Whenever some form of beneficent killing--for example, voluntary euthanasia--is advocated, the proposal is greeted with a flood of slippery-slope arguments warning of the dangers of a Nazi-style slide into genocide. This paper is an attempt systematically to evaluate arguments of this kind. Although there are slippery-slope arguments that are sound and convincing, typical formulations of the Nazi-invoking argument are found to be seriously deficient both in logical rigour and in the social history and psychology required as a scholarly underpinning. As (...) an antidote, an attempt is made both to identify some of the likely causes of genocide and to isolate some of the more modest but legitimate fears that lie behind slippery-slope arguments of this kind. (shrink)

We frequently engage in activities that impose a risk of serious harm on innocent others in order to realise trivial benefits for ourselves or third parties. Many moral theories tie the evidence-relative permissibility of engaging in such activities to the size of the risk that an individual agent imposes. I argue that we should move away from such a reliance on quantified individual risks when conceptualising morally permissible risk imposition. Under most circumstances of interest, a conscientious reasoner will identify a (...) gap between the factors they deem potentially relevant to the riskiness of an agent’s behaviour, and the factors they are reasonably able to quantify. This then leads a conscientious reasoner to conclude that they cannot, in good faith, come up with a quantitative risk estimate that is genuinely tailored to the agent’s particular situation. Based on this, I argue that principles of morally permissible risk imposition fail to provide us with practical guidance if they ask us to take into account our agent-specific risks in a quantified manner. I also argue that principles of permissible risk imposition which appeal to quantified individual risks implausibly imply that it is frequently indeterminate whether engaging in some risky activity is morally permissible. For both of these reasons, I contend that principles of morally permissible risk imposition should make no reference to quantified individual risks. They should instead acknowledge that any quantitative estimates that an agent might usefully be able to consider will likely not be tailored to the agent’s idiosyncratic situation. (shrink)

This paper argues that mandatory, government-enforced vaccination can be justified even within a libertarian political framework. If so, this implies that the case for mandatory vaccination is very strong indeed as it can be justified even within a framework that, at first glance, loads the philosophical dice against that conclusion. I argue that people who refuse vaccinations violate the ‘clean hands principle’, a moral principle that prohibits people from participating in the collective imposition of unjust harm or risk of harm. (...) In a libertarian framework, individuals may be forced to accept certain vaccines not because they have an enforceable duty to serve the common, and not because cost–benefit analysis recommends it, but because anti-vaxxers are wrongfully imposing undue harm upon others. (shrink)

This paper argues that mandatory, government-enforced vaccination can be justified even within a libertarian political framework. If so, this implies that the case for mandatory vaccination is very strong indeed as it can be justified even within a framework that, at first glance, loads the philosophical dice against that conclusion. I argue that people who refuse vaccinations violate the ‘clean hands principle’, a moral principle that prohibits people from participating in the collective imposition of unjust harm or risk of harm. (...) In a libertarian framework, individuals may be forced to accept certain vaccines not because they have an enforceable duty to serve the common, and not because cost–benefit analysis recommends it, but because anti-vaxxers are wrongfully imposing undue harm upon others. (shrink)

This paper answers two questions. First, on the assumption that risk of harm is of moral significance, does risk’s moral significance lay in its being harmful? Second, is risk of harm itself harmful? I argue that either risk is not harmful or that risk is harmful only in a small range of cases. If risk is not harmful, and yet risk is of moral significance, risk’s moral significance cannot lie in its being harmful. And if risk is harmful only in (...) a small range of the cases in which risk is of moral significance, risk’s moral significance cannot lie in its being harmful. (shrink)

We consider a special set of risky prospects in which the outcomes are either life or death. There are various alternatives to the utilitarian objective of minimizing the expected loss of lives in such prospects. We start off with the two-person case with independent risks and construct taxonomies of ex ante and ex post evaluations for such prospects. We examine the relationship between the ex ante and the ex post in this restrictive framework: There are more possibilities to respect ex (...) ante and ex post objectives simultaneously than in the general framework, i.e. without the restriction to binary utilities. We extend our results to n persons and to dependent risks. We study optimal strategies for allocating risk reductions given different objectives. We place our results against the backdrop of various pro-poorly off value functions for the evaluation of risky prospects. (shrink)

