One fundamental healthcare issue brought to the fore by the current COVID-19 pandemic concerns the scope and nature of the right to healthcare. Given our increasing need for the usually limited healthcare resources, to what extent can we demand provision of these resources as a matter of right? One philosophical way of handling this issue is to clarify the nature of this right. Using the challenges of COVID-19 in the Philippines as the context of (...) analysis, we argue for the view that regards the right to healthcare as fundamentally moral in kind, which should thereby guide its legal and contractual appropriations. In particular, we respond to objections against this view stemming from issues concerning the universality and satisfiability of the right’s correlative duty. We deal with such issues by invoking the relative degree of incumbency of moral rights and the capability-relativity of positive duties. We further contend that as these factors define the scope of the moral right to healthcare, they thus constrain what we can demand as a matter of right to meet our healthcare needs in this time of the pandemic. (shrink)

In this chapter, I consider the prospects for deploying the concept of public reason in settling practical bioethical questions, focusing in particular on entitlements to healthcare. I begin by tracing the origins of the concept of public reason to the aspirations of the liberal political theorist to find a justification for the authority of government, which reconciles a basic belief in the autonomy of the individual with the legitimacy of the coercive institutions that create and govern the public sphere. (...) I then consider how the concept of public reason may be used in order to justify a universal entitlement to healthcare, paying particular attention to the work of Norman Daniels. Finally, I briefly consider the objection that an entitlement to healthcare grounded on such terms is insufficiently robust, because it downplays the values that healthcare encodes. I conclude by reflecting on whether the concept of public reason can be stretched to include a more robust conception of the value of health. (shrink)

Gender-affirming healthcare interventions are medical or surgical interventions that aim to allow trans and non-binary people to better affirm their gender identity. It has been argued that rights to GAH must be grounded in either a right to be cured of or mitigate an illness—gender dysphoria—or in harm prevention, given the high rates of depression and suicide among trans and non-binary people. However, these grounds of a right to GAH conflict with the prevalent view among theorists, institutions (...) and activists that trans and non-binary people do not have a mental illness and that one can be trans and entitled to GAH without being depressed or suicidal. This paper challenges the orthodoxy that a right to GAH must be grounded in either of these ways and instead argues for a right to GAH grounded in a right to live and act with integrity. The standard view, which this paper explains, is that our rights to live and act with integrity ground a right to religious accommodation in many cases such as a right to not be denied social security due to one’s refusal to work a job on a holy day. This paper argues that if our rights to live and act with integrity can ground prima facie rights to religious accommodation, our rights to live and act with integrity ground prima facie rights to GAH. There are no data in this work. (shrink)

Trans healthcare and thus trans people have been severely affected by the COVID-19 pandemic. Trans people’s healthcare situations have turned out to be so vulnerable in this crisis because they have been precarious to begin with. There are multiple ways in which trans healthcare has been affected: Surgeries and other procedures have been cancelled or postponed, and mental health services have been paused or moved online. This raises ethical questions around discrimination against trans people in the (...) class='Hi'>healthcare system. This article argues that cancelling trans surgeries and procedures in the COVID-19 crisis is made possible through an understanding of trans healthcare as non-essential. The article explores how trans healthcare in particular has been affected by the pandemic. (shrink)

There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from (...) the fact that a patient has an obligation to know that she does not also have a right not to know. The right not to know is held against medical professionals at a formal institutional level. We have reason to protect patients’ control over the information that they receive, even if in individual instances patients exercise this control in ways that violate obligations. (shrink)

The potential to collect brain data more directly, with higher resolution, and in greater amounts has heightened worries about mental and brain privacy. In order to manage the risks to individuals posed by these privacy challenges, some have suggested codifying new privacy rights, including a right to “mental privacy.” In this paper, we consider these arguments and conclude that while neurotechnologies do raise significant privacy concerns, such concerns are—at least for now—no different from those raised by other well-understood data (...) collection technologies, such as gene sequencing tools and online surveillance. To better understand the privacy stakes of brain data, we suggest the use of a conceptual framework from information ethics, Helen Nissenbaum’s “contextual integrity” theory. To illustrate the importance of context, we examine neurotechnologies and the information flows they produce in three familiar contexts—healthcare and medical research, criminal justice, and consumer marketing. We argue that by emphasizing what is distinct about brain privacy issues, rather than what they share with other data privacy concerns, risks weakening broader efforts to enact more robust privacy law and policy. (shrink)

The purpose of this article is to show that animal rights are not necessarily at odds with the use of animals for research. If animals hold basic moral rights similar to those of humans, then we should consequently extend the ethical requirements guiding research with humans to research with animals. The article spells out how this can be done in practice by applying the seven requirements for ethical research with humans proposed by Ezekiel Emanuel, David Wendler and Christine Grady to (...) animal research. These requirements are i) social value, ii) scientific validity, iii) independent review, iv) fair subject selection, v) favorable risk-benefit ratio, vi) informed consent, and vii) respect for research subjects. In practice, this means that we must reform the practice of animal research to make it more similar to research with humans, rather than completely abolish the former. Indeed, if we banned animal research altogether, then we would also deprive animals of its potential benefits – which would be ethically problematic. (shrink)

The rapid advancement of digital health innovation, including Artificial Intelligence (AI), is transforming healthcare. The growing role the European Union (EU) plays in regulating the use of AI in healthcare renders national laws insufficient to safeguard patients from unique AIrelated risks. This underscores the urgent need for the recognition of a canon of patients' rights in the scope of EU law. This paper proposes the blueprint for an EU Charter for Digital Patients' Rights, consolidating and adapting existing rights (...) for patients to address these specific challenges. Traditional patients' rights such as the right to privacy and the right to informed consent are interpreted in light of the challenges posed by AI. It also proposes novel rights for patients, such as the right not to be subject to automated medical decision-making and the right to meaningful human contact. This paper highlights the EU's central role in protecting patients' rights and outlines strategies for effective implementation. This comprehensive approach aims to address the current shortcomings and enhance the legal framework governing digital health in Europe. (shrink)

