Is public policy ethics possible and, if so, is it desirable? This twofold question can – and sometimes does — elicit a smile or a frown. The smile implies that ethical theorizing rests on a naïve idea of policy-making; the frown implies that there is something tasteless or incongruous in expecting philosophy to engage with problems of policy and with the political bargaining and compromise that policy-making often involves. These reactions – familiar to many (...) working in this academic discipline – point to the ways in which ethics and public policy have been taken to be separate areas of practical concern and theoretical inquiry. (shrink)

Social scientists and research ethicists have begun, somewhat belatedly, to confront and address the ethical challenges raised by public policy experiments. In doing so however, they have not fully availed themselves of the large and sophisticated literature on the ethics of clinical research which has developed over the past 40 years. While clinical and public policy research are different, I argue that the clinical research ethics literature yields valuable insights for discussions of the (...) class='Hi'>ethics of policy experiments. Focusing on seven ethical issues which have received a good deal of attention in public and scholarly discussions of the ethics of policy experiments, I make use of the history of reflection on the ethics of clinical research to provide guidance to researchers planning and conducting policy experiments. (shrink)

In 1996, the U.S. Fish and Wildlife Service made a proposal to restore and preserve 30,000 acres of wetlands in Indiana's Kankakee River basin. Local farmers opposed this, expressing concerns about how a wildlife refuge would affect farming communities along the Kankakee River. Undergirding what seems to be a simple conflict between incompatible environmental and economic interests is a more fundamental conflict between competing ethical frameworks for evaluating public policy. One helpful approach is to examine the normative issues (...) in the Kankakee dispute in terms of the contrast between consequentialist and non-consequentialist ethical frameworks. This article attempts to establish that a failure to recognize alternatives to the consequentialist framework has resulted in a failure of opposing parties to recognize and address each other's ethical concerns. An analysis of the Kankakee wetlands dispute will reveal why it is important for environmentalists to be cognizant of alternatives to consequentialist ethical frameworks. (shrink)

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For (...) all arms of a policy RCT, policy experts must either reasonably disagree about whether the trial arms are more effective than this policy, or know that they are. (shrink)

What can philosophy tell us about ethics and public policy? What can the ethics of public policy tell us about philosophy? Those are the questions that Jonathan Wolff addresses in his wonderful little book. At one level, of course, the answer is straightforward – ethics is a branch of philosophy, so philosophy can tell us about the ethics of public policy, understood as a matter of deciding ‘what we should do' (...) in a manner that is institutionalised and collectively binding. But at another level, as Wolff shows, there is something deeply puzzling about the idea that philosophy can tell us anything very useful about public policy and about the ethical dilemmas that it raises. Those dilemmas arise as a result of political constraints, struggles and resources which generally have little to do with philosophy and, for the most part, rather little to do with ethics. So what, exactly, should philosophers expect from an engagement with public policy? (shrink)

There are many ethical dimensions of public policy. Public policy as actions to solve the collective problems includes directly or indirectly making ethical judgments. Public policy takes into account reconciliation of conflicting interests of individuals, groups, and organizations which is based on the values agreeing which influences on the objectives, principles, and styles of policy implementation. Ethical judgments about selecting more and less important as well as more positive problem solutions are present on (...) all stages of policy cycle. (shrink)

Based on field research in Africa, this essay explores three claims: first, that sport hunting places economic value on wildlife and habitats; second, that this motivates conservation practices in the interest of sustaining revenue sources; and, third, that this benefits human populations. If true, then sport hunting may sometimes be justifiable on utilitarian grounds. While not dismissing objections from the likes of Singer and Regan, we suggest their views – if converted into policy in desperately impoverished places – would (...) destroy animals and the habitats on which they depend. There are empirical verifications of this, which we discuss. (shrink)

This paper critically explores the ethical dimensions of Behavioral Public Policy (BPP), a domain grounded in the understanding that human rationality is bounded and that this limitation often leads to behaviors deemed irrational. By applying the behavioral lens, which posits that people operate under bounded rationality, BPP aims to craft interventions that safeguard individuals against their biases. However, this approach raises significant ethical concerns, both in the scientific underpinnings of BPP and its application through policy interventions. Accordingly, (...) this paper examines two distinct ethical dimensions of BPP, both as a scientific discipline and through its intervention methodologies. The analysis of the first dimension argues that, viewing bounded rationality as only instrumental in decision-making processes, risks oversimplifying ethical complexities. Such simplification may ignore the moral and value-based rationalities underlying decisions, potentially misattributing instances of immorality and akrasia (the failure to act according to one's judgment) to mere deficiencies in rational thinking. Secondly, the paper examines the impact of BPP on moral behavior and character development, addressing ethical concerns like the evidentiary basis of BPP research, the bounded rationality of choice architects themselves, and the morality of behavior changes induced by policy. Overall, this article provides a much-needed examination of the moral considerations associated with behavioral strategies in public policy and its epistemological foundations, contributing to a more comprehensive understanding of their ethical implications . (shrink)

