According to much modern social psychology, behavioural economics and common sense, people's actions and beliefs are frequently the result of rapid intuitive thought rather than careful deliberation. Richard Thaler and Cass Sunstein, in their influential book, Nudge, synthesised the literature and used it as the basis for numerous policy ideas.1 Not least, they gave the word ‘nudge’ as a handy term to apply to all sorts of ways of taking advantage of people's psychological quirks without coercing or bribing them. But (...) while Nudge was long on ideas and enthusiasm, it was short on conceptual clarity. The idea of a nudge was inconsistent with some of the policies Thaler and Sunstein endorsed and their account of nudging's relation to freedom and paternalism was flawed.In Salvaging the concept of nudge, Yashar Saghai acts as a friendly critic who thinks nudging has plenty to offer the policy world but sees that it needs both conceptual clarity and ethical defence.2 He wants to show how some of ways of taking advantage of people's psychology could leave them as free as before and he is especially concerned with what I would describe as a question of manipulation: …. (shrink)

In recent years, ‘nudge’ theory has gained increasing attention for the design of population-wide health interventions. The concept of nudge puts a label on efficacious influences that preserve freedom of choice without engaging the influencees’ deliberative capacities. Given disagreements over what it takes genuinely to preserve freedom of choice, the question is whether health influences relying on automatic cognitive processes may preserve freedom of choice in a sufficiently robust sense to be serviceable for the moral evaluation of actions and policies. (...) In this article, I offer an argument to this effect, explicating preservation of freedom of choice in terms of choice-set preservation and noncontrol. I also briefly explore the healthcare contexts in which nudges may have priority over more controlling influences. (shrink)

Scientists have shown that the practice of factory farming is an increasingly urgent danger to human health, the environment, and nonhuman animal welfare. For all these reasons, moral agents must consider alternatives. Vegetarian food production, humane food animal farming, and in-vitro meat production are all explored from a variety of ethical perspectives, especially utilitarian and rights-based viewpoints, all in the light of current U.S. and European initiatives in the public and private sectors. It is concluded that vegetarianism and potentially in-vitro (...) meat production are the best-justified options. (shrink)

Testimony is a crucial source of knowledge: we are to a large extent reliant upon what others tell us. It has been the subject of much recent interest in epistemology, and this volume collects twelve original essays on the topic by some of the world's leading philosophers. It will be the starting point for future research in this fertile field. Contributors include Robert Audi, C. A. J. Coady, Elizabeth Fricker, Richard Fumerton, Sanford C. Goldberg, Peter Graham, Jennifer Lackey, Keith Lehrer, (...) Richard Moran, Frederick F. Schmitt, Ernest Sosa, and James Van Cleve. (shrink)

Our trust in the word of others is often dismissed as unworthy, because the illusory ideal of "autonomous knowledge" has prevailed in the debate about the nature of knowledge. Yet we are profoundly dependent on others for a vast amount of what any of us claim to know. Coady explores the nature of testimony in order to show how it might be justified as a source of knowledge, and uses the insights that he has developed to challenge certain widespread assumptions (...) in the areas of history, law, mathematics, and psychology. (shrink)

Although epistemic values have become widely accepted as part of scientific reasoning, non-epistemic values have been largely relegated to the "external" parts of science (the selection of hypotheses, restrictions on methodologies, and the use of scientific technologies). I argue that because of inductive risk, or the risk of error, non-epistemic values are required in science wherever non-epistemic consequences of error should be considered. I use examples from dioxin studies to illustrate how non-epistemic consequences of error can and should be considered (...) in the internal stages of science: choice of methodology, characterization of data, and interpretation of results. (shrink)

Suppose that we develop a medically safe and affordable means of enhancing human intelligence. For concreteness, we shall assume that the technology is genetic engineering (either somatic or germ line), although the argument we will present does not depend on the technological implementation. For simplicity, we shall speak of enhancing “intelligence” or “cognitive capacity,” but we do not presuppose that intelligence is best conceived of as a unitary attribute. Our considerations could be applied to specific cognitive abilities such as verbal (...) fluency, memory, abstract reasoning, social intelligence, spatial cognition, numerical ability, or musical talent. It will emerge that the form of argument that we use can be applied much more generally to help assess other kinds of enhancement technologies as well as other kinds of reform. However, to give a detailed illustration of how the argument form works, we will focus on the prospect of cognitive enhancement. (shrink)

Mandatory vaccination, including for COVID-19, can be ethically justified if the threat to public health is grave, the confidence in safety and effectiveness is high, the expected utility of mandatory vaccination is greater than the alternatives, and the penalties or costs for non-compliance are proportionate. I describe an algorithm for justified mandatory vaccination. Penalties or costs could include withholding of benefits, imposition of fines, provision of community service or loss of freedoms. I argue that under conditions of risk or perceived (...) risk of a novel vaccination, a system of payment for risk in vaccination may be superior. I defend a payment model against various objections, including that it constitutes coercion and undermines solidarity. I argue that payment can be in cash or in kind, and opportunity for altruistic vaccinations can be preserved by offering people who have been vaccinated the opportunity to donate any cash payment back to the health service. (shrink)