While there is a prolific debate surrounding the issue of conscientious objection of individuals towards performing certain clinical acts, this debate ignores the fact that there are other reasons why clinicians might wish to object providing specific services. This paper briefly discusses the idea that healthcare workers might object to providing specific services because they are against their professional judgement, they want to maintain a specific reputation, or they have pragmatic reasons. Reputation here is not simply understood as being (...) in good standing with a professional body. Rather, reputation is treated in the sense that a craftsman might wish to be known for providing a specific type, quality, and style of service. Professionalism is understood as acting according to the philosophical and scientific principles that are the basis of healthcare (such as acting for the benefit of the patient’s health and following well- evidenced treatment pathways). (shrink)

A dogma accepted in many ethical, religious, and legal frameworks is that the reasons behind conscientious objection (CO) in healthcare cannot be evaluated or judged by any institution because conscience is individual and autonomous. This paper shows that this background view is mistaken: the requirement to reveal and explain the reasons for conscientious objection in healthcare is ethically justified and legally desirable. Referring to real healthcare cases and legal regulations, this paper argues that these reasons should be (...) evaluated either ex ante or ex post and defends novel conceptual claims that have not been analyzed in the debates on CO. First, a moral threshold requirement: CO is only justified if the reasons behind a refusal are of a moral nature and meet a certain threshold of moral importance. Second, this paper considers the rarely discussed conceptual similarities between CO in healthcare and the legal regulations concerning military refusals that place the burden of proof on conscientious objectors. This paper concludes that conscientious objection in healthcare can be accommodated only in some cases of destroying or killing human organisms. (shrink)

Digital Rights Management (DRM) covers the description, identification, trading, protection, monitoring and tracking of all forms of rights over both tangible and intangible assets. The Digital Object Identifier (DOI) system provides a framework for the persistent identification of entities involved in this domain. Although the system has been very well designed to manage object identifiers, some important questions relating to the creation and assignment of identifiers are left open. The paradigm of a Referent Tracking System (RTS) recently advanced in the (...) healthcare and life sciences environment is able to fill these gaps. This is demonstrated by pointing out inconsistencies in the existing DOI models and by showing how they can be corrected using an RTS. (shrink)

Semantic interoperability can be defined as the ability of two or more computer systems to exchange information in such a way that the meaning of that information can be automatically interpreted by the receiving system accurately enough to produce useful results to the end users of both systems. Several activities are currently being performed by a variety of stakeholders to achieve semantic interoperability in healthcare. Many of these activities are not beneficial, because they place too great a focus on (...) business aspects and not enough on involvement of the right sorts of researchers, in particular those that are able to see how the data and information relate to the entities of concern on the side of the patient. The lack of a central focus on the patient, and the associated focus on ‘concepts’, have spawned a variety of mutually incompatible terminologies exhibiting non-resolvable overlap. The predominance of the healthcare IT industry in the writing and selection of semantic interoperability standards mitigates against the benefits that standards, when well designed, can bring about. (shrink)

The current debate on closed-loop brain devices (CBDs) focuses on their use in a medical context; possible criminal justice applications have not received scholarly attention. Unlike in medicine, in criminal justice, CBDs might be offered on behalf of the State and for the purpose of protecting security, rather than realising healthcare aims. It would be possible to deploy CBDs in the rehabilitation of convicted offenders, similarly to the much-debated possibility of employing other brain interventions in this context. Although such (...) use of CBDs could in principle be consensual, there are significant differences between the choice faced by a criminal offender offered a CBD in the context of criminal justice, and that faced by a patient offered a CBD in an ordinary healthcare context. Employment of CBDs in criminal justice thus raises ethical and legal intricacies not raised by healthcare applications. This paper examines some of these issues under three heads: autonomy, human rights, and accountability. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is (...) obligatory to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

The Artificial Intelligence (AI) is being used in healthcare in Jordan, paying special attention to the ethical and legal issues it brings. Although AI can greatly benefit health services by enhancing diagnostics, patient care, and how things run smoothly, it also raises some worries about data privacy, transparency, and following the rules. To understand the situation in Jordan better, the study involved a discussion group with healthcare workers, legal professionals, and AI experts. The results indicate that while the (...) Jordanian government is eager to embrace AI, there are some missing pieces when it comes to laws specifically for AI systems. Participants stressed the importance of strong regulations, clear ethical guidelines, and solid training for healthcare staff to make sure AI is used safely and fairly. If these issues are addressed, it could really change the way healthcare is delivered while ensuring that patient trust and ethical standards are upheld. (shrink)

This paper argues that assessing personal responsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients’ sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. The duty (...) of doctors and healthcare professionals is to help patients as best they can—not to judge them. Patients should not be forced into giving up any more personal information than what is strictly necessary to receive an adequate treatment, and their medical data should only be used for appropriate purposes. Medical ethics codes should reflect these data rights. When a doctor asks personal questions that are irrelevant to diagnose or treat a patient, the appropriate response from the patient is: ‘none of your business’. (shrink)

AI-enabled predictive analytics is widely deployed in clinical care settings for healthcare monitoring, diagnostics and risk management. The technology may offer valuable insights into individual and population health patterns, trends and outcomes. Predictive analytics may, however, also tangibly affect individual patient privacy and the right thereto. On the one hand, predictive analytics may undermine a patient’s state of privacy by constructing or modifying their health identity independent of the patient themselves. On the other hand, the use of predictive (...) analytics may violate the patient’s right to privacy if the patient has no control over the use or output of the technology. These repercussions ultimately erode patient autonomy and agency. This paper discusses these implications in further detail, and proposes possible measures for their mitigation. They involve the incorporation in the AI systems of accuracy-enhancing statistical models and methods, more privacy-conscious institutional policies and practices, and effective choice for patients to accept or refuse diagnostics and treatment drawing on AI-enabled predictive analytics. (shrink)