The Distribution View provides a model that integrates four distributional concerns in the evaluation of risky prospects. Starting from these concerns, we can generate an ordering over a set of risky prospects, or, starting from an ordering, we can extract a characterization of the underlying distributional concerns. Separability of States and/or Persons for multiple-person risky prospects, for single-person risky prospects and for multiple-person certain prospects are discussed within the model. The Distribution View sheds light on public health policies and provides (...) a framework for the discussion of Parfit's Priority View for risky prospects. (shrink)

Wherever a government or state is concerned with the welfare of its citizens, there will probably also exist policies which compel the individual citizen to undertake or abstain from activities which affect that citizen alone. The set of theories behind such policies is collectively known as ‘paternalism’. It is not hard to understand why this term has developed strong pejorative overtones. Policies of this type appear to offend a fundamental tenet of liberal societies: namely, that the individual is best placed (...) to know what is in his or her interests. Paternalistic policies imply, and are concerned with correcting, failures of precisely this kind of judgement. And yet, at the same time, there is a popular consensus that compelling people to wear a seat belt when driving a car is a reasonable restriction of personal liberty. Paternalism may be difficult to accept in principle, but it is equally difficult to avoid in practice. Not surprisingly, the literature reveals a long heritage of debate in a wide range of academic disciplines. This debate reveals a failure to make progress in two areas in particular. First, analyses of paternalism often confuse policies which are actually concerned with correcting failures of market exchange — in particular, those concerned with insufficient or imperfect information — with those which are genuinely paternalistic. One objective of this paper will be to clarify the difference between these two kinds of policy. (shrink)

(No abstract is available for this citation).

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so (...) is explained, and the implications of this position regarding the relation between rights and duties is explored. (shrink)

The question of when people may impose risks on each other is of fundamental moral importance. Forms of “quantified risk assessment,” especially risk cost-benefit analysis, provide one powerful approach to providing a systematic answer. It is also well known that such techniques can show that existing resources could be used more effectively to reduce risk overall. Thus it is often argued that some current practices are irrational. On the other hand critics of quantified risk assessment argue that it cannot adequately (...) capture all relevant features, such as “societal concern” and so should be abandoned. In this paper I argue that current forms of quantified risk assessment are inadequate, and in themselves, therefore, insufficient to demonstrate that current practices are irrational. In particular, I will argue that insufficient attention has been given to the cause of a hazard, which needs to be treated as a primary variable in its own right. However rather than reject quantified risk assessment I wish to supplement it by proposing a framework to make explicit the role causation plays in the understanding of risk, and how it interacts with factors which influence perception of risks and other attitudes to risk control. Once an improved description of risk perception is available it will become possible to have a more informed debate about the normative question: how safety should be regulated. (shrink)

Public health policies which involve active intervention to improve the health of the population are often criticized as paternalistic. This article argues that it is a mistake to frame our discussions of public health policies in terms of paternalism. First, it is deeply problematic to pick out which policies should count as paternalistic; at best, we can talk about paternalistic justifications for policies. Second, two of the elements that make paternalism problematic at an individual level—interference with liberty and lack of (...) individual consent—are endemic to public policy contexts in general and so cannot be used to support the claim that paternalism in particular is wrong. Instead of debating whether a given policy is paternalistic, we should ask whether the infringements of liberty it contains are justifiable, without placing any weight on whether or not those infringements of liberty are paternalistic. Once we do so, it becomes apparent that a wide range of interventionist public health policies are justifiable. (shrink)

The COVID-19 pandemic crisis has necessitated widespread adaptation of revised treatment regimens for both urgent and routine medical problems in patients with and without COVID-19. Some of these alternative treatments maybe second-best. Treatments that are known to be superior might not be appropriate to deliver during a pandemic when consideration must be given to distributive justice and protection of patients and their medical teams as well the importance given to individual benefit and autonomy. What is required of the doctor discussing (...) these alternative, potentially inferior treatments and seeking consent to proceed? Should doctors share information about unavailable but standard treatment alternatives when seeking consent? There are arguments in defence of non-disclosure; information about unavailable treatments may not aid a patient to weigh up options that are available to them. There might be justified concern about distress for patients who are informed that they are receiving second-best therapies. However, we argue that doctors should tailor information according to the needs of the individual patient. For most patients that will include a nuanced discussion about treatments that would be considered in other times but currently unavailable. That will sometimes be a difficult conversation, and require clinicians to be frank about limited resources and necessary rationing. However, transparency and honesty will usually be the best policy. (shrink)