This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd immunity’, ‘public goods’, and ‘vaccine refusal’; and explains why failure (...) to vaccinate raises certain ethical issues. The second chapter analyses, from a philosophical perspective, the relationship between individual, collective, and institutional responsibilities with regard to the realisation of herd immunity. The third chapter is about the principle of least restrictive alternative in public health ethics and its implications for vaccination policies. Finally, the fourth chapter presents an ethical argument for unqualified compulsory vaccination, i.e. for compulsory vaccination that does not allow for any conscientious objection. The book will appeal to philosophers interested in public health ethics and the general public interested in the philosophical underpinning of different arguments about our moral obligations with regard to vaccination. (shrink)

Why our workplaces are authoritarian private governments—and why we can’t see it One in four American workers says their workplace is a “dictatorship.” Yet that number almost certainly would be higher if we recognized employers for what they are—private governments with sweeping authoritarian power over our lives. Many employers minutely regulate workers’ speech, clothing, and manners on the job, and employers often extend their authority to the off-duty lives of workers, who can be fired for their political speech, recreational activities, (...) diet, and almost anything else employers care to govern. In this compelling book, Elizabeth Anderson examines why, despite all this, we continue to talk as if free markets make workers free, and she proposes a better way to think about the workplace, opening up space for discovering how workers can enjoy real freedom. (shrink)

In their recently published book Nudge (2008) Richard H. Thaler and Cass R. Sunstein (T&S) defend a position labelled as ‘libertarian paternalism’. Their thinking appeals to both the right and the left of the political spectrum, as evidenced by the bedfellows they keep on either side of the Atlantic. In the US, they have advised Barack Obama, while, in the UK, they were welcomed with open arms by the David Cameron's camp (Chakrabortty 2008). I will consider the following questions. What (...) is Nudge? How is it different from social advertisement? Does Nudge induce genuine preference change? Does Nudge build moral character? Is there a moral difference between the use of Nudge as opposed to subliminal images to reach policy objectives? And what are the moral constraints on Nudge? (shrink)

In 2008 the Australian Government introduced a national reform agenda to increase organ and tissue donation. Australia continues to perform poorly by international standards on measures of organ procurement, however. This paper outlines three proposals to improve donation rates and considers the empirical evidence available for each. A number of ethical objections frequently given to resist such proposals are also addressed. Firstly, it is recommended that Australia implement an ‘opt-out’ system of organ donation. Secondly, the existing veto rules should be (...) changed to better protect the wishes of those who wish to donate. Finally, a numer of incentives should be offered to increase donation rates; these could include incentives of financial value, but also non-financial incentives such as prioritisation for the receipt of organs for previous donors. (shrink)

We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (...) despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies. We show that two types of arguments—namely a utilitarian argument based on Parfit’s Principle of Group Beneficence and a contractualist argument—can ground an individual moral obligation to be vaccinated, in spite of the imperceptible contribution that any single vaccination makes to vaccine coverage rates. We add a further argument for a moral obligation to be vaccinated that does not require embracing problematic comprehensive moral theories such as utilitarianism or contractualism. The argument is based on a “duty of easy rescue” applied to collectives, which grounds a collective moral obligation to realise herd immunity, and on a principle of fairness in the distribution of the burdens that must be borne to realise herd immunity. (shrink)

Philosophers have long agreed that moral responsibility might not only have a freedom condition, but also an epistemic condition. Moral responsibility and knowledge interact, but the question is exactly how. Ignorance might constitute an excuse, but the question is exactly when. Surprisingly enough, the epistemic condition has only recently attracted the attention of scholars, and it is high time for a full volume on the topic. The chapters in this volume address the following central questions. Does the epistemic condition require (...) akrasia? Why does blameless ignorance excuse? Does moral ignorance sustained by one’s culture excuse? Does the epistemic condition involve knowledge of the wrongness or wrongmaking features of one’s action? Is the epistemic condition an independent condition, or is it derivative from one’s quality of will or intentions? Is the epistemic condition sensitive to degrees of difficulty? Are there different kinds of moral responsibility and thus multiple epistemic conditions? Is the epistemic condition revisionary? What is the basic structure of the epistemic condition? (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)

Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be more effective in reducing influenza-related morbidity and mortality than those (...) targeting HCPs or the elderly. This is true even though influenza-related morbidity and mortality amongst children are low, except in the very young. Further, we argue that there are no decisive reasons to suppose that children-focused strategies are less ethically acceptable than elderly or HCP-focused strategies. (shrink)

The conservative, mainly Anglo-Saxon, critique of “social engineering” in Enlightenment thinking, which goes back to Edmund Burke and David Hume, among others, has recently resurfaced in the works of Michael Oakeshott, Roger Scruton, and Friedrich Hayek. This article focuses on their conservative critiques and more specifically on two common issues: the unintended negative consequences of political planning, and the institutions in civil society that act as a positive counterpart to this form of engineering.