A number of health care professionals assert a right to be exempt from performing some actions currently designated as part of their standard professional responsibilities. Most advocates claim that they should be excused from these duties simply by averring that they are conscientiously opposed to performing them. They believe that they need not explain or justify their decisions to anyone; nor should they suffer any undesirable consequences of such refusal. Those who claim this right err by blurring or (...) conflating three issues about the nature and role of conscience, and its significance in determining what other people should permit them to do (or not do). Many who criticize those asserting an exemption conflate the same questions and blur the same distinctions, if not expressly, by failing to acknowledge that sometimes a morally serious agent should not do what she might otherwise be expected to do. Neither side seems to acknowledge that in some cases both claims are true: a conscientious professional should not do her professional duty AND others need not permit or excuse her refusal. I identify these conflations and specify conditions in which a professional might reasonably refuse to do what she is required to do. Then I identify conditions in which the public should exempt a professional from some of her responsibilities. I argue that professionals should refuse far less often than most advocates do . . . and that they should be even less frequently exempt for that failure. Finally, there are compelling reasons why we could not implement a consistent moral policy giving advocates what they want, likely not even in qualified form. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to participate (...) in the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

Corruption deprives people of access to health care and can lead to the wrong treatments being administered. Drug counterfeiting, facilitated by corruption, kills en masse. Cases are recorded of water being substituted for life-saving adrenaline and of active ingredients being diluted by counterfeiters, triggering drug-resistant strains of malaria, tuberculosis and HIV. The poor are disproportionately affected by corruption in the health sector, and cannot afford to pay for private alternatives where corruption has depleted public health services. Analysis of corruption in (...) the health sector of the UK can redress the information imbalance between UK government and service providers and patients. Health is a major global industry, a key responsibility and budget expense for governments and businesses. Corruption deprives people of access to health care and leads to poor health outcomes. (shrink)

Euthanasia and the duty to die have both been thoroughly discussed in the field of bioethics as morally justifiable practices within medical healthcare contexts. The existence of a narrow connection between both could also be established, for people having a duty to die should be allowed to actively hasten their death by the active means offered by euthanasia. Choosing the right time to end one’s own life is a decisive factor to retain autonomy at the end of our (...) lives. However, there is no definitive consensus on why physicians should be the ones performing the medical procedure to end a person’s life. The moral problems arising from such assertion are not to be taken lightly, for medical tradition has long regarded the duty not to kill, not to actively end a patient’s life, as the core moral obligation that gives meaning to the medical profession. Our concern is to question the moral justifiability of the arguments offered by physicians not to actively help patients die. (shrink)

The development of new methods in the field of prenatal testing leads to an expansion of information that needs to be provided to expectant mothers. The aim of this research is to explore opinions and attitudes of gynecologists in Germany, Poland and Russia towards access to prenatal testing and diagnostics in these countries. Semi-structured interviews were conducted with n = 18 gynecologists in Germany, Poland and Russia. The interviews were analyzed using the methods of content analysis and thematic analysis. Visible (...) in all three countries is a connection of prenatal medicine with the politically and socially contentious issue of pregnancy termination. Respondents in Poland and Russia concentrated on the topic of inadequate resources. Quality of information for expectant mothers is an important point in all three countries. Only in Germany was the issue of language barriers in communication raised. With regard to non-invasive prenatal testing (NIPT) respondents in Germany focused on the ethical issues of routinization of testing; in Poland and Russia they concentrated on fair access to NIPT. Challenges in all three countries arise from structural factors such as imprecise and prohibitive regulations, lack of resources or organization of healthcare services. These should be addressed on a political and medico-ethical level. (shrink)

English-speaking research on morally right decisions in a healthcare context over the past three decades has been dominated by two major perspectives, namely, the Four Principles, of which the principle of respect for autonomy has been most salient, and the ethic of care, often presented as a rival to not only a focus on autonomy but also a reliance on principles more generally. In my contribution, I present a novel ethic applicable to bioethics, particularly as it concerns human (...) procreation, that I argue is a promising alternative to these two approaches. According to this new moral theory, an act is right just insofar as it treats people’s capacity to commune with respect, where communing is a matter of identifying with others and exhibiting solidarity with them. This ethic is inspired by relational ideals of communion and harmony from the African philosophical tradition, but is shown to be attractive to a broad, indeed global, audience, with regard to its implications for the morality of reproduction. (shrink)

“Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper (...) is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law. (shrink)

The moral justification of intellectual property is often called into question when placed in the context of pharmaceutical patents and global health concerns. The theoretical accounts of both John Rawls and Robert Nozick provide an excellent ethical framework from which such questions can be clarified. While Nozick upholds an individuals right to intellectual property, based upon its conformation with Lockean notions of property and Nozicks ideas of just acquisition and transfer, Rawls emphasizes the importance of basic liberties, such as (...) an individuals right to health, superceding such secondary rights as intellectual property rights. From a policy perspective, patent protection for pharmaceutical products necessarily entails the balancing of corporate intellectual property interests and public interests in healthcare. The moral dilemma that occurs when these two interests clash is not easily resolved. Aside from corporate and public interests, the state maintains an interest in creating and preserving policies that regulate the moral dilemma itself. This paper analyzes the economic and ethical factors surrounding the production and distribution of the anti-HIV medication, AZT. Potential policy implications and recommendations are also discussed. (shrink)

