Judicial review by constitutional courts is often presented as a necessary supplement to democracy. This book questions its effectiveness and legitimacy. Drawing on the republican tradition, Richard Bellamy argues that the democratic mechanisms of open elections between competing parties and decision-making by majority rule offer superior and sufficient methods for upholding rights and the rule of law. The absence of popular accountability renders judicial review a form of arbitrary rule which lacks the incentive structure democracy provides to ensure rulers treat (...) the ruled with equal concern and respect. Rights based judicial review undermines the constitutionality of democracy. Its counter-majoritarian bias promotes privileged against unprivileged minorities, while its legalism and focus on individual cases distort public debate. Rather than constraining democracy with written constitutions and greater judicial oversight, attention should be paid to improving democratic processes through such measures as reformed electoral systems and enhanced parliamentary scrutiny. (shrink)

Using the controversy over the MMR vaccine, I consider the reasons why non-experts should defer to experts, and I sketch a model for understanding cases where they fail to defer. I first suggest that an intuitively plausible model of the expert/non-expert relationship is complicated by shifting epistemic standards. One possible moderate response to this challenge, based on a more complex notion of non-experts' relationship with experts, seems unappealing as an account of the MMR controversy. A more radical suggestion is that (...) non-experts might have a political reason to defer to experts, when not doing so will involve ‘epistemological free-riding’. I investigate the implications. (shrink)

The philosophy of evidence-based medicine -- What is EBM? -- What is good evidence for a clinical decision? -- Ruling out plausible rival hypotheses and confounding factors : a method -- Resolving the paradox of effectiveness : when do observational studies offer the same degree of evidential support as randomized trials? -- Questioning double blinding as a universal methodological virtue of clinical trials : resolving the Philip's paradox -- Placebo controls : problematic and misleading baseline measures of effectiveness -- Questioning (...) the methodological superiority of "placebo" over "active" controlled trials -- Examining the paradox that traditional roles for mechanistic reasoning and expert -- Judgment have been up-ended by EBM -- A qualified defence of the EBM stance on mechanistic reasoning -- Knowledge that versus knowledge how : situating the EBM position on expert clinical judgment -- Moving EBM forward. (shrink)

author. University Professor in the School of Law, Columbia University. (From July 2006, Professor of Law, New York University.) Earlier versions of this Essay were presented at the Colloquium in Legal and Social Philosophy at University College London, at a law faculty workshop at the Hebrew University of Jerusalem, and at a constitutional law conference at Harvard Law School. I am particularly grateful to Ronald Dworkin, Ruth Gavison, and Seana Shiffrin for their formal comments on those occasions and also to (...) James Allan, Aharon Barak, Richard Bellamy, Aileen Cavanagh, Arthur Chaskalson, Michael Dorf, Richard Fallon, Charles Fried, Andrew Geddis, Stephen Guest, Ian Haney-Lopez, Alon Harel, David Heyd, Sam Issacharoff, Elena Kagan, Kenneth Keith, Michael Klarman, John Manning, Andrei Marmor, Frank Michelman, Henry Monaghan, Véronique Munoz-Dardé, John Morley, Matthew Palmer, Richard Pildes, Joseph Raz, Carol Sanger, David Wiggins, and Jo Wolff for their suggestions and criticisms. Hundreds of others have argued with me about this issue over the years: This Essay is dedicated to all of them, collegially and with thanks. (shrink)

Mainstream epistemology is a highly theoretical and abstract enterprise. Traditional epistemologists rarely present their deliberations as critical to the practical problems of life, unless one supposes—as Hume, for example, did not—that skeptical worries should trouble us in our everyday affairs. But some issues in epistemology are both theoretically interesting and practically quite pressing. That holds of the problem to be discussed here: how laypersons should evaluate the testimony of experts and decide which of two or more rival experts is most (...) credible. It is of practical importance because in a complex, highly specialized world people are constantly confronted with situations in which, as comparative novices, they must turn to putative experts for intellectual guidance or assistance. It is of theoretical interest because the appropriate epistemic considerations are far from transparent; and it is not clear how far the problems lead to insurmountable skeptical quandaries. This paper does not argue for flat-out skepticism in this domain; nor, on the other hand, does it purport to resolve all pressures in the direction of skepticism. It is an exploratory paper, which tries to identify problems and examine some possible solutions, not to establish those solutions definitively. (shrink)

The transformation of health-care delivery from fee-for-service medicine to managed care represents a fundamental philosophical shift away from the prevailing medical ethos that the needs of the individual patient take precedence over competing social values, such as reducing health-care costs. In managed care, financial incentives to reduce health-care utilization may result in denying an individual’s claim for medical services.Litigation challenging managed care’s resource allocation decisions often presents the need to resolve conflicting social policy goals, such as the tension between an (...) individual patient’s access to health care and a managed care organization’s need to restrain costs. Conflicts may arise when a patient’s desire for unconstrained health care clashes with a provider’s and an insurer’s cost containment strategies. In turn, cost containment strategies may raise questions about restrictions on physician autonomy and conflicts among stakeholders for control over resource allocation decisions. (shrink)

Jeremy Waldron is one of the world's leading legal and political philosophers. This collection brings together thirteen of his most recent essays which, in the course of working the book up for publication, the author has revisited and thoroughly revised. He addresses central issues within the liberal tradition, focusing on the law and its role in a pluralistic state which experiences deep disagreements about values and rights, and about the role of the state itself.