We subsist under the law where we claim our rights and are obliged to do something enforced. What is a law? The question would be perplexing in history, and one of crucial themes with many lawyers or legal philosophers. As we know, two most important perspectives had earned a universal and historical forge in academics, to say, the natural law and legal positivism. The concept of natural law deals in its primacy for the humanity and natural order which often can (...) be traded as something inviolable or inalienable. The concept has strands in several aspects; (i) its anchor with the civil democratic revolution around 17 and 18 centuries (ii) its supremacy with the new constitutional states (iii) less quality as a realist law from ambiguities and lack of clear definition. The concept of public policy may be related with the social justice, ethics and administration. It generally pursues a justice and desired state of public or community where the tension and conflict always exist between the ruling class and citizens. Historically, the public policy could be mightier to address the society than law where the benevolent Kings or Sovereigns liked to address both their needs and social justice. They may abrogate, more in endowment and divinity, the laws or social customs. The tension between the public power and private interests could be one reason as well as offers a good dualism in understanding the rule of law concept and advent of modern democracy. In this dimension, the King would no longer be divine nor entitled to exercise a plenary power of state rule. Instead, the popular sovereignty in the US democracy or parliamentary type in the UK were to be established to resolve a feudal conflict within the class and society. Lighted to be in vein of influence could arise the two contexts which are a contractarian view and plutocracy desire of the founding fathers. They underlay the mood and philosophical ethos of US revolution. Hence, three concepts as a pillar in private law were sanctified in the very foundation of US constitutional state, sanctity of property right, freedom of contract and due limits for the civil liability. The governmental power should be limited to protect the life and limb of citizens which addressed the Hobbes’ evil, “war against all the rest.” The due process concept was expressed as a fundamental principle of constitution where the human rights are inviolable and inalienable. The separation of powers principle could serve the freedom and wealth of new civil class in the continent, and bicameralism was devised for the check and balance within the federal congress. They see the role of judicial branch is important to preserve their civil interest. Then we can derive some assumptions between the law and public policy. First, a law plays to protect the private interest while the public policy pursues the social justice and mediates the competing interests, “private v. private” and “public v. private.” The civil courts may address a first nature of conflict and the law of takings or regulatory laws may deal with the second aspect. Second, the public or administrative law can shape a legal plane of bureaucracies or public administration, and may guarantee the rule of law ideals. It plays as an enabling authority and, on the other, monitors an arbitrariness and unfairness in the bureaucratic government. In this context, the unresponsive and unfathomable bureaucracy in the Kafka’s could be remedied. Third, for the welfare state in the late 19th and 20th century, a law can well be seen as one of authoritative expression of public policy to redress the evils of capitalist states. Some public laws, such as the Sherman Act classically and Lanham Act recently, may act to regulate the monopoly or oligopoly while other laws were enacted to restore justice between the labor and employers. Through the chapters, the fundamentals of law and public policy will be considered to address their proper status. (shrink)

Many people look to religion to help resolve the serious moral and legal issues associated with assisted reproductive technologies. Doing so presupposes that religion is the cornerstone of ethics, but this assumption is not well founded. While various faiths are entitled to articulate their views on matters of human reproduction, the contradictions involved in doing so make it unwise to rely on religion in the formulation of law and policy. These contradictions – such as the indeterminacy about what (...) revealed truths means – make moral secular philosophy a better guide for the protection of human welfare. (shrink)

This brief commentary reappraises the issue of emigration of physicians from developing countries to developed countries. A methodological framework is developed for assessing the impact of physician emigration on population health outcomes. The evidence from macro and micro studies suggest that developing countries especially in sub-Saharan Africa would benefit from regulating physician emigration because the loss of physicians can lower quality of healthcare services and lead to worse health outcomes. Further discussion is contained in an e-letter: http://jme.bmj.com/content/early/2013/05/30/medethics-2013-101409/reply.

In the United States, prohibitionist policies are used as the primary approach to combat the negative effect of substance use on society. An extensive academic literature spanning the disciplines of economics, political science, and multiculturalism documents the great social costs of the United States’ “War on Drugs” both nationally and internationally. These costs come with at best marginal effect on substance abuse and other crimes linked to the drug trade. In many cases, there is a reason to believe that these (...) policies exacerbate the problems they aim to address. This article explores psychologists’ ethical commitments to social change concerning such drug policy, given the field of psychology’s expanding commitment to social justice. We examine arguments regarding the boundaries between psychologists’ personal and professional ethics with regard to political participation. Using drug prohibition as an exemplar, we suggest that many psychologists’ political actions and professional ethics may be misaligned. Ultimately, we conclude that the endorsement of prohibitionist drug policies is in direct conflict with the guiding ethical principles put forth by the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. (shrink)

This paper is a survey of the positive and negative aspects of cannabis use from the point of view of the individual on one hand and from the point of view of the society on the other hand. Health, social, and political motives are all discussed, and the best method of harm reduction is analysed. The upshot is that zero tolerance policy is obsolete, and that most individuals would be better off using cannabis rather than other drugs.

