Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...) overall impact of health policy. This chapter considers what weight health policy should give to its “spill-over effects,” namely non-health and indirect benefits. (shrink)

When allocating scarce healthcare resources, the expected benefits of alternative allocations matter. But, there are different kinds of benefits. Some are direct benefits to the recipient of the resource such as the health improvements of receiving treatment. Others are indirect benefits to third parties such as the economic gains from having a healthier workforce. This article considers whether only the direct benefits of alternative healthcare resource allocations are relevant to allocation decisions, or whether indirect benefits are relevant too. First, we (...) distinguish different conceptions of direct and indirect benefits and argue that only a recipient conception could be morally relevant. We analyze four arguments for thinking that indirect benefits should not count and argue that none is successful in showing that the indirectness of a benefit is a good reason not to count it. We conclude that direct and indirect benefits should be evaluated in the same way. (shrink)

Given the long‐standing controversy about whether the brain‐dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain‐dead loved one continues to receive supportive care. We argue that while it would be ethically (...) inappropriate to continue to devote scarce acute care resources to such patients in a hospital setting, it may not be ethically inappropriate for patients to receive these resources in certain other settings. Thus, if a family insists on continuing to care for their brain‐dead loved at their home, we should not, from a policy perspective, interfere with the family's wishes. We also argue that healthcare professionals should make some effort to facilitate the transfer of brain‐dead patients to these other settings when families insist on continued treatment despite being informed about the lack of any potential for recovery of consciousness. Our arguments are strengthened by the fact that patients in a persistent vegetative state, who, when correctly diagnosed, also have no potential for recovery of consciousness, are routinely transferred from hospitals to nursing homes or long‐term care facilities where they continue to be ventilated, tube fed and to receive other supportive care. We also briefly explore the question of who should be responsible for the costs of such treatment at the long‐term care facility. (shrink)

In this article, I consider the question of whether having pets is morally permissible. However, I do so indirectly by considering three objections to the practice of having pets — what I shall call the ‘restriction of freedom objection’, the ‘property objection’, and the ‘dependency objection’. The restriction of freedom objection is dismissed relatively easily. The property objection also fails to show that having pets is morally impermissible. However, my consideration of this second objection does lead to the conclusion that (...) we ought to aim at changing existing legal systems and the majority of people's attitudes towards pets such that they (pets) are no longer considered to be the personal property of the humans in whose homes they are kept. But, while it is clear that we ought to aim at ending the practice of owning pets, it is not clear whether we ought to aim at ending the practice of keeping pets. Indeed, I do not to reach a definitive conclusion about the cogency of the dependency objection. However, I argue that this lack of clarity is of little concern at this time as our present moral obligations to pets are quite clear. (shrink)

In this dissertation, I provide an account of the protections to which most captive non-human animals are morally entitled when they participate in health-related research. At least in the animal ethics literature, it is uncontroversial that the protections currently afforded to captive research animals are inadequate. This has much to do with the fact that most animals who serve as research participants are 1) sentient and, thus, have important morally considerable interests; 2) unable to provide informed consent to their research (...) participation; and 3) seriously harmed as a result of their participation. Unsurprisingly, then, a number of authors have proposed alternative sets of protections that they take to be appropriately responsive to the morally considerable interests of research animals. However, none of the alternatives proposed ensures the ethically appropriate treatment of research animals because all are demonstrably more permissive than the set of protections governing research involving children. This seems problematic given that most animal research participants, like most pediatric research participants, are sentient and unable to provide informed consent for their research participation, and, furthermore, that these are the very characteristics that render children vulnerable — and so entitled to additional protections — in the context of research. I examine a number of reasons that might be thought to justify the discrepancy between the protections afforded to these two groups of research participants, and argue that no non-speciesist justification is forthcoming. Consequently, we ought to reflect upon how the protections currently in place for pediatric research participants might be extended to most animal research participants. I argue that most pediatric research protections, when suitably amended to account for relevant differences between most children and animals, can and should be extended to most animal research participants. I also demonstrate that doing so would require that substantial changes are made to most extant animal research studies. Since this, in turn, would require a radical transformation of the research enterprise as we know it, I also gesture towards how we might get from where we currently are to a truly just research enterprise. (shrink)

Sara Kolmes has argued that the human ‘handlers’ of emotional support animals should have the sorts of body-like rights to those animals that people with prosthetics have to their prosthetics. In support of this conclusion, she argues that ESAs both function and feel like prosthetics, and that the disanalogies between ESAs and prosthetics are irrelevant to whether humans can have body-like rights to their ESAs. In response, we argue that Ms Kolmes has failed to show that ESAs are body-like in (...) the ways that paradigmatic prostheses are and that, even if they were, these similarities would be outweighed by a crucial dissimilarity that she underestimates. (shrink)

BackgroundThe practice of giving animal research subjects proper names is frowned on by the academic scientific community. While researchers provide a number of reasons for desisting from giving their animal subjects proper names, the most common are that naming leads to anthropomorphising which, in turn, leads to data and results that are unobjective and invalid; and while naming does not necessarily entail some mistake on the researcher’s part, some feature of the research enterprise renders the practice impossible or ill-advised.ObjectivesMy aim (...) is to assess whether the scientific community’s attitude towards naming animal research subjects is justified. That is, I wish to consider whether the practice of naming animal research subjects is good or bad for the purposes of scientific research.MethodAfter reviewing the extant literature, I constructed a list of the main arguments researchers provide for desisting from naming their animal research subjects. I then analysed these arguments, with a view to determining whether they in fact provide good reasons to avoid naming animal research subjects.ConclusionI argue that none of the aforementioned reasons usually provide good grounds for not naming animal research subjects. Moreover, there are usually powerful reasons in favour of researchers giving their research animals proper names. This is because the practice usually leads to greater empathy and so to improved animal well-being. This, in turn, leads to better animal science. Thus, the scientific community’s attitude towards naming animal research subjects is not justified. (shrink)

Jessica du Toit wonders if our relationship with our pets can be morally defended.