met: (1) the vaccine is expected to (...) result in a net benefit to each individual vaccinated, (2) the expected harms from the side effects of the vaccine are lower than the non-voluntary harms of smoking, and (3) there are no less manipulative methods available that are as effective at preventing smoking initiation. Finally, we show how the framework developed here could be used to analyze the ethics of other chemical interventions designed to modify children’s behavior. (shrink)

I defend one way of solving the Impermissibility Problem—that is, the problem that on moralized approaches to coercion, coerciveness and permissibility are mutually exclusive. This brings up intuitive difficulties for cases such as taxation, which seem to be both coercive and permissible. I gloss three popular theories of coercion—the moralized baseline, nonmoralized baseline, and enforcement approaches—and conclude that only the nonmoralized baseline approach clearly solves the problem. However, Robert Nozick’s famous “slave case” raises another serious issue for the nonmoralized baseline (...) approach. So, in order to solve both the slave case and the Impermissibility Problem, I draw on Grant Lamond’s discussion of the coerciveness of law to propose the pro tanto wrong approach. On this approach, coercion is not impermissible simpliciter, but requires some sort of special justification. The pro tanto wrong approach is moralized, but on it, moralization comes in coercion’s need for justification, not in whether it is, in fact, justified. Thus impermissibility is neither necessary nor sufficient for coerciveness, and the Impermissibility Problem is avoided. I conclude that solving the problem in this way is desirable because it preserves a core belief of liberalism: certain acts, including taxation, may be both coercive and permissible. (shrink)

The tradable refugee quota scheme constitutes one proposal for institutionalising the general right to asylum. The scheme allows states to purchase and sell quotas of refugees that are initially assigned to them through a collectivised status-determination process. In this paper I focus on examining the ethical dimensions of one particular component of the tradable refugee quota scheme: the market. I consider three objections against the quota trading practices: ‘the preference objection’, ‘the dignity objection’, and ‘the exploitation objection’. The first objection (...) suggests that the tradable quota scheme is problematic due to the fact that it fails to consider refugees’ desires regarding the final country in which asylum is provided. The second objection claims that the scheme demeans refugees and violates their dignity. The final objection claims that the scheme leads to the exploitation of weak countries. I argue that the objections fail to show that the tradable quota scheme is inherently problematic. I conclude that either the examined objections can be rejected or it is possible to address the concerns through specific institutional arrangements. (shrink)

Social contract theory has a rich history. It originated among the ancients with recognition that social arrangements were not products of nature but convention. It developed through the centuries as theorists sought ethical criteria for distinguishing good conventions from bad. The search for such ethical criteria continues in recent attempts to apply social contract theory to organizations. In this paper, I question the concept ofconsent as a viable ethical criterion, and I argue for an alternate principle of impartiality as a (...) more appropriate moral norm in a social contracttheory of organizations. (shrink)

This article provides a comment on The Force of Law, which is Schauer's new and illuminating contribution to the place of law in our societies and in our lives. It constitutes a strong defence of the importance of coercion in law. First, I consider cases where the law is not able to motivate human behaviour adequately, in order to show that legal coercion is not always justified. Second, I examine the Rawlsian distinction between the ideal and the nonideal theory and (...) its application to the theory of law. Third, I tentatively argue that coercion has no place in ideal theory, but a core place in nonideal theory. In this way, it may be plausible to reconstruct the motivation to accept the law, at least when the law is normatively justified. (shrink)

This article addresses the impact of the potential conflict between the roles of physicians who are both clinicians and researchers on the recruitment of persons into research trials. It has been proposedthat a physician breaches inter-role confidentiality when he or she uses information gathered in his or her clinical role to inform patients about trials for which they may be eligible and that clinician-researchers should adopt a model of preliminary consent to be approached about research prior to commencing a clinical (...) relationship. This article argues that even if we grant the legitimacy of inter-role confidentiality (which is open to question), there are circumstances in which other obligations physicians bear override the obligation of inter-role confidentiality. Moreover, it is argued that the practice of preliminary consent is morally suspect and that such consent cannot be deemed valid. The article concludes with a series of recommendations of ways in which the legitimate concern regarding the conflicting roles of clinician-researchers can be addressed in the recruitment stage of research. (shrink)