From the point of view of a theorist in ethics, the interest in public policy usually centres on the policy outcomes. But this point of view does not take much account of the roles and practices through which public policies are enacted. What additional ethical focuses for the policy agent might these entail? I outline four features of policy making, centred on the agent's performance of their role in the process, that raise ethical (...) issues. These features are: the nature of the policy process; the definition of the public; the treatment of policy agents; and accounting for public policy decisions. Brief examples are used to illustrate the nature of the issues and support the conclusion that these present additional ethical focuses for agents in public policy roles. (shrink)

Government agencies and nonprofit organizations have increasingly turned to randomized controlled trials (RCTs) to evaluate public policy interventions. Random assignment is widely understood to be fair when there is equipoise; however, some scholars and practitioners argue that random assignment is also permissible when an intervention is reasonably expected to be superior to other trial arms. For example, some argue that random assignment to such an intervention is fair when the intervention is scarce, for it is sometimes fair to (...) use a lottery to allocate scarce goods. We investigate the permissibility of randomization in public policy RCTs when there is no equipoise, identifying two sets of conditions under which it is fair to allocate access to a superior intervention via random assignment. We also reject oft-made claims that alternative study designs, including stepped-wedge designs and uneven randomization, offer fair ways to allocate beneficial interventions. (shrink)

Some of the challenges in Sanders et al. (this issue) can be aptly illustrated by means of charity nudges, that is, nudges designed to increase charitable donations. These nudges raise many ethical questions. First, Oxfam’s triptychs with suggested donations are designed to increase giving. If successful, do our actions match ex ante or ex post preferences? Does this make a difference to the autonomy of the donor? Second, the Behavioural Insights Team conducted experiments using social networks to nudge people to (...) give more. Do these appeals steer clear of exploiting power relations? Do they respect boundaries of privacy? Third, in an online campaign by Kiva, donors are asked to contribute directly to personalized initiatives. In many cases, the initiative has already been funded and donor money is funnelled to a new cause. Is such a “pre-disbursal” arrangement truthful and true to purpose as a social business model? (shrink)

This article will address the considerations that must be examined in the design of public policies and government programs to achieve an intercultural approach to the health of the Pu Mapuce Zomo (Mapuce women). In this sense, the proposed objective is to formulate three essential aspects that serve as a basis to promote adequate frameworks for public health policies oriented towards an intercultural approach. For this, methodologically, from a qualitative approach, the ethical, gender(s) and epistemic aspects that must (...) be considered in the configuration of health programs that favor the health care of indigenous women will be investigated. With this purpose, it begins by delimiting the unavoidable ethical-normative and gender approach to highlight the basic needs of Mapuce women. This approach seeks to establish a parameter about the obligations that States have in relation to the development of human capabilities. Finally, three aspects will be presented that the State must replicate in its health proposals to guarantee the construction of an intercultural approach to health, appropriate to the basic needs of Mapuce women in Argentina. (shrink)

The field of public policy is dominated by the social sciences. Schools and departments of public policy and public administration are largely populated by economists, political scientists, and sociologists, and the vast majority of work in prestigious public policy journals employs empirical methods. This is unsurprising, in one respect, for collecting data, predicting and identifying the causal impacts of policies, and understanding political institutions and processes are massive, important tasks that require the tools (...) of the social sciences. It is surprising, in another respect however, since much policy scholarship and analysis aspires to offer recommendations to policymakers, and recommendations necessarily involve evaluative judgments, for example, that the status quo is deficient and that a certain course of action will make things better. To defend such judgments, policy scholars and analysts cannot appeal to the social sciences alone for these judgments concern the realm of values, not facts. Instead, careful ethical reflection and analysis is required. This need for ethical reflection in public policy is particularly evident in the practice of policy analysis, a principal analytic tool of the field. Policy analyses involve the identification of policy problems, the specification of criteria for evaluating possible solutions, and the recommendation that a policy option offers the best balance of trade offs. This identification of bads, the specification of goods policies should realize, and the weighing of these goods with the judgment that policymakers should or ought to pursue this course of action or that, are all deeply ethical activities. Ethical reflection and analysis is thus a constituent feature of policy analysis, and like the amassing of evidence and projection of outcomes, this reflection and analysis may be performed well or badly. The overall aim of this book is to provide students, scholars, and practitioners of public policy with guidance regarding the ethical dimensions of policy analysis. My aim in this chapter is to set the stage, providing an overview of these dimensions. After providing a brief overview of the practice of policy analysis, I identify the steps of an analysis where analysts must make ethical judgments in order to move forward, and fully articulate the ethical questions they must confront and take a position on. (shrink)