This book provides answers to the questions that biomedical and biotechnological research has posed to our societies by proposing the introduction of biorights. It shows how bioscience affects our individual and social lives by discussing and answering important questions such as; Are we becoming more vulnerable and unable to protect ourselves? How can we ensure fairness and justice with regards to the access to health care? Are human dignity, autonomy and equality at risk? Do we need new and special rights: (...) neurorights, genetic rights? What is the meaning and scope of the right to life, health, privacy or non-discrimination? Biorights are the suggested solution for dealing with these challenges. Healthcare professionals, bio-researchers, policy makers, scholars, and citizens will, in this book, find a guide to knowing how bioscience affects our lives. Furthermore, this book provides a comprehensive method for biomedical and biotechnological decision-making that comprises human or basic rights dimensions alongside technical and ethical dimensions. (shrink)

This chapter examines whether high prices for gene therapies are justified and whether the problems associated with high prices can be solved by the "pay for performance" (P4P) reimbursement model. To this end, we first describe how prices for new drugs, including gene therapies, are set in Germany (section 2.). P4P is then presented as an example of a reimbursement model (section 3.). The subsequent ethical analysis (section 4.) first examines whether P4P models can sustainably guarantee the right to (...) health and healthcare for all people (section 4.1; cf. on the "sustainable right to health" already Alex, 2021). It is then shown that cost-benefit analyses for setting prices for new gene therapies must be viewed critically from an ethical perspective and pose a problem for equity of access and thus also for the sustainable guarantee of a right to health (section 4.2). The final question is whether P4P is compatible with the idea of human dignity (Article 1 I 1 of the German Basic Law) (section 4.3; cf. already König et al., 2020). -/- Alex, K. (2021): Ethical conceptualization of a sustainable right to health(care). In: Schildmann, J. et al. (eds.): Defining the value of medical interventions. Normative and empirical challenges. Kohlhammer, Stuttgart: 29-48. PMID: 36256802 König, J. et al. (2020): Am individuellen Therapieergebnis orientierte Erstattungsverfahren in der Onkologie: ethische Implikationen am Beispiel der CAR-T-Zelltherapie. In: Ethik Med 32: 85–92. doi: 10.1007/s00481-020-00565-3. (shrink)

Several philosophers argue that individuals have an interest-protecting right to parent; specifically, the interest is in rearing children whom one can parent adequately. If such a right exists it can provide a solution to scepticism about duties of justice concerning distant future generations and bypass the challenge provided by the non-identity problem. Current children - whose identity is independent from environment-affecting decisions of current adults - will have, in due course, a right to parent. Adequate parenting requires (...) resources. We owe duties of justice to current children, including the satisfaction of their interest-protecting rights; therefore we owe them the conditions for rearing children adequately in the future. But to engage in permissible parenting they, too, will need sufficient resources to ensure their own children's future ability to bring up children under adequate conditions. Because this reasoning goes on ad infinitum it entails that each generation of adults owes its contemporary generation of children at least those resources that are necessary for sustaining human life indefinitely at an adequate level of wellbeing. (shrink)

There are numerous ways in which “the particular”—particular individuals, particular ideologies, values, beliefs, and perspectives—are sometimes overlooked, ignored, or even driven out of the healthcare profession. In many such cases, this is bad for patients, practitioners, and the profession. Hence, we should seek to find a place for the particular in health care. Specific topics that I examine in this essay include distribution of health care based on the particular needs of patients, the importance of protecting physicians’ right (...) to conscientious objection, the value in tolerating a plurality of moral and medical perspectives within the field, and more. Ultimately, as the imagery in the essay’s title suggests, I argue that if one cares about the “well-being” of the medical profession, then one should seek to avoid destroying the many diverse and particular entities that constitute it. (shrink)

This research focuses on transgender patients discrimination in Yogyakarta in accessing healthcare services. There are two questions on this research: what is the obstacle faced by the transgender-patients in accessing healthcare services? How is the analysis of biomedical ethics seeing this issue? The results on this research are despite the fact they were not being discriminated in the hospital, they did not get the health insurance by the government because of the administrative issue which can not accommodate their (...) gender choice. Therefore, this research seeks to understand the barriers of transgender patients in accessing healthcare services through the perspective of biomedical ethics of Tom L. Beauchamp and James Childress. The researcher concludes that the general rule on social benefits applied in society is still limited only to the specific genders. It is not in accordance with the two principles in biomedical ethics: the principle of justice states that the transgender who is physically harmed has right to get social benefits to remedy the effect of the disadvantages due to their natural property and to have more equal chance of life; and the principle of autonomy states that an autonomous decision of the transgender people to choose their gender is related to the individual rights although they have different view with others and as long as their action do not leave the disadvantage to others, it must be respected as a moral obligation. (shrink)

This study attempts an exposition of different perceptions of obligation to medical treatment that have emerged from the Islamic theological understanding and how they contribute to diversity of options and flexibility in clinical practice. Particularly, an attempt is made to formulate an Islamic perspective on ordinary and extraordinary means of medical treatment. This distinction is of practical significance in clinical practice, and its right understanding is also important to public funded healthcare authorities, guardians of the patients, health and (...) life insurance institutions, and employers who provide health care coverage to their employees. Not only these parties, but also lawyers and justice administration functionaries such as public prosecutors and judges are in need of understanding this distinction to deal with relevant litigations. The distinction could be made regarding terminally ill patients and non-terminally ill patients separately. The essential factors that matter in making the distinction between ordinary and extraordinary means of treatment are: (1) patient capacity (2) expert advice, and (3) nature of medication. Regarding terminally ill patients, medical treatment can become extraordinary because of (1) patient capacity and (2) nature of medication. In both these case the deciding condition applies: the expert advice taken from a group of physicians. In regards to non- terminally ill patients, extraordinary medical treatment includes three cases: (1) treatment that is known to be useless and futile, (2) treatment that endangers the life or cause more harm than what it removes, and (3) useful treatment, but the patient is unable to bear the cost. (shrink)