Though political philosophers often presuppose that coercive enforcement is fundamental to law, many legal philosophers have doubted this. This article explores doubts of two types. Some legal philosophers argue that given an adequate account of coercion and coerciveness, the enforcement of law in actual legal systems will generally not count as coercive. Others accept that actual legal systems enforce many laws coercively, but they deny that law has a necessary connection with coercion. There can be individual laws that lack coercive (...) sanctions, and it is at least conceptually possible for there to be a legal system that lacks coercive enforcement altogether. This article then examines why most political philosophers and some legal philosophers have been reluctant to treat the conceptual possibility of non-coercive law as significant. (shrink)

This paper considers the relation between medical ethics (ME) and common morality (CM), professional norms, and moral philosophy. It proceeds by analyzing two recent book-length critical analyses of this relationship by Bob Baker in “The Structure of Moral Revolutions—Studies of Changes in the Morality of Abortion, Death, and the Bioethics Revolution” and Rosamond Rhodes in “The Trusted Doctor—Medical Ethics and Professionalism.” It argues that despite the strengths of these critical arguments, there is nevertheless a relationship between ME, understood as the (...) professional ethics of the healthcare professions, and both CM and moral philosophy. It also argues that ME cannot and should not be understood purely as the internally developed professional norms of the medical or healthcare professions. (shrink)

ABSTRACTSome suggest that the duty of humanitarian intervention should be discharged by states that are historically responsible for the occurrence of violence. A fundamental problem with this suggestion is that historically responsible states might be ill-suited to intervene because they are unlikely to enjoy support from the local population. Cécile Fabre has suggested a way around that problem, arguing that responsible states ought to pay for humanitarian interventions even though they ought not to take part in the military operations. We (...) claim that Fabre’s idea is subject to two concerns. First, the duty to perform might not be appropriately transferrable from the historically responsible state to another state because it would allow the primary duty bearer to escape the worst costs of intervention. Second, an intervention might be as unlikely to generate local support when a historically responsible state pays for an intervention as when it performs it. These problems are enough to cast doubt on Fabr... (shrink)

According to Rainer Forst, a critical theory of power must break with the tendency of political theorists to conceive of power in opposition to normativity. Appropriately, Forst proposes a noumenal definition according to which power is normative: It works through recognition of reasons and is thereby open to critical assessment. In this discussion note, I first clarify the normativity of power in Forst’s noumenal theory by means of Donald Davidson’s theory of action and then explain how theory of action leads (...) to a different understanding of force and violence from Forst’s noumenal theory. In doing this, I find reason to endorse a non-normative definition of power on the lines proposed by Robert Dahl and endorsed by most authors in analytical political theory. This definition nevertheless remains faithful to Forst’s methodological guideline that a theory of power must keep in view the relations between power and normativity. (shrink)

Treatment pressures are communicative strategies that mental health professionals use to influence the decision-making of mental health service users and improve their adherence to recommended treatment. Szmukler and Appelbaum describe a spectrum of treatment pressures, which encompasses persuasion, interpersonal leverage, offers and threats, arguing that only a particular type of threat amounts to informal coercion. We contend that this account of informal coercion is insufficiently sensitive to context and fails to recognize the fundamental power imbalance in mental healthcare. Based on (...) a set of counterexamples, we argue that what makes a proposal coercive is not whether service users will actually be made worse off if they reject the proposal, but rather whether they have the justified belief that this is the case. Whether this belief is justified depends on the presence of certain contextual factors, such as strong dependency on professionals and the salient possibility of formal coercion. (shrink)