Precautionary principles are frequently appealed to both in public policy and in discussions of individual decision-making. They prescribe omission or reduction of an activity, or taking precautionary measures whenever potential harmful effects of the activity surpass some threshold of likelihood and severity. One crucial appeal of precautionary principles has been that they seem to help guard against procrastinating on confronting certain kinds of risk. I raise a challenge for precautionary principles serving as effective action-guiding tools to guard against (policy) inaction, (...) procrastination, or recklessness. Since risks that are sufficiently harmful and sufficiently likely to fulfil the antecedent of a precautionary principle typically accumulate over time, precautionary principles are only effective if they constrain an agent’s decision-making over time. On the basis of this observation, I argue for two claims. First, to yield the verdicts proponents of precautionary principles would like to make, precautionary principles must be understood to be diachronic principles, which requires some added structure to how they are commonly formulated. Second, such diachronic precautionary principles invite policy procrastination and inaction in their own right, due to both the vagueness of thresholds, and because agents will often fail to abide by the principles if they ignore bygone risks. (shrink)

Pharmaceutical paternalism is the normative stance upheld by pharmaceutical regulatory agencies like the US Food and Drug Administration. These agencies prevent patients from accessing treatments declared safe and ineffective for the patient’s good without their consent. Libertarian critics of the FDA have shown a number of significant flaws in regulatory paternalism. Against these objections, I will argue that, in order to make an informed decision about treatments, a libertarian patient should request full disclosure of the uncertainty about an experimental treatment. (...) But pharmaceutical markets, on their own, are not a reliable source of information about such uncertainty. And companies have the power to capture any independent expert who may assess it. Therefore, the libertarian is better off deferring on an independent regulatory body the assessment of the pharmaceutical risks, constraining access to treatments until tested. (shrink)

Many activities impose risks of harm on other people. One such class of risks are those that individuals culpably impose on others, such as the risk arising from reckless driving. Do such risks in themselves constitute a harm, over and above any harm that actually eventuates? This paper considers three recent views that each answer in the affirmative. I argue that each fails to overcome what I call the ‘interference objection’. The risk of harm itself, whether taken as a subjective (...) or an objective risk, is unable to interfere with the interests of victims in order to constitute a harm. This does not mean that a risk of harm cannot itself be wrongful, but the conclusion does weaken the moral objectionableness of impositions of risks of harm. (shrink)

This essay answers two questions that continue to drive debate in moral and legal philosophy; namely, ‘Is a risk of harm a wrong?’ and ‘Is a risk of harm a harm?’. The essay’s central claim is that to risk harm can be both to wrong and to harm. This stands in contrast to the respective positions of Heidi Hurd and Stephen Perry, whose views represent prominent extremes in this debate about risks. The essay shows that there is at least one (...) category of risks – intentional impositions of risk on unconsenting agents – which can be both wrongful and harmful. The wrongfulness of these risks can be established when, on the balance of reasons, one ought not to impose them. The harmfulness of these risks can be established when the risks are shown to set back legitimate interests. In those cases where risks constitute a denial of the moral status of agents, risks set back agents’ interest in dignity. In these ways, the essay shows that there are instances when a risk can constitute both a wrong and a harm. (shrink)

This work shows that two problems—the reference class and the mental state of the agent—undermine the plausibility of the ‘blameworthiness tracks risk thesis’ (BTRT), which states, prima facie, an agent is more blameworthy for imposing a greater rather than smaller risk. The article first outlines core concepts. It then shows how the two problems undermine BTRT; namely, (1) no blame attribution based on risk imposition is unequivocal; (2) when the materialization of risk is subject to chance, an agent’s decision can (...) ground an equal degree of blameworthiness regardless of whether the risk is greater or lesser. (shrink)