The “Right to be forgotten” lies at the heart of the infosphere debate. It embodies how mature information societies cope and deal with their memories. As such, it has become a defining issue of our time. Drawing on the author’s experience as a member of the Google Advisory panel, this paper discusses some of the salient points of the “Right to be forgotten” discourse, including: privacy vs. freedom of speech and availability vs. accessibility of information. It argues that, (...) while there should be no removal of past information, steps must be taken to ensure that this is not constantly, or unnecessarily, recalled. (shrink)

This paper presents an account of the right to privacy that is inspired by classic control views on this right and recent developments in moral psychology. The core idea is that the right to privacy is the right that others not make personal information about us flow unless this flow is an expression of and does not conflict with our deep self. The nature of the deep self will be spelled out in terms of stable intrinsic (...) desires. The paper argues that this view has advantages over alternative accounts of the right to privacy, that it is extensionally adequate in interesting test cases, that there is a good reason to think that the right to privacy, thus understood, can be justified, and that this view helps identify what kind of information is protected by the right to privacy. (shrink)

It appears at least intuitively appropriate to claim that we owe it to victims to punish those who have wronged them. It also seems plausible to state that we owe it to society to punish those who have violated its norms. However, do we also owe punishment to perpetrators themselves? In other words, do those who commit crimes have a moral right to be punished? This work examines the sustainability of the right to be punished from the standpoint (...) of the two main theories of rights—the will and the interest conceptions. The right to be punished is shown to be largely indefensible on both accounts: on the will theory, the right to be punished conflicts with autonomy, and it can neither be claimed nor waived by a perpetrator; on the interest theory, a perpetrator’s interest in punishment, inasmuch as it exists, is not sufficient to ground a duty on the part of the state. (shrink)

In this short paper I will discuss the ambiguous and, even, controversial term ‘right to die’ in the context of the euthanasia debate and, in particular, in the case of passive euthanasia. First I will present the major objections towards the moral legitimacy of a right to die, most of which I also endorse myself; then I will investigate whether the right to die could acquire adequate moral justification in the case of passive euthanasia. In the light (...) of the Kantian tradition I will argue that since rights are understood as based upon duties, the right to die should also presuppose a corresponding duty, which to me could be either an imperfect, solidarity-related duty, or an autonomy-related one, at least as far as the unwanted prolongation of life is concerned. I will conclude with the view that the right to die could actually be considered a legitimate one in the case of passive euthanasia, when the application of life-supporting techniques is against the wishes and the best interests of the patient. (shrink)

The Importance of Socialist Principles in Balancing the Increasing Efficiency of Capitalism -/- Capitalism, as an economic system, thrives on innovation, competition, and efficiency. Over the centuries, it has fueled unprecedented advancements in technology, productivity, and global economic growth. However, capitalism’s focus on profit maximization and market efficiency often comes at the expense of social equity, environmental sustainability, and human well-being. This imbalance creates systemic issues such as income inequality, labor exploitation, and resource depletion. In this context, the integration of (...) socialist principles is essential to balance the increasing efficiency of capitalism and address its inherent shortcomings. -/- Mitigating Income Inequality -/- One of the most pressing consequences of capitalism’s efficiency is the widening gap between the wealthy elite and the working majority. As technological advancements increase productivity and profitability, the benefits often accumulate disproportionately to capital owners rather than laborers. Socialist principles, such as progressive taxation, wealth redistribution, and Universal Basic Income (UBI), can ensure that the gains of economic growth are shared more equitably across society. UBI, which involves providing all citizens with a guaranteed, unconditional income, offers a safety net for those displaced by automation and economic disruptions. Countries like Finland and Canada have piloted UBI programs, demonstrating its potential to reduce poverty, improve mental health, and foster economic stability by giving individuals the means to participate in the economy without fear of financial insecurity. -/- Protecting Workers’ Rights -/- Capitalism’s relentless pursuit of efficiency frequently leads to labor exploitation, such as low wages, poor working conditions, and job insecurity. Automation and artificial intelligence, while enhancing productivity, also threaten to displace millions of workers. Socialist principles emphasize the protection of workers’ rights through fair wages, safe workplaces, and collective bargaining. In Germany, for instance, co-determination policies ensure that workers have representation on corporate boards. Coupled with concepts like UBI, workers can face technological disruptions with greater resilience, as basic income offers a cushion against job displacement while they retrain or transition to new opportunities. -/- Promoting Environmental Sustainability -/- Capitalism’s focus on short-term profits often overlooks long-term environmental consequences. The pursuit of economic growth has led to overconsumption, pollution, and climate change, threatening the planet’s ecosystems and future generations. Socialist principles prioritize the common good over individual profit and advocate for sustainable development. Denmark has demonstrated this balance by integrating socialist-inspired environmental policies within its mixed economy. The country invests heavily in renewable energy and enforces strict environmental regulations. Additionally, concepts from Modern Monetary Theory (MMT) could play a crucial role in funding sustainability initiatives. MMT posits that governments with sovereign currencies can issue money to finance large-scale public projects without being constrained by budget deficits, as long as inflation remains under control. This framework could help finance green energy transitions and other critical investments needed to address climate change. -/- Ensuring Social Cohesion -/- Unbridled capitalism fosters competition and individualism, which can erode social cohesion and create divisions within society. Socialist principles, by contrast, emphasize solidarity, cooperation, and community well-being. A balanced approach to capitalism involves fostering a sense of shared responsibility for societal progress. Universal Basic Income is a key tool for enhancing social cohesion, as it guarantees a minimum standard of living for everyone, reducing inequality and poverty. For example, in Canada, the pilot UBI program in Ontario demonstrated how such initiatives could strengthen the social fabric by reducing financial stress, encouraging education, and improving health outcomes. When coupled with policies like free access to healthcare and education, socialist principles create a society where all members feel valued and supported. -/- Encouraging Ethical Capitalism with Modern Monetary Theory -/- Modern Monetary Theory provides a vital framework for ethical capitalism by allowing governments to prioritize public well-being over austerity measures. By rethinking budgetary constraints, MMT enables the funding of universal programs such as healthcare, education, and UBI. For example, New Zealand has embraced well-being-focused budgeting, prioritizing resources for mental health, child poverty reduction, and environmental protection. This approach aligns with socialist principles, ensuring that economic policies serve broader societal goals rather than simply maximizing GDP growth. MMT challenges the traditional capitalist notion that government spending must always be offset by tax revenues, opening the door for innovative social programs that benefit all. -/- Conclusion -/- While capitalism has proven to be a powerful engine for innovation and economic growth, its increasing efficiency can exacerbate systemic issues such as inequality, exploitation, and environmental degradation. Socialist principles provide a vital counterbalance, emphasizing fairness, equity, and collective responsibility. Tools like Modern Monetary Theory and Universal Basic Income further enhance the potential of socialist principles to address these challenges. Countries such as Finland, Germany, Denmark, Canada, and New Zealand exemplify how mixed economic systems can combine the strengths of capitalism with the equity of socialism. By adopting these principles, societies can create a sustainable and inclusive economic system that harnesses the strengths of capitalism while mitigating its weaknesses. In an era of rapid technological advancement and global interconnectivity, this balance is more important than ever for building a just and resilient future. -/- . (shrink)