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

Although vaccines are considered an efficient public health tool by medical experts, in different countries, people’s confidence in them has been decreasing. COVID-19 has elevated medical scientists’ and practitioners’ social reputation, and it may have reduced global vaccination hesitancy. Still, this alone will not altogether remove the existent frictions that prevent people from complying with vaccination schedules. This paper will review the common causes behind vaccination hesitancy. It will also explore different types of public policy interventions that (...) health experts in governments and institutions employ to fight vaccine hesitancy and non-compliance. The main objective of this article is to argue that, considering the nature of the issue (vaccine hesitancy and its causes), among the various possibilities, policies based on behavioral insights can provide an effective instrument to remove those frictions. Among them, special attention will be devoted to nudges which promise efficiency while avoiding some of the ethical and political costs of other interventions, thanks to their libertarian paternalistic frame. The article concludes by suggesting that public health policymakers should consider the libertarian paternalistic approach of nudges when deploying interventions that aim at changing people’s attitudes and behavior. (shrink)

The scientific consensus regarding anthropogenic climate change is firmly established yet climate change denialism, a species of what I call pseudoskepticism, is on the rise in industrial nations most responsible for climate change. Such denialism suggests the need for a robust ethics of inquiry and public discourse. In this paper I argue: (1) that ethical obligations of inquiry extend to every voting citizen insofar as citizens are bound together as a political body. (2) It is morally condemnable for (...) public officials to put forward assertions contrary to scientific consensus when such consensus is decisive for public policy and legislation. (3) It is imperative upon educators, journalists, politicians and all those with greater access to the public forum to condemn, factually and ethically, pseudoskeptical assertions made in the public realm without equivocation. (shrink)

We identify the ethics of reparations policies as its own distinct field of inquiry, and consider several neglected ethical issues that arise in the process of devising reparations programmes. The problem of political instrumentalization has to do with the fact that reparations can be a way for the governments to bolster their legitimacy rather than achieve justice. The problem of exclusion refers to individuals with seemingly valid claims being turned away. Finally, the problem of inclusion has to do with (...) including would-be claimants who are not mobilized in making a reparations demand, as well as with reconciling competing reparations demands. (shrink)

The identification of plausible epistemic approaches in science as well as the social problem definitions with which scientists implicitly work is essential for the quality of a deliberative public policy. While responding to the Nanofutures project, I will reflect on the essential elements of such a policy.

This article is a critical survey of the debate over the value of the social discount rate, with a particular focus on climate change. The ma- jority of the material surveyed is from the economics rather than from the philosophy literature, but the emphasis of the survey itself is on founda- tions in ethical and other normative theory rather than highly technical details. I begin by locating the standard approach to discounting within the overall landscape of ethical theory, and explaining (...) the assumptions and simplifications that are needed in order to arrive at the model that is standard in the discounting literature. The article then covers the general theory of the Ramsey equation and its relationship to observed interest rates, arguments for and against a positive rate of pure time preference, the consumption elasticity of utility, and the effect of various sorts of uncertainty on the discount rate. Finally, it turns specifically to the ap- plication of this debate to the case of climate change, focussing on the recent controversy over the low discount rate used in the Stern Review of the Economics of Climate Change. (shrink)

In this chapter, Gary Comstock considers whether it is ethically justified to pursue genetically modified ( GM) crops and foods. He first considers intrinsic objections to GM crops that allege that the process of making GMOs is objectionable in itself. He argues that there is no justifiable basis for the objections- i.e. GM crops are not intrinsically ethically problematic. He then considers extrinsic objections to GM crops, including objections based on the precautionary principle, which focus on the potential harms that (...) may result from the adoption of GM organisms. He argues that these concerns have some merit. However, they do not justify giving up GM crops altogether. Instead, they require that GM crops be developed carefully and with appropriate oversight. Comstock then presents the positive case for GM crops that he endorses. It is based on three considerations: (i) the right of people to choose to adopt GM technology; (ii) the balance of likely benefits over harms to consumers and the environment from GM technology; and (iii) the wisdom of encouraging discovery, innovation, and careful regulation of GM technology. (shrink)