Imposing pure risks—risks that do not materialise into harm—is sometimes wrong. The Harm Account explains this wrongness by claiming that pure risks are harms. By contrast, The Autonomy Account claims that pure risks impede autonomy. We develop two objections to these influential accounts. The Separation Objection proceeds from the observation that, if it is wrong to v then it is sometimes wrong to risk v‐ing. The intuitive plausibility of this claim does not depend on any account of the facts that (...) ground moral wrongness. This suggests a close relationship between the factors that make an act wrong and the factors that make risking that act wrong, which both accounts fail to recognise. The Determinism Objection holds that both accounts fail to explain the wrongness of pure risks in a deterministic world. We then develop an alternative—The Buck‐Passing Account—that withstands both objections. (shrink)

What makes careless conduct careless is easily one of the deepest and most contested questions in negligence law, tort theory, and moral theory. Answering it involves determining the conditions that make the imposition of risk unjustifiable, wrong, or impermissible. Yet there is a still deeper as well as overlooked and undertheorized question: Why does subjecting others to risk of harm call for justification in the first place? That risk can be impermissibly imposed upon otherspresupposes that imposing risk is the kind (...) of thing that can be impermissible. Unless imposing risk can be impermissible after all, unjustified risking is literally impossible. In this discussion, I explore what I call the moral significance of risking, arguing that the moral significance of risking resides in a certain kind of nonmaterial autonomy interest that is implicated whenever one imposes risk of harm on another. (shrink)

A common argument against lockdowns is that they restrict freedom. On this view, lockdowns might be effective in protecting public health, but their impact on freedom is purely negative. This article challenges that view. It argues that while lockdowns restrict freedom, so too do viruses. Since viruses restrict freedom and lockdowns protect us from viruses, lockdowns can protect us from the harmful effects that viruses have on freedom. The problem we face is not necessarily freedom versus public health. Sometimes it (...) is freedom itself—or its value or distribution—that provides reason for lockdowns. (shrink)

This paper surveys the current philosophical discussion of the ethics of risk imposition, placing it in the context of relevant work in psychology, economics and social theory. The central philosophical problem starts from the observation that it is not practically possible to assign people individual rights not to be exposed to risk, as virtually all activity imposes some risk on others. This is the ‘problem of paralysis’. However, the obvious alternative theory that exposure to risk is justified when its total (...) benefits exceed its total costs faces the standard distributional challenges of consequentialism. Forms of contractualism have been proposed as a solution, but how exactly such theories can be formulated remains problematic, especially when confronted with the difficult cases of mass, novel, risk such as climate change. (shrink)

The article investigates the resources of contractualist moral theory to make sense of the ethics of risk imposition. In some ways, contractualism seems well placed to explain how it can be reasonable to accept exposure to risk of harms whose direct imposition would not be acceptable. However, there are difficulties getting clear about what directness comes to here, especially given the difficulty of adequately motivating traditional views that assign ethical significance to what the agent intends as opposed to merely foreseeing. (...) The article considers two principles which might help the contractualist: the Redistribution Principle, which, while attractive, is perhaps somewhat too restrictive, and the Aim Consistency Principle, which grants ethical significance to the aims with which our actions are in principle consistent whatever our actual intentions may be. The article also considers the relative significance of ex ante and ex post perspectives from which to evaluate actions and principles. Key Words: contractualism • Doctrine of Double Effect • ethics • intention • justice • risk • T.M. Scanlon • utilitarianism. (shrink)

I argue that riskier killings of innocent people are, other things equal, objectively worse than less risky killings. I ground these views in considerations of disrespect and security. Killing someone more riskily shows greater disrespect for him by more grievously undervaluing his standing and interests, and more seriously undermines his security by exposing a disposition to harm him across all counterfactual scenarios in which the probability of killing an innocent person is that high or less. I argue that the salient (...) probabilities are the agent’s sincere, sane, subjective probabilities, and that this thesis is relevant whether your risk-taking pertains to the probability of killing a person or to the probability that the person you kill is not liable to be killed. I then defend the view’s relevance to intentional killing; show how it differs from an account of blameworthiness; and explain its significance for all-things-considered justification and justification under uncertainty. (shrink)