Deontologists believe in two key exceptions to the duty to promote the good: restrictions forbid us from harming others, and prerogatives permit us not to harm ourselves. How are restrictions and prerogatives related? A promising answer is that they share a source in rights. I argue that prerogatives cannot be grounded in familiar kinds of rights, only in something much stranger: waivable rights against oneself.

Poverty as a Product of Systemic Failure, Violation of Balance, and Ignorance -/- By: Angelito Enriquez Malicse -/- Introduction -/- Poverty is not merely an economic condition; it is a deeply rooted social issue that stems from systemic failure, violation of balance, and ignorance. While poverty is often viewed as an individual problem, it is, in reality, a consequence of flawed institutions, unsustainable practices, and a lack of proper education. When societies fail to establish equitable systems, disrupt the natural balance (...) of resources, and allow ignorance to thrive, they create conditions where poverty becomes inevitable. This essay explores how these three fundamental factors contribute to the persistence of poverty and how they can be addressed through a more structured and holistic approach. -/- Systemic Failure: The Structural Root of Poverty -/- Poverty does not arise in isolation; it is a direct consequence of systemic failures within economic, political, and social structures. Societies that fail to establish fair economic policies, effective governance, and accessible social services create environments where large portions of the population struggle to meet their basic needs. -/- 1. Corrupt Governance and Wealth Concentration -/- Many governments, particularly in developing nations, misallocate resources due to corruption, leading to inefficiency and economic inequality. Instead of distributing wealth fairly, corrupt leaders allow a small elite to control national resources while the rest of the population remains impoverished. This imbalance makes it nearly impossible for the poor to break free from their conditions. -/- 2. Unregulated Capitalism and Economic Exploitation -/- Capitalism, when left unchecked, often prioritizes profit over people. Large corporations exploit labor by paying unfair wages, reducing access to job security, and minimizing social benefits. This system traps workers in a cycle of poverty where they are overworked but underpaid, unable to save or improve their living conditions. -/- 3. Inadequate Social Safety Nets -/- In many societies, social welfare systems are either weak or nonexistent. Without universal access to healthcare, education, and employment opportunities, the poor remain stuck In survival mode, unable to invest in their future. In contrast, nations with strong social support systems experience significantly lower poverty rates. -/- Thus, systemic failure creates poverty by failing to distribute wealth fairly, regulate economic policies, and provide safety nets for the vulnerable. -/- Violation of Balance: The Disruption of Sustainable Living -/- Your universal law of balance in nature states that everything must exist in harmony to sustain life. Poverty can be seen as a direct result of the violation of this balance, where human decisions have disrupted the natural and social equilibrium. -/- 1. Overexploitation of Resources -/- The reckless consumption of natural resources by a few nations or corporations leaves entire populations without access to food, clean water, and land. When industries prioritize profit over sustainability, they destroy ecosystems, leading to poverty in regions that depend on these resources for survival. -/- 2. Unsustainable Population Growth -/- Many developing nations experience rapid population growth without corresponding economic development. This creates an imbalance where resources such as food, water, and housing become insufficient to support growing populations, leading to mass poverty. Without proper planning and regulation, countries struggle to maintain sustainable living conditions. -/- 3. Extreme Wealth Disparity and Economic Instability -/- A major violation of balance occurs when a small percentage of people control the majority of a nation’s wealth. This concentration of resources leads to social instability, crime, and reduced economic mobility for the poor. A balanced system would ensure that wealth is distributed fairly so that all individuals have access to opportunities for growth. -/- When societies disrupt the balance between population, resources, and economic distribution, they create unsustainable conditions that lead to widespread poverty. -/- Ignorance: The Barrier to Poverty Eradication -/- Perhaps the most critical cause of poverty is ignorance, which manifests both at the individual and societal levels. Ignorance prevents people from understanding, addressing, and solving the very systems that keep them impoverished. -/- 1. Lack of Education and Critical Thinking -/- Without education, individuals cannot acquire the skills needed to escape poverty. Many impoverished regions suffer from low literacy rates, making it difficult for people to find stable jobs, understand their rights, or challenge unfair systems. A lack of critical thinking skills also allows misinformation and propaganda to control public perception, preventing meaningful change. -/- 2. Cultural and Religious Barriers -/- Many societies hold onto outdated traditions or religious dogma that discourage people from questioning authority, using birth control, or demanding better governance. While faith and tradition can provide social cohesion, they can also reinforce poverty when they discourage progress and education. -/- 3. Misinformation and Media Manipulation -/- The spread of false information, especially through social media and political propaganda, keeps people unaware of the true causes of their suffering. Governments and corporations manipulate public perception, convincing the poor that their situation is unchangeable or that economic inequality is “natural.” As a result, people fail to demand better policies or take action to change their circumstances. -/- Ignorance prevents individuals from recognizing the structural causes of their poverty, keeping them trapped in a cycle of economic hardship. -/- Solutions: Restoring Balance and Systemic Reform -/- If poverty is a product of systemic failure, imbalance, and ignorance, then the solution must involve structural reform, balance restoration, and education. -/- 1. Systemic Change: Governments must regulate capitalism, eliminate corruption, and create fair economic policies that ensure wealth is distributed equitably. -/- 2. Restoring Balance: Countries must implement sustainable development strategies, control population growth through education and planning, and ensure that natural resources are used responsibly. -/- 3. Eliminating Ignorance: A reformed educational system must teach critical thinking, scientific reasoning, and ethical leadership to empower future generations to challenge unjust systems. -/- Your holistic educational approach, based on the universal law of balance in nature, could serve as the foundation for eradicating poverty by reprogramming societal thinking and decision-making at a fundamental level. -/- Conclusion -/- Poverty is not simply an unfortunate condition—it is the result of broken systems, disrupted balance, and widespread ignorance. Governments, corporations, and social structures have failed to provide a fair and sustainable way of living, while economic exploitation and misinformation keep people from rising out of poverty. To truly solve poverty, we must rebuild social systems, restore balance, and educate future generations to think critically and act responsibly. Only through such a holistic, scientifically grounded approach can humanity achieve a world where poverty is no longer a systemic inevitability but a preventable condition. -/- . (shrink)