Background -/- Emerging technologies and societal changes create new ethical concerns and greater need for cross-disciplinary and cross–stakeholder communication on navigating ethics in research. Scholarly articles are the primary mode of communication for researchers, however there are concerns regarding the expression of research ethics in these outputs. If not in these outputs, where should researchers and stakeholders learn about the ethical considerations of research? Objectives -/- Drawing on a scoping review, analysis of policy in a specific disciplinary (...) context (learning and technology), and reference group discussion, we address concerns regarding research ethics, in research involving emerging technologies through developing novel policy that aims to foster learning through the expression of ethical concepts in research. Approach -/- This paper develops new editorial policy for expression of research ethics in scholarly outputs across disciplines. These guidelines, aimed at authors, reviewers, and editors, are underpinned by: -/- a cross-disciplinary scoping review of existing policy and adherence to these policies; a review of emerging policies, and policies in a specific discipline (learning and technology); and, a collective drafting process undertaken by a reference group of journal editors (the authors of this paper). -/- Results -/- Analysis arising from the scoping review indicates gaps in policy across a wide range of journals (54% have no statement regarding reporting of research ethics), and adherence (51% of papers reviewed did not refer to ethics considerations). Analysis of emerging and discipline-specific policies highlights gaps. Conclusion -/- Our collective policy development process develops novel materials suitable for cross-disciplinary transfer, to address specific issues of research involving AI, and broader challenges of emerging technologies. (shrink)

The ethics of voting is a new field of academic research, uniting debates in ethics and public policy, democratic theory and more empirical studies of politics. A central question in this emerging field is whether or not voters should be legally required to vote. This chapter examines different arguments on behalf of compulsory voting, arguing that these do not generally succeed, although compulsory voting might be justified in certain special cases. However, adequately specifying the forms of (...) voluntary voting that are consistent with democratic norms is likely to be philosophically complex and politically controversial. (shrink)

Through engagement with key informants and review of ethical theories applicable to refugee policy, this paper examines the ethical and policy considerations that policy-level stakeholders believe should factor into setting the refugee resettlement ceiling. We find that the ceiling traditionally has been influenced by policy goals, underlying values, and practical considerations. These factors map onto several ethical approaches to resettlement. There is significant alignment between U.S. policy interests and ethical obligations toward refugees. We argue that (...) the refugee ceiling should be restored to historical norms, and that there exists a corresponding obligation to counter negative public perceptions about refugees and the costs of resettlement. (shrink)

One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. (...) In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. (shrink)

This thesis under the title “Public Health Policy in Resource Allocation: the Role of Ubuntu Ethics in Redressing Resource Disparity between Public and Private Healthcare in South Africa” explores health care disparities pertaining to resource allocation between public and private sector. It is of relevance and importance in South Africa where 54% of the population live on less than US$3 per day. Although the government has instituted certain changes aimed at transforming the public health (...) care system, the resource allocation gap between the two persists and remains wide. The research gives special attention to the role that Ubuntu ethics can play in redressing the resource allocation disparities between public and private health care sectors in South Africa, pointing out the existing gap in financing, as well as human resource between public and private health care sectors, which leads to poor health outcomes in public sector. Therefore, the problem is the prevalent inequality of resource allocation between private and public health care sectors. The analysis of policy gaps, as well as evaluating the cause of disparities in the health system is the goal of this research. The study endeavours to redress the disparities within the context of Ubuntu ethical principles and proposes a change in public policy so as to enhance healthcare for the benefit of the people. The study is philosophical and ethical, so the methodology used is discursive in nature, majorly focusing on critically reviewing existing literature, that is, the philosophical resources on Ubuntu ethics and justice theories as well as a range of government resources inclusive of public health policy documents. Social determinants of health and their impact in a South African context are discussed with the implication that health is not merely freedom from disease and or incapacity, but rather being well mentally, physically and socially. The attainment of a healthy status goes beyond ability to access healthcare services, and incorporates social determinants including but not limited to conditions in which people have been born into, stay, establish career and grow old in. It also includes the arrangements put in place to deal with illness and determine health. Issues of revenue, literacy, communal safety networks, vocation and conditions under-which vocation is undertaken, lack of work and vocation insecurity, early stages of human development, gender, cultural group, dietary insecurity, housing communal exclusion and disability all come into the picture as factors that determine health. But there is also discussion of the socio-economic status as contributors to health inequity wherein alcohol abuse, sugar intake, and smoking are identified as behavioural factors that complicate public health. One outstanding feature of this research is that it establishes a link between Ubuntu and public health policy. The researcher establishes that Ubuntu ethics is appropriate for not only discussing public morality, but also for formulating public policy that is morally tenable for South Africa, especially for the public health sector. This thesis calls for an application of Ubuntu in a proper context in order to enhance societal well-being for the benefit of many, if not all. The research proposes the fundamental principle of Ubuntu ethics in which the good of the community is as important as the good of every member of the community. Since Ubuntu ethics does not merely seek to fulfil what benefits the majority, as would be the case in a utilitarian society, the researcher advocates for the building of consensus on the common good, which should be understood to imply not just what is good for everyone in the community, but also what is good for the continued well-being of the community as a single unit. In this regard, the research finds it important that deliberate effort be made to integrate Ubuntu ethics into policies, citing the example of the National Health Insurance (NHI). The good health of all the members of a community is an assurance of the well-being and continuity of the whole national community. The research concludes that public health policy should integrate Ubuntu ethical values such as community, sharing, care, solidarity, identity, harmony, respect, and dignity into policy documents and legislation. (shrink)