A natural view in distributive ethics is that everyone's interests matter, but the interests of the relatively worse off matter more than the interests of the relatively better off. I provide a new argument for this view. The argument takes as its starting point the proposal, due to Harsanyi and Rawls, that facts about distributive ethics are discerned from individual preferences in the "original position." I draw on recent work in decision theory, along with an intuitive principle about risk-taking, to (...) derive the view. (shrink)

Many believe that severe intellectual impairment, blindness or dying young amount to serious harm and disadvantage. It is also increasingly denied that it matters, from a moral point of view, whether something is biologically normal to humans. We show that these two claims are in serious tension. It is hard explain how, if we do not ascribe some deep moral significance to human nature or biological normality, we could distinguish severe intellectual impairment or blindness from the vast list of seemingly (...) innocent ways in which we fail to have as much wellbeing as we could, such not having super-intelligence, or not living to 130. We consider a range of attempts to draw this intuitive normative distinction without appealing to normality. These, we argue, all fail. But this doesn't mean that we cannot draw this distinction or that we must, implausibly, conclude that biological normality does possess an inherent moral importance. We argue that, despite appearances, it is not biological normality but rather statistical normality that, although lacking any intrinsic moral significance, nevertheless makes an important moral difference in ways that explain and largely justify the intuitive distinction. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Autonomy, Well-Being, Disease, and DisabilityJulian Savulescu (bio)Keywordsautonomy, well-being, mental disorder, psychiatric disease, disability, welfare, body integrity identity disorderVarelius seeks to redefine what constitutes mental disorder or mental illness. (I use these terms interchangeably.) "According to this account, 'a person is mentally disordered when her psychological capacity for autonomy is diminished as compared with that of a typical member of our species of her age-group" (Varelius 2009). This is a (...) stimulating and important paper. Varelius describes fruitfully the relationship between mental illness and autonomy, specifically the ways in which mental disorder can undermine autonomy. This is valuable in understanding the impact of mental illness on the lives of people who suffer from it, which is a serious issue in practical ethics. But is it what constitutes mental disorder or illness? There are logical, conceptual reasons why we should not redefine mental illness in this way.Incomplete Account of Mental DisorderThere are a family of related concepts: disease, injury, disorder, illness, disability. There are old and entrenched disputes about how we should define these concepts. Varelius' paper is a contribution to the definition of mental disorder and illness.The primary classificatory category that defines medical practice is that of health and disease. Disease, broadly construed, involves the presence of pathology. Pathology can result from processes primarily or predominantly internal to the organism, such as genetic disease (although external factors affect their expression), or from processes primarily or predominantly external to the organism, such as injuries.The concepts of disorder and illness relate to the concept of disease. Disorder could be defined in terms of the functional effect of pathology. Illness could be defined in terms of the experiential impact of disease.1 How these terms are precisely defined and related need not concern us at the present. What matters is that the primary category is disease.Psychiatry has evolved in its use of terminology. What used to be called psychiatric diseases are now often called mental disorders. I now claim, for the purposes of illustration of the argument (though it does not require this claim), that the dominant category is disease. Indeed, what are called mental disorders appear in the International Classification of Diseases.Disease can be divided into the mental and physical. I believe that the mental will one day be [End Page 59] shown to be shown to be entirely a subset of the physical. That is, that brain pathology will be a cause, if not the only cause, of mental disease. But others may believe the sets of mental and physical disease are intersecting but not coextensive.What matters is that mental disease is a subcategory of the more general category of disease. It must have the same definitional features as "disease" plus some extra ones specific to the "mental," or mind. (The same points apply if you use "disorder" as the dominant category rather than "disease.")One problem for Varelius is this: how does this autonomy account of "mental disease" relate to an account of "physical disease," and "disease" in general? If mental disease is defined in terms of its impact on the psychological capacities necessary for autonomy, how is "disease" in general, or physical disease, to be defined? One obvious response is to define these related concepts in a similar way:Disease: "a person is diseased when her capacity for autonomy is diminished as compared to that of a typical member of our species of her age-group." Physical disease: "a person is physically disordered when her physical capacity for autonomy is diminished as compared to that of a typical member of our species of her age-group."This interpretation is suggested by the following passage from Varelius:As contrasted with the actual condition of being autonomous, as a capacity of an individual autonomy means that a person has the psychological and bodily abilities that being autonomous... requires.(2009)It would be radical to define disease in general in terms of capacity for autonomy. There is no doubt that disease affects our autonomy, and that is morally significant, but these seem clearly separable concepts. Varelius could respond that he is not defining mental disease but rather the mental component... (shrink)