This paper provide the first extended discussion in the philosophical literature of the epistemic significance of the phenomenon of “being known” and the relationship it has to reparations that are distinctively epistemic. Drawing on a framework provided by the United Nations of the “right to know,” it is argued that victims of gross violations and injustices not only have the right to know what happened, but also the right to be known—to be a giver of knowledge to (...) others about their own experiences. It is shown that such victims can suffer epistemic wrongs by being rendered invisible, vilified or demonized, or systematically distorted, and that these ways of not being known demand epistemic reparations. While there are traditional reparations that are epistemic in nature, such as memorialization and education, it is argued that there is a prior and arguably more important epistemic reparation—knowing victims of gross violations and injustices in the sense of bearing witness. The paper concludes with a sketch of an epistemological picture to underwrite this notion of epistemic reparations, one that significantly expands the traditional picture by including epistemic duties that are imperfect in nature and concern actions in addition to beliefs. (shrink)

In this article I present a characterization of the right to mental integrity (RMI), expanding and refining the definition proposed by Ienca and Andorno’s (Life Science Society Policy 13 5, 2017) and clarifying how the scope of this right should be shaped in cases of cognitive extension (EXT). In doing so, I will first critically survey the different formulations of the RMI presented in the literature. I will then argue that the RMI protects from i) nonconsensual interferences that (...) ii) bypass reasoning and iii) produce mental harm. Contrary to other definitions proposed in the literature, my formulation disentangles the RMI from the right to cognitive liberty (RCL) (Lavazza in Frontiers Neuroscience 12 82, 2018), the right to mental privacy (RMP) (Lavazza and Giorgi in Neuroethics 16 (1): 1-13, 2023), and the right to psychological continuity (RPC) (Zohny et al. in Neuroethics 16: 20, 2023), thus enabling a fine-grained assessment of their simultaneous or individual violation. Finally, I analyse how the extended mind thesis (EXT) reshapes the scope of the RMI, proposing a layered protection of extended mental integrity, which grants stronger protection to the organism-bound cognitive system and self in case of manipulative influences of the mind-extending device. To conclude, I present a variety of neurorights violations and mental harms inflicted to organism-bound and cognitively extended agents. (shrink)

The right to withdraw from participation in research is recognized in virtually all national and international guidelines for research on human subjects. It is therefore surprising that there has been little justification for that right in the literature. We argue that the right to withdraw should protect research participants from information imbalance, inability to hedge, inherent uncertainty, and untoward bodily invasion, and it serves to bolster public trust in the research enterprise. Although this argument is not radical, (...) it provides a useful way to determine how the right should be applied in various cases. (shrink)

Since approval of the EU General Data Protection Regulation (GDPR) in 2016, it has been widely and repeatedly claimed that the GDPR will legally mandate a ‘right to explanation’ of all decisions made by automated or artificially intelligent algorithmic systems. This right to explanation is viewed as an ideal mechanism to enhance the accountability and transparency of automated decision-making. However, there are several reasons to doubt both the legal existence and the feasibility of such a right. In (...) contrast to the right to explanation of specific automated decisions claimed elsewhere, the GDPR only mandates that data subjects receive meaningful, but properly limited, information (Articles 13-15) about the logic involved, as well as the significance and the envisaged consequences of automated decision-making systems, what we term a ‘right to be informed’. Further, the ambiguity and limited scope of the ‘right not to be subject to automated decision-making’ contained in Article 22 (from which the alleged ‘right to explanation’ stems) raises questions over the protection actually afforded to data subjects. These problems show that the GDPR lacks precise language as well as explicit and well-defined rights and safeguards against automated decision-making, and therefore runs the risk of being toothless. We propose a number of legislative and policy steps that, if taken, may improve the transparency and accountability of automated decision-making when the GDPR comes into force in 2018. (shrink)