Publication ethics is an important aspect of both the research and publication enterprises. It is particularly important in the field of biomedical science because published data may directly affect human health. In this article, we examine publication ethics policies in biomedical journals published in Central and Eastern Europe. We were interested in possible differences between East European countries that are members of the European Union (Eastern EU) and South-East European countries (South-East Europe) that are not members of the (...) European Union.The most common ethical issues addressed by all journals in the region were redundant publication, peer review process, and copyright or licensing details. Image manipulation, editors’ conflicts of interest and registration of clinical trialswere the least common ethical policies. Three aspects were significantly morecommon in journals published outside the EU: statements on the endorsement of international editorial standards, contributorship policy, and image manipulation.On the other hand, copyright or licensing information were more prevalent in journals published in the Eastern EU. The existence of significant differences amongbiomedical journals’ ethical policies calls for further research and active measuresto harmonize policies across journals. On the other hand, copyright or licensing information were more prevalent in journals published in the Eastern EU. The existence of significant differences among biomedical journals’ ethical policies calls for further research and active measures to harmonize policies across journals. (shrink)

Governments are increasingly using randomized controlled trials (RCTs) to evaluate policy interventions. RCTs are often understood to provide the highest quality evidence regarding the causal efficacy of an intervention. While randomization plays an essential epistemic role in the context of policy RCTs however, it also plays an important distributive role. By randomly assigning participants to either the intervention or control arm of an RCT, people are subject to different policies and so, often, to different types and levels of (...) benefits. In this paper, I identify one necessary condition as well as a set of sufficient conditions for the permissible use of random assignment by government agencies. I argue first that random assignment is permissible only if it is consistent with governments’ duty to realize morally important outcomes. I argue second that random assignment is permissible in cases where investigators are in a state of genuine equipoise regarding all arms of the experiment and the policy to which people have a claim of justice. Finally, I defend a set of conditions under which random assignment is permissible in cases where one or more arms of a policy RCT are reasonably expected to be either superior or inferior to this policy. (shrink)

How should we think of the preferences of citizens? Whereas self-optimal policy is relatively straightforward to produce, socially optimal policy often requires a more detailed examination. In this paper, we identify an issue that has received far too little attention in welfarist modelling of public policy, which we name the "hidden assumptions" problem. Hidden assumptions can be deceptive because they are not expressed explicitly and the social planner (e.g. a policy maker, a regulator, a legislator) (...) may not give them the critical attention they need. We argue that ethical expertise has a direct role to play in public discourse because it is hard to adopt a position on major issues like public health policy or healthcare prioritisation without making contentious assumptions about population ethics. We then postulate that ethicists are best situated to critically evaluate these hidden assumptions, and can therefore play a vital role in public policy debates. (shrink)

This essay seeks to see if one side or the other in the hunting debate gets more purchase if we first ask what gives the state the moral right to promote sport hunting when the practice is in deep decline. We look at the dominant economic and political reasons for state support, none of which settle the moral matter. We then look at various state appeals to moral justification (ethical hunting, the right to hunt, the value of heritage, etc.) and (...) determine that they beg the same prior questions that hunters beg--questions about the new scientific understanding of animal cognition and about the ideal individual and society in the 21st C. Neither side in the philosophical debate is helped by state promotion of hunting, given that anti-hunters also often dispense with the deeper questions and the relevant science. Conclusion: the debate should be based on the new scientific understanding of animals' capacities and on current ideals of the individual and society. State policy should reflect that. -/- thehe state should see that it is on slippery ground when it devises programs to gratify hunters and to encourage the innocent, the reluctant, and the lapsed to take up the practice. (shrink)

COVID19 pandemic has clarified that public health policies are central for the future of human societies from several perspectives. As a matter of fact, they are based on certain premises that are practical-political (e.g., ensuring the health of citizens), moral (e.g., health is a value), or epistemological (e.g., certain ideas concerning expertise and shared knowledge). Indeed, effective policies require first and foremost not only to be based on reliable data and models (i.e., so-called evidence-based policy) but also to (...) ensure that these policies are democratically accepted, shared (e.g., considering both cognitive and social dimensions), and hopefully formed after a deliberative process involving experts from various fields alongside citizens. (shrink)