Baselines are commonly used to enable harm identification. The temporal, the counterfactual and the duty-based normative baselines are the most prominent. Each of these captures an aspect of common conceptions of what it is to harm and be harmed. However, each baseline also fails to deliver workable identifications of harm when presented with certain types of case. Problematic cases are found readily in childhood, a venue in which harm identification is often called for. Without a reliable means of identifying harm (...) in childhood, harm cannot properly play a central role in normative assessments of parental practices and state intervention. This paper presents childhood cases in which the prominent baselines fail and offers an alternative: the interest-based normative baseline. Should the interest-based normative baseline replace its rivals and reign supreme? I argue not, presenting a case for maintaining a suite of baselines for use in varying contexts. (shrink)

In this paper I examine the prospects for a rights-based approach to the morality of pure risk-imposition. In particular, I discuss a practical challenge to proponents of the thesis that we have a right against being imposed a risk of harm. According to an influential criticism, a right against risk-imposition will rule out all ordinary activities. The paper examines two strategies that rights theorists may follow in response to this “Paralysis Problem”. The first strategy introduces a threshold for when a (...) risk-imposition is a rights violation. The second strategy drops the claim that rights are absolute and maintains that all rights infringements generate compensation duties. It is argued that both strategies face significant practical problems of their own and that the Paralysis Problem seems fatal for a right against risk-imposition in the absence of an adequate account of the morally relevant threshold risk. (shrink)

The reference class problem arises when we want to assign a probability to a proposition (or sentence, or event) X, which may be classified in various ways, yet its probability can change depending on how it is classified. The problem is usually regarded as one specifically for the frequentist interpretation of probability and is often considered fatal to it. I argue that versions of the classical, logical, propensity and subjectivist interpretations also fall prey to their own variants of the reference (...) class problem. Other versions of these interpretations apparently evade the problem. But I contend that they are all “no-theory” theories of probability - accounts that leave quite obscure why probability should function as a guide to life, a suitable basis for rational inference and action. The reference class problem besets those theories that are genuinely informative and that plausibly constrain our inductive reasonings and decisions. I distinguish a “metaphysical” and an “epistemological” reference class problem. I submit that we can dissolve the former problem by recognizing that probability is fundamentally a two-place notion: conditional probability is the proper primitive of probability theory. However, I concede that the epistemological problem remains. (shrink)

This paper surveys the current philosophical discussion of the ethics of risk imposition, placing it in the context of relevant work in psychology, economics and social theory. The central philosophical problem starts from the observation that it is not practically possible to assign people individual rights not to be exposed to risk, as virtually all activity imposes some risk on others. This is the ‘problem of paralysis’. However, the obvious alternative theory that exposure to risk is justified when its total (...) benefits exceed its total costs faces the standard distributional challenges of consequentialism. Forms of contractualism have been proposed as a solution, but how exactly such theories can be formulated remains problematic, especially when confronted with the difficult cases of mass, novel, risk such as climate change. (shrink)

Cost–benefit analysis (CBA) is much more philosophically interesting than has in general been recognized. Since it is the only well-developed form of applied consequentialism, it is a testing-ground for consequentialism and for the counterfactual analysis that it requires. Ten classes of philosophical problems that affect the practical performance of cost–benefit analysis are investigated: topic selection, dependence on the decision perspective, dangers of super synopticism and undue centralization, prediction problems, the indeterminateness of our control over future decisions, the need to exclude (...) certain consequences for moral reasons, bias in the delimitation of consequences, incommensurability of consequences, difficulties in defending the essential requirement of transferability across contexts, and the normatively questionable but equally essential assumption of interpersonal compensability. (Published Online July 31 2007). (shrink)