Most anti-paternalists claim that informed and competent self-regarding choices are protected by autonomy, while ill-informed or impaired self-regarding choices are not. Joel Feinberg, among many others, argues that we can in this way distinguish impermissible “hard” paternalism from permissible “soft” paternalism. I argue that this view confronts two related problems in its treatment of ill-informed decision-makers. First, it faces a dilemma when applied to decision-makers who are responsible for their ignorance: it either permits too much, or else too little, intervention (...) to satisfy its proponents. Second, the most promising rationales in favor of the view ignore the distinction between an agent’s voluntarily bringing about some state of affairs, on the one hand, and an agent’s voluntarily assuming a risk, on the other. I conclude that a decision-maker’s ignorance is irrelevant to the permissibility of intervention on her behalf. If it is permissible to intervene in a given ill-informed choice, it would be permissible to intervene in an otherwise similar but informed choice, at least provided that intervention would produce similar benefits in both cases. This shows that we should sometimes accept straightforwardly paternalistic rationales. (shrink)

A question that has recently attracted considerable attention is this: What is the nature and significance of the normative relationship a person bears to herself ? On one view, it is held that persons are self-owners : as Locke put it in one of the more famous passages in the Second Treatise : [E]very man has a property in his own person : this no body has any right to but himself. The labour of his body, and the work of (...) his hands, we may say, are properly his. (shrink)

In this paper I propose to continue the analysis of the appeal to authority begun at the last OSSA conference. I proceed by examining the well-documented use of the appeal made by the ancient Roman advocate, Cicero. The fact that Cicero expressed his opinion was expectably sufficient to give his auditors--responsible citizens all--reason to do as he desired. But why? The resolution of this puzzle points to a strong sense in which arguments can be called rhetorical , for the rational (...) force of Cicero's authority depends necessarily on what he says. (shrink)

Psychopathy is a disorder involving personality and behavioral features associated with a high rate of violent aggression and recidivism. This paper explores potential psychopharmacological therapies to modulate dysfunctional neural pathways in psychopaths and reduce the incidence of their harmful behavior, as well as the ethical and legal implications of offering these therapies as an alternative to incarceration. It also considers whether forced psychopharmacological intervention in adults and children with psychopathic traits manifesting in violent behavior can be justified. More generally, the (...) paper addresses the question of how to weigh the psychopath’s presumptive right to non-interference in his brain and mind against the public interest in avoiding harm. (shrink)

Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...) at school or day-care by default, without requiring parental authorization, but with parents retaining the right to opt their children out of vaccination. We show that such a policy is likely to be effective, at least in cases in which non-vaccination is due to practical obstacles, rather than to strong beliefs about vaccines, ethically acceptable and less controversial than some alternatives because it is not coercive and affects individual autonomy only in a morally unproblematic way, and likely to receive support from the UK public, on the basis of original empirical research we have conducted on the lay public. (shrink)

Justificatory liberalism is liberal in an abstract and foundational sense: it respects each as free and equal, and so insists that coercive laws must be justified to all members of the public. In this essay I consider how this fundamental liberal principle relates to disputes within the liberal tradition on “the extent of the state.” It is widely thought today that this core liberal principle of respect requires that the state regulates the distribution of resources or well-being to conform to (...) principles of fairness, that all citizens be assured of employment and health care, that no one be burdened by mere brute bad luck, and that citizens' economic activities must be regulated to insure that they do not endanger the “fair value” of rights to determine political outcomes. I argue in this essay: a large family of liberal views are consistent with the justificatory liberals project, from classical to egalitarian formulations ; overall, the justificatory project tilts in the direction of classical formulations. (shrink)

This paper argues that extortion is a clear threat in intergenerational relations, and that the threat is manifest in some existing proposals in climate policy and latent in some background tendencies in mainstream moral and political philosophy. The paper also claims that although some central aspects of the concern about extortion might be pursued in terms of the entitlements of future generations, this approach is likely to be incomplete. In particular, intergenerational extortion raises issues about the appropriate limits to the (...) sway of central values such as welfare and distributive justice. We should be wary of ways in which such values invite us to buy off, or perhaps to join, an intergenerational climate Mafia. (shrink)