Arguments from human dignity feature prominently in the Lethal Autonomous Weapons moral feasibility debate, even though their exists considerable controversy over their role and soundness and the notion of dignity remains under-defined. Drawing on the work of Dieter Birnbacher, I fix the sub-discourse as referring to the essential value of human persons in general, and to postulated moral rights of combatants not covered within the existing paradigm of the International Humanitarian Law in particular. I then review and critique dignity-based arguments (...) against LAWS: argument from faulty targeting process, argument from objectification, argument from underappreciation of the value of human life and the argument from the absence of mercy. I conclude that the argument from the absence of mercy is the only dignity-based argument that is both valid and irreducible to another class of arguments within the debate, and that it offers insufficient justification for a global ban on LAWS. (shrink)

Under no circumstances should the absurd "right to roam‟ be incorporated into the legislation of this country. In reality, it is clearly a mere licence to trespass. Armed with the appropriate economic and philosophical arguments, we should eventually be able to offer an effective counter-attack with a movement for the "right to own‟ privately every last one of the state-controlled commons, heaths, hills, mountains, downs, woodlands, rivers, beaches, and footpaths. As a result, there will be no imposition on (...) legitimate landowners and more access to better resources for ramblers. (shrink)

The stakes associated with an algorithmic decision are often said to play a role in determining whether the decision engenders a right to an explanation. More specifically, “high stakes” decisions are often said to engender such a right to explanation whereas “low stakes” or “non-high” stakes decisions do not. While the overall gist of these ideas is clear enough, the details are lacking. In this paper, we aim to provide these details through a detailed investigation of what we (...) will call the “Simple Stakes Thesis”. The Simple Stakes Thesis, as it will turn out, is too simple. For even if the stakes associated with a specific one-off decision are low—and hence does not engender a right to an explanation—such decisions may nevertheless form part of a high stakes pattern or aggregate of decisions. In such cases, we argue, even a low stakes decision may engender a right to explanation. Not only does this show that the right to explanation is more demanding than so far recognized. It also shows that the stakes thesis is significantly harder to apply in practice. (shrink)

Hunger strikes are commonly repressed in prison and seen as disruptive, coercive, and violent. Hunger strikers and their advocates insist that incarcerated persons have a right to hunger strike, which protects them against repression and force-feeding. Physicians and medical ethicists generally ground this right in the right to refuse medical treatment; lawyers and legal scholars derive it from incarcerated persons’ free speech rights. Neither account adequately grounds the right to hunger strike because both misrepresent the hunger (...) strike as noncoercive and nonviolent. I articulate an alternative, dual account of the right to hunger strike. On the remedial argument, the right to hunger strike should be legally protected as a right to petition for redress, in light of incarcerated people’s structural vulnerability to abuse and given inadequate grievance mechanisms. The constructive argument derives the right to hunger strike from the right to resist oppression and stresses the normative permissibility of the use of coercive tactics to defend one’s liberty interests in the face of carceral oppression. -/- . (shrink)

The idea that citizens have a right to receive information that is relevant for their suitable exercise of political rights and liberties is well established in democratic societies. However, this right has never been systematically analyzed, thus remaining a blurry concept. This article tackles this conceptual gap by conceptualizing citizens’ right to information. After reviewing previous approaches to this idea, I locate citizens’ right to information on the map of communication rights, and put forward a systematic (...) framework for both justifying and analyzing it. This framework focuses on this right’s grounds, its function, its holders, its content, and its correlative duties. Although the conceptualization offered here will be incomplete, it will be enough to distinguish the general concept of citizens’ right to information from both its specific conceptions and from the other two best-known rights of the public: freedom of information and the public’s right to know. (shrink)

A short paper discussing the question of whether adults' interest in parenting can play a role in justifying the right to rear children.

A recent challenge to statist arguments defending the right of states to exclude prospective immigrants maintains that such statist arguments prove too much. Specifically, the challenge argues that statist arguments, insofar as they are correct, entail that states may permissibily exclude current members' newcomers by birth, which seems to violate a widely held intuition that members' newcomers by birth ought automatically to be granted membership rights. The basic claim is that statist arguments cannot account for the differntial treatment between (...) prospective immigrants and newcomers by birth. Call this the newcomer-by-birth objection. This article rejects the newcomer-by-birth rejection. It begins by sketching the precise extent to which the objection applies to statist arguments. It then examines the case of newcomers by birth and argues for a principled basis for treating them differentially from prospective immigrants such that a right to exclude prospective immigrants need not entail a right to exclude newcomers by birth. But this distinction holds only in most cases, not all, and therefore the newcomer-by-birth objection is not entirely defeated. With respect to the cases in which the objection does hold, it is argued that such cases are morally akin to international adoption, and thus morally benign. All considered, statist arguments easily survive the newcomer-by-birth objection. (shrink)

This paper investigates one of the central questions in the ethics of migration: is migration a matter of freedom or justice? The former claims that it is a human right, whereas the latter defends a remedial right to immigrate as a way to meet the requirements of global distributive justice. These arguments seem to enter into an intractable contradiction. On the one hand, if freedom of movement is a human right, it should not be subordinated to the (...) maximization of justice. On the other hand, in a non-ideal world an open-borders policy would be of little help in the assignment of priorities, and its redistributive effects would be suboptimal. The solution, I will argue, lies in a package of global redistributive measures. More open borders now can bring us closer to justice, and only then would immigration make sense as a human right. (shrink)