Mainstream moral theories deal with situations in which the outcome of each possible action is well-determined and knowable. In order to make ethics relevant for problems of risk and uncertainty, moral theories have to be extended so that they cover actions whose outcomes are not determinable beforehand. One approach to this extension problem is to develop methods for appraising probabilistic combinations of outcomes. This approach is investigated and shown not to solve the problem. An alternative approach is then developed. Its (...) starting-point is that everyone has a prima facie moral right not to be exposed to risk. However, this right can be overridden if the risk-exposure is part of an equitable system for risk-taking that works to the advantage of the individual risk-exposed person. (shrink)

Many believe that severe intellectual impairment, blindness or dying young amount to serious harm and disadvantage. It is also increasingly denied that it matters, from a moral point of view, whether something is biologically normal to humans. We show that these two claims are in serious tension. It is hard explain how, if we do not ascribe some deep moral significance to human nature or biological normality, we could distinguish severe intellectual impairment or blindness from the vast list of seemingly (...) innocent ways in which we fail to have as much wellbeing as we could, such not having super‐intelligence, or not living to 130. We consider a range of attempts to draw this intuitive normative distinction without appealing to normality. These, we argue, all fail. But this doesn't mean that we cannot draw this distinction or that we must, implausibly, conclude that biological normality does possess an inherent moral importance. We argue that, despite appearances, it is not biological normality but rather statistical normality that, although lacking any intrinsic moral significance, nevertheless makes an important moral difference in ways that explain and largely justify the intuitive distinction. (shrink)

In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...) to these resources rather than use RAND to allocate such resources. (shrink)

Slippery slope arguments (SSAs) are used in a wide range of philosophical debates, but are often dismissed as empirically ill-founded and logically fallacious. In particular, leading authors put forward a meta-SSA which points to instances of empirically ill-founded and logically fallacious SSAs and to the alleged existence of a slippery slope leading to such SSAs to demonstrate that people should avoid using SSAs altogether. In this paper, I examine these prominent calls against using SSAs and argue that such calls do (...) not withstand scrutiny. I then identify several types of mechanisms leading to slippery slopes in real-life contexts to demonstrate that both the strength of SSAs and the justifiability of using SSAs are best assessed on a case-by-case basis. This result does not exempt the proponents of SSAs from the task of vindicating their use of SSAs. However, if correct, it undermines the often-made claim that people should avoid using SSAs altogether. (shrink)

This paper provides a philosophical assessment of leading theory-based, evidence-based and coherentist approaches to the definition and the measurement of well-being. It then builds on this assessment to articulate a reformed division of labor for the science of well-being and argues that this reformed division of labor can improve on the proffered approaches by combining the most plausible tenets of theory-based approaches with the most plausible tenets of coherentist approaches. This result does not per se exclude the possibility that theory-based (...) and coherentist approaches may be independently improved or amended in the years to come. Still, together with the challenges that affect these approaches, it strengthens the case for combining the most plausible tenets of those approaches. (shrink)

According to Jonathan Quong’s _moral status account_ of liability to defensive harm, an agent is liable to defensive harm only when she mistakenly treats others as if their moral status is diminished (for example, as if they lack a right that they in fact possess). Quong argues that, by the lights of the moral status account, a conscientious driver (Driver) who faultlessly threatens to kill Pedestrian is not liable to defensive harm. Quong argues that Driver’s action is evidence-relative permissible, despite (...) the risks it imposes, because the general practice of prudent driving is permissible. The practice is permissible because (a) its risks do not disproportionately fall on some groups rather than others, (b) the threatened harms are incidental, and (c) the risk that driving imposes is acceptable in light of the benefits everyone derives from driving. Because the correct moral theory tells us that prudent driving is permissible, Pedestrian lacks a right that Driver refrain from driving. Hence, Driver does not, by driving, treat Pedestrian as lacking a right that Pedestrian in fact possesses. Driver is not liable to defensive force. I argue, against Quong, that cost–benefit analyses of types of risky activity cannot justify individual tokens of risk imposition. Actions that risk incidentally harming others must be justified by the prospective benefits of that token action. Hence, Driver’s imposition of risk on Pedestrian cannot be justified by the benefits of the general practice of driving. I argue that the permissibility of Driver’s imposing risk on Pedestrian via prudent driving turns on whether Driver is willing to internalise at least the foreseeable costs of that risky action. One can lack a right that a person refrain from performing a risky action whilst possessing a right not to be harmed by that risky action. Even if Pedestrian cannot reasonably demand that Driver refrain from driving, she can reasonably demand that Driver refrain from forcing her to bear the costs of his driving. (shrink)