This paper concerns the relationship between two questions. The first is a question about inner freedom: What is it to be rendered unfree, not by external obstacles, but by aspects of oneself? The second is a question about agency: What is it to fail at being a thing that genuinely acts, and instead to be a thing that is merely acted upon, passive in relation to its own behaviour? It is widely believed that answers to the first question must rest (...) on or be partly explained by answers to the second. Here I argue that this is a mistake: losses of inner freedom are not, after all, explicable in terms of failures of agency. To establish this conclusion, I consider three familiar lines of thought that appear to tie ideas about inner freedom to ideas about agency, each relating to a different conception of inner freedom: absence of inner constraint, self-government, and absence of determination by external forces. I argue that, in each case, any apparent conceptual reliance on a special conception of agency is merely illusory, the result being that we must allow clear water between our theories of inner freedom and our theories of agency. This conclusion is of significance for contemporary theories of agency and personal autonomy, as well as for ‘positive’ conceptions of political liberty. (shrink)

:A common justification offered for unequal pay is that it encourages socially beneficial productivity. G. A. Cohen famously criticizes this argument for not questioning the behaviour and attitudes that make those incentives necessary. I defend the communal status of incentives against Cohen's challenge. I argue that Cohen's criticism fails to appreciate two different contexts in which we might grant incentives. We might grant unequal payment to someone because they demand it. However, unequal payment might be an offer instead. I claim (...) that incentives as offers promote the ideal of society as a cooperative venture for mutual advantage. (shrink)

In this paper, we examine how the availability of massive quantities of data i.e., the “Big Data” phenomenon, contributes to the creation, spread, and harms of online misinformation. Specifically, we argue that a factor in the problem of online misinformation is the evolved human instinct to recognize patterns. While the pattern-recognition instinct is a crucial evolutionary adaptation, we argue that in the age of Big Data, these capacities have, unfortunately, rendered us vulnerable. Given the ways in which online media outlets (...) profit from the spread of misinformation by preying on this pattern-finding instinct, we conceptualize the problem that we identify as a morally objectionable form of “epistemic exploitation.” As we argue, the consumer of digital misinformation is often exploited by having her pattern-recognition instinct used against her. This exploitation is morally objectionable because it deprives her of an epistemic good to which she has a right. This epistemic good is the integrity of the pattern-recognition instinct itself which, we argue, is a capacity that allows us to participate in uniquely human goods. While our primary goal is to bring attention to this form of epistemic exploitation, we conclude by briefly evaluating some general solutions to the growing problem of online misinformation. (shrink)

For several decades, Kant scholars, inspired by the Groundwork false-promising example, have constructed consent-based criteria for using another merely as a means. Unfortunately, these consent-based accounts produce assessments that are both counter-intuitive and un-Kantian in relatively simple cases. This article investigates why these consent-based accounts fail and offers an alternative. The Groundwork false-promising example has encouraged a problematically narrow understanding of the conditions for using another merely as a means in virtue of the fact that the example involves a consent-sensitive (...) duty. This article demonstrates that the scope of the prohibition on using another merely as a means includes both consent-sensitive and consent-insensitive duties and offers a duty-based account that reflects this. (shrink)