The involvement of the public in the governance of genomics has become a topic of growing interest among scholars, practitioners and policy-makers. The implementation of public involvement programmes may be quite expensive, and the design and evaluation of public participation is a matter of controversy. Thus, this paper examines the justifications for public participation in the governance of genomic research to help understand whether public involvement is worthwhile and to provide a guide to the (...) design of public participation. I identify four primary justifications in support of public involvement. I argue that three of them have serious flaws: neither an increase in the stability of institutions, nor the positive effects on the virtues of individuals, nor the epistemic merits of participatory activities provide a solid ground for the engagement of the public in the governance of genomics. However, the ideal of legitimacy in the exercise of coercive power appears to lend strong support to public involvement programmes. Given that the reasons why public involvement is sought shape the design of the participatory activities, restricting the range of valid justifications promises to simplify the task of designing and evaluating public involvement. (shrink)

How should International Political Theory (IPT) relate to public policy? Should theorists aspire for their work to be policy- relevant and, if so, in what sense? When can we legitimately criticize a theory for failing to be relevant to practice? To develop a response to these questions, I will consider two issues: (1) the extent to which international political theorists should be concerned that the norms they articulate are precise enough to entail clear practical advice under different (...) empirical circumstances; (2) whether they should provide concrete practical advice on policy choice and institutional reform. These questions are related but distinct, and we should answer each quite differently. Regarding the first, I shall argue that it counts heavily against a theory if it is not precise enough to guide policy and reform given certain empirical assumptions. On the second, I will argue that theorists should be very cautious when engaging with questions of policy and institutional design. Some principles of IPT can be criticized for being insufficiently precise, but a degree of abstraction from concrete policy recommendations is a virtue, rather than a vice, of an element of IPT. I conclude that we should aim to be precise without being concrete. To help fix ideas and anchor my argument, I will discuss these issues with reference to a principle that John Rawls has advocated in his influential work The Law of Peoples (Rawls 1999a): a duty of assistance to societies that lack the capacity to satisfy the basic needs or protect the basic rights of their people. (shrink)

New York City has extensive public health regulations. Some regulations aim to reduce smoking, and they include high cigarette taxes and bans on smoking in public places such as bars, restaurants, public beaches, and public parks. Other regulations aim to combat obesity. They include regulations requiring display of calorie information on some restaurant menus and the elimination of transfats in much public cooking. One important issue is whether New York City officials -- including both (...) class='Hi'>public health officials and other city officials -- have adequately explained the justification to the public. Explanation has practical importance; the public might not back controversial and restrictive regulations unless offered a good rationale. But explanation is also an official duty, since public officials should make their reasoning transparent to their constituents. This article argues that New York City has not adequately communicated the rationales for its regulations to the public. It then offers several suggestions for improving public communication. After laying out those suggestions, this article points out that even if communication were improved, New York City’s regulations would still raise difficult philosophical issues. Those issues are briefly discussed in the final sections. NOTE: this is a reprint of a conference presentation. (shrink)

In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that (...) enjoy a presumption in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

Political theorists have offered many accounts of collective decision-making under pluralism. I discuss a key dimension on which such accounts differ: the importance assigned not only to the choices made but also to the reasons underlying those choices. On that dimension, different accounts lie in between two extremes. The ‘minimal liberal account’ holds that collective decisions should be made only on practical actions or policies and that underlying reasons should be kept private. The ‘comprehensive deliberative account’ stresses the importance of (...) giving reasons for collective decisions, where such reasons should also be collectively decided. I compare these two accounts on the basis of a formal model developed in the growing literature on the ‘discursive dilemma’ and ‘judgment aggregation’ and address several questions: What is the trade-off between the (minimal liberal) demand for reaching agreement on outcomes and the (comprehensive deliberative) demand for reason-giving? How large should the ‘sphere of public reason’ be? When do the decision procedures suggested by the two accounts agree and when not? How good are these procedures at truthtracking on factual matters? What strategic incentives do they generate for decision-makers? My discussion identifies what is at stake in the choice between minimal liberal and comprehensive deliberative accounts of collective decisionmaking, and sheds light not only on these two ideal-typical accounts themselves, but also on many characteristics that intermediate accounts share with them. (shrink)

This chapter explores some features of pragmatic pluralism as an ethical perspective on climate change. It is inspired in part by Andrew Light’s work on climate diplomacy as U.S. Assistant Secretary of Energy for International Affairs, and by Bryan Norton’s environmental pragmatism, while drawing more explicitly than Light or Norton from classical pragmatist sources such as John Dewey. The primary aim of the chapter is to characterize, differentiate, and advance a general pragmatist approach to climate ethics. The main line (...) of argument is that we are suffering culturally from a sort of “moral jetlag” due in part to “moral fundamentalist” habits, and that a critical focus on pragmatic pluralism—in moral theory generally and climate ethics particularly—would be salutary for our recovery if philosophers are to speak more effectively to “wicked problems” in a way that aids public deliberation and social learning. Moral fundamentalist habits, and the monistic one-way assumption that unintentionally—but not blamelessly—exercises and unduly reinforces them, are obstacles to fostering habits of moral and political inquiry better suited to dealing with predicaments rapidly transforming our warming planet. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted (...) by two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

