:Self-ownership theorists argue that many of our most morally urgent and enforceable rights stem from the fact that we own ourselves. Critics of self-ownership argue that the claim that people own their bodies commits self-ownership theorists to several implausible conclusions because self-ownership theory relies on several vague moral predicates, and any precisification of the required predicates is seemingly too permissive or too restrictive. I argue that this line of criticism does not undermine the case for self-ownership theory because self-ownership theory (...) does not require precisification of each moral concept that it is based on and, even if it did, the theory’s alleged extensional inadequacy does not undermine its justification. (shrink)

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate legal regulation. We (...) also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

This paper discusses Jessica Flanigan’s book, _Pharmaceutical Freedom_. The paper advances two main claims. First, the paper argues that, despite what Flanigan claims, there is a coherent way to endorse the Doctrine of Informed Consent while resisting the view that there is a right to self-medicate. Second, the paper argues that Flanigan is committed to a more radical conclusion than she acknowledges in the book; namely, that under some conditions it is morally permissible for people to take medications from drug (...) manufacturers or pharmacies without paying the full price for those medications. The paper concludes by suggesting that this thesis about permissible theft, when combined with some further premises regarding the morality of defensive force, implies some even more radical conclusions regarding the use of force to obtain these medications. (shrink)

Jessica Flanigan argues that individuals have the right to self-medicate. Flanigan presents two arguments in defense of this right. The first she calls the epistemic argument and the second she calls the rights-based argument. I argue that the right to self-medicate hangs and falls on the rights-based argument. This is because for the epistemic argument to be sound agents must be assumed to be epistemically competent. But, Flanigan’s argument for a constitutionally mandated right to self-medicate models agents as epistemically incompetent. (...) For Flanigan, agents are different at the pharmacy than they are at the polls. I identify this behavioral asymmetry and advocate a symmetric and realistic behavioral postulate for both arguments. The result, however, is that the success of the epistemic argument becomes contingent which fails to justify a constitutionally mandated right. I proceed to raise skepticism about the rights-based argument as well. I conclude that there is reason to be skeptical that these arguments can justify a constitutionally mandated right to self-medicate. Ultimately, a bottom-up approach to pharmaceutical ethics is preferable. (shrink)

In her Pharmaceutical Freedom, Jessica Flanigan argues that antibiotics can be regulated consistent with her otherwise largely deregulatory view with respect to pharmaceuticals and recreational drugs. I contend in this essay that the reasons for justifying antibiotic regulation are reasons that can be offered to justify the regulation of many other drugs, both pharmaceutical and recreational. After laying out the specifics of Flanigan’s view, I suggest that it is amenable to the regulation of drugs like varenicline. Though such drugs can (...) legitimately improve the quality of a patient’s life by helping them quit smoking, they could be permissibly regulated if they expose others to impermissible risks. I then argue that recreational drugs like alcohol could be regulated using the same reasoning. In the penultimate section of this essay, I anticipate objections that one might have to my extension of arguments favoring antibiotic regulation to drugs correlated with aggression. Flanigan might find my extrapolation of her view as entirely plausible and accept that her view is relatively friendly to these regulations, or she might reconsider her antibiotic caveat if these regulations are overly paternalistic on her understanding. I conclude by briefly considering the benefits and drawbacks of adopting each view. (shrink)

Patient-driven drug development is an emerging approach to pharmaceutical research that is forged in rare-disease communities and patient advocacy networks. Patients and their advocates increasingly engage in drug discovery and influence early-stage drug research as clinical trial participants or through compassionate-use programs. Some advocacy groups and patients also influence which therapies are developed by financing promising treatments that otherwise would not secure funding. Though some critics of patient-driven drug development worry about the ethical and scientific implications of this new approach (...) to research, it also has several advantages over the current system. In this essay I argue that patient-driven drug development is morally permissible. (shrink)

Jessica Flanigan defends patients' rights of self-medication on the grounds that same moral reasons against medical paternalism in clinical contexts are also reasons against paternalistic pharmaceutical policies, including prohibitive approval processes and prescription requirements.

Several philosophers have defended versions of Minimax Complaint, or MC. According to MC, other things equal, we should act in the way that minimises the strongest individual complaint. In this paper, I argue that MC must be rejected because it has implausible implications in certain cases involving risk. In these cases, we can apply MC either ex ante, by focusing on the complaints that could be made based on the prospects that an act gives to people, or ex post, by (...) focusing on the complaints that could be made based on the actual results that an act has for people. I argue that MC has implausible implications either way. I then defend a view on which, other things equal, we should act in the way that minimizes the sum of complaints. (shrink)

Deontologists have long been upbraided for lacking an account of justified decision- making under risk and uncertainty. One response is to develop a deontological decision theory—a set of necessary and sufficient conditions for an act’s being permissible given an agent’s imperfect information. In this article, I show that deontologists can make more use of regular decision theory than some might have thought, but that we must adapt decision theory to accommodate agent- centered options—permissions to favor or sacrifice our own interests, (...) when doing so is overall morally worse. Accommodating options requires more than just amend- ing the decision-theoretic ‘value function’. We must change the decision rule as well. (shrink)

This paper takes on several distinct but related tasks. First, I present and discuss what I will call the “Ignorance Thesis,” which states that whenever an agent acts from ignorance, whether factual or moral, she is culpable for the act only if she is culpable for the ignorance from which she acts. Second, I offer a counterexample to the Ignorance Thesis, an example that applies most directly to the part I call the “Moral Ignorance Thesis.” Third, I argue for a (...) principle—Don’t Know, Don’t Kill—that supports the view that the purported counterexample actually is a counterexample. Finally, I suggest that my arguments in this direction can supply a novel sort of argument against many instances of killing and eating certain sorts of animals. (shrink)

Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person’s self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic errors (...) in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view. (shrink)

In _Pharmaceutical Freedom_ Professor Flanigan argues we ought to grant people self-medication rights for the same reasons we respect people’s right to give (or refuse to give) informed consent to treatment. Despite being the most comprehensive argument in favour of self-medication written to date, Flanigan’s _Pharmaceutical Freedom_ leaves a number of questions unanswered, making it unclear how the safe-guards Flanigan incorporates to protect people from harming themselves would work in practice. In this paper, I extend Professor Flanigan’s account by discussing (...) a hypothetical case to illustrate how these safe-guards could work together to protect people from harms caused by their own ignorance or incompetence. (shrink)

It is natural for those with permissive attitudes toward abortion to suppose that, if they have examined all of the arguments they know against abortion and have concluded that they fail, their moral deliberations are at an end. Surprisingly, this is not the case, as I argue. This is because the mere risk that one of those arguments succeeds can generate a moral reason that counts against the act. If this is so, then liberals may be mistaken about the morality (...) of abortion. However, conservatives who claim that considerations of risk rule out abortion in general are mistaken as well. Instead, risk-based considerations generate an important but not necessarily decisive reason to avoid abortion. The more general issue that emerges is how to accommodate fallibilism about practical judgment in our decision-making. (shrink)