This paper considers the moral status of bystanders affected by medical research trials. Recent proposals advocate a very low threshold of permissible risk imposition upon bystanders that is insensitive to the prospective benefits of the trial, in part because we typically lack bystanders' consent. I argue that the correct threshold of permissible risk will be sensitive to the prospective gains of the trial. I further argue that one does not always need a person's consent to expose her to significant risks (...) of even serious harm for the sake of others. That we typically need the consent of participants is explained by the fact that trials risk harmfully using participants, which is very hard to justify without consent. Bystanders, in contrast, are harmed as a side-effect, which is easier to justify. I then consider whether the degree of risk that a trial may impose on a bystander is sensitive to whether she is a prospective beneficiary of that trial. (shrink)

This paper examines the efforts of contractualists to develop an alternative to aggregation to govern our duty not to harm (duty to rescue) others. I conclude that many of the moral principles articulated in the literature seem to reduce to aggregation by a different name. Those that do not are viable only as long as they are limited to a handful of oddball cases at the margins of social life. If extended to run-of-the-mill conduct that accounts for virtually all unintended (...) (in the sense of undesired) harm to others—noncriminal activities that impose some risk of harm on others—they would rule out all action. Moreover, because such conduct poses an irreducible conflict between freedom of action and freedom from expected harm, it can be regulated only by principles that accept the necessity of making precisely the sorts of interpersonal trade-offs that contractualism is foundationally committed to reject: trade-offs in which the numbers count, such that a risk of serious harm to one person can be justified by small benefits to the many. (shrink)

Seat belt mandates seem like a paradigmatic case of justified paternalism. Even those who generally object to paternalism often concede that seat belt laws are justified. Against this near-consensus in favor of mandates, I argue that seat belt laws are unjust and public officials should not enforce them. The most plausible exceptions to a principle of anti-paternalism do not justify seat belt mandates. Some argue that seat belt mandates are not paternalistic because unbelted riders are not fully autonomous. Others claim (...) that the decision to ride unbelted harms other people. Yet these attempts to defend seat belt mandates on non-paternalistic grounds cannot overcome the case against seat belt mandates. I therefore conclude that even seat belt mandates are unjust. With this comprehensive case against seat belt mandates, I demonstrate the more general difficulties in justifying any form of coercive paternalism. (shrink)

_ Source: _Page Count 24 Seat belt mandates seem like a paradigmatic case of justified paternalism. Even those who generally object to paternalism often concede that seat belt laws are justified. Against this near-consensus in favor of mandates, I argue that seat belt laws are unjust and public officials should not enforce them. The most plausible exceptions to a principle of anti-paternalism do not justify seat belt mandates. Some argue that seat belt mandates are not paternalistic because unbelted riders are (...) not fully autonomous. Others claim that the decision to ride unbelted harms other people. Yet these attempts to defend seat belt mandates on non-paternalistic grounds cannot overcome the case against seat belt mandates. I therefore conclude that _even_ seat belt mandates are unjust. With this comprehensive case against seat belt mandates, I demonstrate the more general difficulties in justifying any form of coercive paternalism. (shrink)

Vaccine refusal harms and risks harming innocent bystanders. People are not entitled to harm innocents or to impose deadly risks on others, so in these cases there is nothing to be said for the right to refuse vaccination. Compulsory vaccination is therefore justified because non-vaccination can rightly be prohibited, just as other kinds of harmful and risky conduct are rightly prohibited. I develop an analogy to random gunfire to illustrate this point. Vaccine refusal, I argue, is morally similar to firing (...) a weapon into the air and endangering innocent bystanders. By re-framing vaccine refusal as harmful and reckless conduct my aim is to shift the focus of the vaccine debate from non-vaccinators’ religious and refusal rights to everyone else’s rights against being infected with contagious illnesses. Religious freedom and rights of informed consent do not entitle non-vaccinators to harm innocent bystanders, and so coercive vaccination requirements are permissible for the sake of the potential victims of the anti-vaccine movement. (shrink)