People’s health is hugely affected by where they live, their occupational status and their socio-economic position. It has been widely argued that the presence of such social determinants in health provides good reasons to reject luck egalitarianism as a theory of distributive justice in health. The literature provides different reasons why this responsibility-sensitive theory of distributive justice should not be applied to health. The critiques submit that the social circumstances undermine or remove people’s responsibility for their health; responsibility sensitive health (...) policies would adversely affect those who are worst off and; the luck egalitarian approach to health distracts from the important task of rectifying socio-economic influences on people's health and provides individualistic solutions to collective problems. But for each of these variants of the critique luck egalitarianism provides suitable answers. The literature on social determinants is no detriment to the project of applying luck egalitarianism to health. (shrink)

Policy-making must always pay attention to race. That is the central claim of this chapter. Regardless of whether some particular policy debate is ostensibly “racial”, policy-makers must attend to questions of race, because race is a ubiquitous, but frequently unnoticed, feature of our world. I examine the type of philosophical question about race that I think philosophers and policy-makers would do well to examine and consider how the question “What is race?” is pertinent to policy (...) debate. Examples will be drawn from Australia, the United States, and Britain to illustrate these abstract arguments. (shrink)

There are a number of important links and similarities between public health and safety. In this extended essay, Gregg D. Caruso defends and expands his public health-quarantine model, which is a non-retributive alternative for addressing criminal behavior that draws on the public health framework and prioritizes prevention and social justice. In developing his account, he explores the relationship between public health and safety, focusing on how social inequalities and systemic injustices affect health outcomes and crime rates, (...) how poverty affects brain development, how offenders often have pre-existing medical conditions (especially mental health issues), how involvement in the criminal justice system itself can lead to or worsen health and cognitive problems, how treatment and rehabilitation methods can best be employed to reduce recidivism and reintegrate offenders back into society, and how a public health approach could be successfully applied within the criminal justice system. Caruso's approach draws on research from the health sciences, social sciences, public policy, law, psychiatry, medical ethics, neuroscience, and philosophy, and he delivers a set of ethically defensible and practically workable proposals for implementing the public health-quarantine model. The essay begins by discussing recent empirical findings in psychology, neuroscience, and the social sciences that provide us with an increased understanding of the social and neurological determinants of health and criminal behavior. It then turns to Caruso's public health-quarantine model and argues that the model provides the most justified, humane, and effective approach for addressing criminal behavior. Caruso concludes by proposing a capability approach to social justice grounded in six key features of human well-being. He argues that we cannot successfully address concerns over public health and safety without simultaneously addressing issues of social justice—including the social determinants of health (SDH) and the social determinants of criminal behavior (SDCB)—and he recommends eight general policy proposals consistent with his model. (shrink)

If the present generation refuses to bear the burden of mitigating global heating, could we motivate sufficient action by shifting that burden to our descendants? Several writers have proposed breaking the political impasse by funding mitigation through public debt. Critics attack such proposals as both unjust and infeasible. In fact, there is reason to think that some debt financing may be more equitable than placing the whole burden of mitigation on the present generation. While it might not be viable (...) for all countries to take this route simultaneously, a vanguard state, or group of states, could use public debt to fund an ambitious programme to develop inexpensive forms of clean low- or no-emission technology. This would ensure that vanguard actor or set of actors a leading role in those sectors while at the same time benefiting future generations around the world. -/- Key policy insights: (a) Debt-financed clean technology research can shift part of the burden of greenhouse gas mitigation to our descendants, breaking the political impasse of inaction or delayed action. (b) Far from being an injustice to future generations, this could actually be fairer than expecting the present generation to bear the full burden of mitigation. (c) Such an initiative may be most feasible if pursued by a vanguard actor. (shrink)

A large portion of normative philosophical thought on immigration seeks to address the question “What policies for admitting and excluding foreigners may states justly adopt?” This question places normative philosophical discussions of immigration within the boundaries of political philosophy, whose concern is the moral assessment of social institutions. Several recent contributions to normative philosophical thought on immigration propose to answer this question, but adopt methods of reasoning about possible answers that might be taken to suggest that normative philosophical inquiry about (...) immigration belongs to the field of ethics, whose concern is the moral assessment of individual action and character. This paper focuses particularly on recent work by Christopher Heath Wellman and Kieran Oberman, both of whom attempt to derive conclusions about the justice of aspects of states’ immigrant admissions policies from answers to the question “Is it morally permissible for person P to migrate internationally?” I argue in this paper that such individualist ethical approaches to normative philosophical reasoning about states’ immigration policies obscure factors consideration of which is indispensable for assessing their justice, producing misguided policy recommendations. These factors include the global structural causes of international migration, and the role wealthy receiving countries of the global North play in shaping these causes – factors that are better appreciated by political philosophy than by ethics, given the respective objects of concern of each. (shrink)