Background Notwithstanding the need to produce evidence-based knowledge on medications for pregnant women, they remain underrepresented in clinical research. Sometimes they are excluded because of their supposed vulnerability, but there are no universally accepted criteria for considering pregnant women as vulnerable. Our aim was to explore whether and if so to what extent pregnant women are vulnerable as research subjects. Method We performed a conceptual and empirical analysis of vulnerability applied to pregnant women. Analysis A conceptual analysis supports Hurst's definition (...) of vulnerability. Consequently, we argue that pregnant women are vulnerable if they encounter an identifiably increased likelihood of incurring additional or greater wrong. According to the literature, this increased likelihood could exist of four alleged features for pregnant women's vulnerability: informed consent, susceptibility to coercion, higher exposure to risk due to lack of knowledge, vulnerability of the fetus. Discussion Testing the features against Hurst's definition demonstrates that they all concern the same issue: pregnant women are only vulnerable because a higher exposure to risk due to lack of scientific knowledge comprises an increased wrong. Research Ethics Committees have a responsibility to protect the vulnerable, but a higher exposure to risk due to lack of scientific knowledge is a much broader issue and also needs to be addressed by other stakeholders. Conclusions The only reason why pregnant women are potentially vulnerable is to the extent that they are increasingly exposed to higher risks due to a lack of scientific knowledge. Accordingly, the discussion can advance to the development of practical strategies to promote fair inclusion of pregnant women in clinical research. (shrink)

Substantial research efforts have been devoted to developing a cure for autism, but some advocates of people with autism claim that these efforts are misguided and even harmful. They claim that there is nothing wrong with people with autism, so there is nothing to cure. Others argue that autism is a serious and debilitating disorder and that a cure for autism would be a wonderful medical breakthrough. Our goal in this essay is to evaluate what assumptions underlie each of these (...) positions. We evaluate the arguments made on each side, reject those that are implausible and then highlight the key assumptions of those that remain. (shrink)

Peterson, Karlawish, and Largent’s “Supported Decision Making with People at the Margins of Autonomy” not only elucidates the conceptual framework but also the practical importance of suppor...

The recent TeGenero phase I trial of a novel monoclonal antibody in healthy volunteers produced a drastic inflammatory reaction in participants receiving the experimental agent. Commentators on the ethics of the research have focused considerable attention on the role of financial considerations: the for-profit status of the biotechnology company and Contract Research Organization responsible respectively for sponsoring and conducting the trial and the amount of monetary compensation to participants. We argue that these financial considerations are largely irrelevant and distort ethical (...) appraisal of this tragic research. Except for administering the antibody to all 6 participants nearly simultaneously, the trial appears to fulfill all of the critical ethical requirements for clinical research—social value, scientific validity, fair subject selection, favorable risk-benefit ratio, independent review, informed consent, and respect for enrolled participants. (shrink)

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (shrink)

For decades, worries about undue inducement have Pervaded clinical research, and are especially common when research is accompanied by payment or conducted in developing countries. Few ethical judgments carry as much moral opprobrium or are thought to undermine the ethical soundness of a clinical trial as thoroughly as undue inducement. Indeed, the admonition to prevent undue inducement is one of the few explicit instructions in the Common Rules requirements for informed consent.Despite their long history and pervasiveness, charges of undue inducement (...) in clinical research are almost always mistaken. Indeed, I will advance an even more radical claim: Aresearch trial that otherwise fulfills the fundamental ethical requirements for human subjects research inherently cannot create the possibility of undue inducement because substantial risk of serious harm isprecluded. Charges of undue inducement tend to express displaced and mislabeled ethical concerns about other aspects of human subjects research. Consequently, claims of undue inducement should rarely be made, and when they are advanced should be treated with skepticism, placing a heavy burden of proofon those advancing such charges. (shrink)

Much discussion of the ethics of participation focuses on electoral participation and whether citizens are obligated or can be coerced to vote. Yet these debates have ignored that citizens must first pay attention to politics and make up their minds about where they stand before they can engage in any form of participation. This article considers the importance for liberal democracy of citizens paying attention to politics, or attentive citizenship. It argues that the democratic state has an obligation to cultivate (...) interest in politics and that this obligation authorizes means up to and including some forms of coercion. The argument is that when citizens are inattentive to politics, it undermines political equality and social justice because it undermines what John Rawls called the fair value of the political liberties. The importance of these ends for liberal democratic states requires them to take steps to promote attentive citizenship. (shrink)