This essay details the resurgence of wellness program as employed by large corporations with the aim of reducing healthcare costs. The essay narrows in on a discussion of how Big Data collection practices are being utilized in wellness programs and the potential negative impact on the worker in regards to privacy and employment discrimination. The essay offers an ethical framework to be adopted by wellness program vendors in order to conduct wellness programs that would achieve cost-saving goals without undue burdens (...) on the worker. The essay also offers some innovative approaches to wellness that may well better serve the goals of healthcare cost reduction. (shrink)

In this paper, I argue that a definition of paternalism must meet certain methodological constraints. Given the failings of descriptivist and normatively charged definitions of paternalism, I argue that we have good reason to pursue a normatively neutral definition. Archard's 1990 definition is one such account. It is for this reason that I return to Archard's account with a critical eye. I argue that Archard's account is extensionally inadequate, failing to capture some cases which are clear instances of paternalism. I (...) refine each of his three conditions, ultimately providing an improved definition of paternalistic interference. This revised definition meets specific methodological constraints, offering a definition that is both neutral between anti- and pro-paternalistic intuitions, but that also explains why paternalism is normatively significant. Specifically, this definition captures the conflict between interfering with an individual's choices and treating the individual benevolently, without making paternalism permissible or impermissible by definition. (shrink)

Das von Cass Sunstein und Richard Thaler ausgearbeitete Projekt eines Libertären Paternalismus stellt fraglos einen der zurzeit meistdiskutierten neopaternalistischen Theorieentwürfe dar. Als hybride Mischung zwischen Theorieprogramm, politischer Bewegung und praxis- und anwendungsorientiertem Policy-Manual, das zuweilen Züge eines populären philosophischen Lebensratgebers trägt, hat Libertärer Paternalismus viel Zuspruch, aber auch heftige Kritik auf sich gezogen, die in diesem Aufsatz auf ihre Plausibilität geprüft werden. Zu diesem Zweck geben die Autoren zunächst einen kurzen Überblick über Ausgangspunkte, Leitorientierungen und Problemvorgaben des Theorie- und Politikprogramms (...) des Libertären Paternalismus. In einem zweiten Schritt werden zentrale Konzepte und Unterscheidungen des libertär paternalistischen Rationales vorgestellt und problematisiert. Daran anschließend werden drei der prominentesten Kritikpunkte an Libertärem Paternalismus auf den Prüfstand gestellt. Hierzu gehören der Manipulationseinwand, Kritiken, die sich auf grundlegende Rechtfertigungsprobleme des Libertären Paternalismus beziehen, und Einwände, die auf langfristige negative Folgen des Nudging verweisen. (shrink)

The precautionary principle has often been described as an extreme principle that neglects science and stifles innovation. However, such an interpretation has no support in the official definitions of the principle that have been adopted by the European Union and by the signatories of international treaties on environmental protection. In these documents, the precautionary principle is a guideline specifying how to deal with certain types of scientific uncertainty. In this contribution, this approach to the precautionary principle is explicated with the (...) help of concepts from the philosophy of science and comparisons with general notions of practical rationality. Three major problems in its application are discussed, and it is concluded that to serve its purpose, the precautionary principle has to (1) be combined with other decision principles in cases with competing top priorities, (2) be based on the current state of science, which requires procedures for scientific updates, and (3) exclude potential dangers whose plausibility is too low to trigger meaningful precautionary action. (shrink)

Proposals for regulating or nudging healthy choices are controversial. Opponents often argue that individuals should take responsibility for their own health, rather than be paternalistically manipulated for their own good. In this paper, I argue that people can take responsibility for their own health only if they satisfy certain epistemic conditions, but we live in an epistemic environment in which these conditions are not satisfied. Satisfying the epistemic conditions for taking responsibility, I argue, requires regulation of this environment. I describe (...) some proposals for such regulation and show that we cannot reject all regulation in the name of individual responsibility. We must either regulate individuals’ healthy choices or regulate the epistemic environment. (shrink)

There are no national recommendations for routine screening for sickle cell trait, nor is there guidance on whether or how to notify donors that they might be tested or identified as having sickle cell trait. As a result, the organizations that collect blood have implemented variable policies about whether and how to inform prospective donors of the possible screening and discovery of this noncommunicable condition. The question of what they should do is related to the broader question of how to (...) handle incidental and secondary findings. In a recent report, the Presidential Commission for the Study of Bioethical Issues outline a framework for handling such findings in the clinical, research, and direct‐to‐consumer contexts. While the commission's report did not directly address incidental and secondary findings in the public health context of blood donation, it made several overarching recommendations that apply in all contexts where such findings might arise. This essay outlines the special issues raised by discovering sickle cell trait in blood donation and considers the implications of the commission's framework for that problem. (shrink)

Food-related non-communicable diseases such as obesity, type 2 diabetes and cardiovascular diseases are key threats to public health. Yet, the responsibility for food-related health harms is contested. While traditionally viewed as mainly an individual responsibility or a governmental responsibility, fingers are nowadays also pointed at the food and beverage industry, as many firms are producing and marketing unhealthy products that contribute to the rise of obesity and other food-related NCDs. Yet, does the behaviour of the industry and the impact its (...) products have on public health also give reason for moral concern? Are these firms doing anything wrong? Are there normative considerations on the basis of which it can be argued that food and beverage firms have a responsibility for public health? This thesis explores the moral grounds for firms in the food and beverage industry to address food-related public health problems, and simultaneously reflects upon what taking responsibility for these problems could entail in practice. Drawing on debates in business ethics, political philosophy, and public health ethics, it is argued that food and beverage firms have distinct responsibilities for food-related health problems, and that these responsibilities spring from considerations of _non-maleficence_, _respect for autonomy _and _justice_. The thesis makes clear how responsibility for public health can be understood as an essentially shared responsibility, and outlines what taking responsibility could entail for various firms in the food and beverage industry and makes recommendations on what kind of behaviour firms should no longer engage in. (shrink)

Motorcycle helmet laws are perceived to infringe upon individual rights even though they reduce mortality and health care costs. We describe proposed helmet legislation that protects individual rights and provides incentives for helmet use through a differential motorcycle registration fee that requires higher fees for those who wish to ride without a helmet.