According to republican theory, we are free persons to the extent that we are protected and secured in the same fundamental choices, on the same public basis, as one another. But there is no public protection or security without a coercive state. Does this mean that any freedom we enjoy is a superficial good that presupposes a deeper, political form of subjection? Philip Pettit addresses this crucial question in On the People's Terms. He argues that state coercion will not involve (...) individual subjection or domination insofar as we enjoy an equally shared form of control over those in power. This claim may seem utopian but it is supported by a realistic model of the institutions that might establish such democratic control. Beginning with a fresh articulation of republican ideas, Pettit develops a highly original account of the rationale of democracy, breathing new life into democratic theory. (shrink)

Courts are increasingly obliged to adjudicate upon challenges to allocative decisions in healthcare, but their involvement continues to be regarded with unease, imperilling the legitimacy of the judicial role in this context. A central reason for this is that judges are perceived to lack sufficient expertise to determine allocative questions. This article critically appraises the claim of lack of judicial expertise through an examination of the various components of a limit-setting decision. It is argued that the inexpertise argument is weak (...) when compared with other rationales for judicial restraint, such as the procedural unsuitability and lack of constitutional competence of courts. (shrink)

How far should we go in protecting and promoting public health? Can we force people to give up unhealthy habits and make healthier choices, or does everyone have the right to decide their own lifestyle? Should we stop treating smokers who refuse to give up smoking? Should we put a tax on fatty foods and ban vending machines in schools to address the obesity epidemic? Should parents be required to have their children vaccinated? Are some of our screening programmes unethical (...) Downs syndrome screening, for example or should we be screening people for more conditions, such as Huntington disease? Such questions are at the heart of public health ethics. Holland shows that to understand and debate these issues requires philosophy: moral philosophies, such as utilitarianism and deontology, as well as political philosophies such as liberalism and communitarianism. And philosophy informs other aspects of public health, such as epidemiology and health promotion. The aim of this book is to provide a lively, accessible and philosophically informed introduction to such issues. It is an ideal textbook for students taking courses in public health ethics. And since this book develops systematic discussions of issues in public health ethics, there is also much here to engage and challenge the more advanced reader. (shrink)

In 'A Constitution of Many Minds' Cass Sunstein argues that the three major approaches to constitutional interpretation – Traditionalism, Populism and Cosmopolitanism – all rely on some variation of a ‘many-minds’ argument. Here we assess each of these claims through the lens of the Condorcet Jury Theorem. In regard to the first two approaches we explore the implications of sequential influence among courts (past and foreign, respectively). In regard to the Populist approach, we consider the influence of opinion leaders.

ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...) experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form.Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. (shrink)

John Coggon argues that the important question for analysts in the fields of public health law and ethics is 'what makes health public?' He offers a conceptual and analytic scrutiny of the salient issues raised by this question, outlines the concepts entailed in, or denoted by, the term 'public health' and argues why and how normative analyses in public health are inquiries in political theory. The arguments expose and explain the political claims inherent in key works in public health ethics. (...) Coggon then develops and defends a particular understanding of political liberalism, describing its implications for critical study of public health policies and practices. Covering important works from legal, moral, and political theory, public health, public health law and ethics, and bioethics, this is a foundational text for scholars, practitioners and policy bodies interested in freedoms, rights and responsibilities relating to health. (shrink)

This paper critically analyses the concept of evidence in evidence-based-policy arguing that there is key problem: that there is no existing practicable theory of evidence, one which is philosophically grounded and yet applicable for evidencebased policy. The paper critically considers both philosophical accounts of evidence and practical treatments of evidence in evidence-based-policy. It argues that both fail in different ways to provide a theory of evidence that is adequate for evidence-basedpolicy. The paper is a valuable contribution to the part of (...) the research project that explores how evidence can and should be used to reduce contingency in science, and policy based on science. (shrink)

This book examines the ways in which reasonable people can disagree about the requirements of political morality. Christopher McMahon argues that there will be a 'zone of reasonable disagreement' surrounding most questions of political morality. Moral notions of right and wrong evolve over time as new zones of reasonable disagreement emerge out of old ones; thus political morality is both different in different societies with varying histories, and different now from what it was in the past. McMahon explores this feature (...) of his theory in detail and traces its implications for the possibility of making moral judgments about other polities, past or present. His study sheds light on an important and often overlooked aspect of political life, and will be of interest to a wide range of readers in moral and political philosophy and in political theory. (shrink)