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Nancy Jecker
University of Washington
  1.  3
    Ending Midlife Bias: New Values for Old Age.Nancy S. Jecker - 2020 - Oup Usa.
    As average lifespans stretch to new lengths, how are human values impacted? Should our values change over the course of our ever-increasing lifespans? Nancy S. Jecker introduces a new concept, the life stage relativity of values, which holds that at different life stages, different ethical concerns should take center stage. For Jecker, the privileging of midlife values raises fundamental problems of fairness, and reveals large gaps in ethical principles and theories. Jecker introduces a new philosophical framework that reflects the life (...)
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  2.  57
    Medical Futility: Its Meaning and Ethical Implications.Lawrence J. Schneiderman, Nancy S. Jecker & Albert R. Jonsen - forthcoming - Bioethics.
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  3.  69
    Vaccine Ethics: An Ethical Framework for Global Distribution of COVID-19 Vaccines.Nancy S. Jecker, Aaron G. Wightman & Douglas S. Diekema - forthcoming - Journal of Medical Ethics.
    This paper addresses the just distribution of vaccines against the SARS-CoV-2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping people with the greatest need, (...)
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  4.  31
    Nothing to Be Ashamed Of: Sex Robots for Older Adults with Disabilities.Nancy S. Jecker - 2021 - Journal of Medical Ethics 47 (1):26-32.
    This paper spotlights ways in which sexual capacities relate to central human capabilities, such as the ability to generate a personally meaningful story of one’s life; be physically, mentally and emotionally healthy; experience bodily integrity; affiliate and bond with others; feel and express a range of human emotions; and choose a plan of life. It sets forth a dignity-based argument for affording older people access to sex robots as part of reasonable efforts to support their central human capabilities at a (...)
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  5.  21
    Prioritizing Frontline Workers During the COVID-19 Pandemic.Nancy S. Jecker, Aaron G. Wightman & Douglas S. Diekema - 2020 - American Journal of Bioethics 20 (7):128-132.
    Volume 20, Issue 7, July 2020, Page 128-132.
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  6.  16
    Is That the Same Person? Case Studies in Neurosurgery.Nancy S. Jecker & Andrew L. Ko - 2017 - American Journal of Bioethics Neuroscience 8 (3):160-170.
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  7.  28
    You’Ve Got a Friend in Me: Sociable Robots for Older Adults in an Age of Global Pandemics.Nancy S. Jecker - 2020 - Ethics and Information Technology 23 (S1):35-43.
    Social isolation and loneliness are ongoing threats to health made worse by the coronavirus disease 2019 pandemic. During the pandemic, half the globe's population have been placed under strict physical distancing orders and many long-term care facilities serving older adults went into lockdown mode, restricting access to all visitors, including family members. Before the pandemic emerged, a 2020 National Academy of Sciences, Engineering and Medicine report warned of the underappreciated adverse effects of social isolation and loneliness on health, especially among (...)
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  8.  5
    African Conceptions of Age‐Based Moral Standing: Anchoring Values to Regional Realities.Nancy S. Jecker - 2020 - Hastings Center Report 50 (2):35-43.
  9.  21
    Vaccine Passports and Health Disparities: A Perilous Journey.Nancy S. Jecker - 2022 - Journal of Medical Ethics 48 (12):957-960.
    This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vaccines are widely and equitably available. It raises health equity concerns related (...)
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  10.  26
    The Moral Standing of Social Robots: Untapped Insights from Africa.Nancy S. Jecker, Caesar A. Atiure & Martin Odei Ajei - 2022 - Philosophy and Technology 35 (2):1-22.
    This paper presents an African relational view of social robots’ moral standing which draws on the philosophy of ubuntu. The introduction places the question of moral standing in historical and cultural contexts. Section 2 demonstrates an ubuntu framework by applying it to the fictional case of a social robot named Klara, taken from Ishiguro’s novel, Klara and the Sun. We argue that an ubuntu ethic assigns moral standing to Klara, based on her relational qualities and pro-social virtues. Section 3 introduces (...)
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  11.  49
    Justice Between Age Groups: An Objection to the Prudential Lifespan Approach.Nancy S. Jecker - 2013 - American Journal of Bioethics 13 (8):3-15.
    Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...)
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  12.  11
    Ethical Guidance for Selecting Clinical Trials to Receive Limited Space in an Immunotherapy Production Facility.Nancy S. Jecker, Aaron G. Wightman, Abby R. Rosenberg & Douglas S. Diekema - 2018 - American Journal of Bioethics 18 (4):58-67.
    Our aims are to set forth a multiprinciple system for selecting among clinical trials competing for limited space in an immunotherapy production facility that supplies products under investigation by scientific investigators; defend this system by appealing to justice principles; and illustrate our proposal by showing how it might be implemented. Our overarching aim is to assist manufacturers of immunotherapeutic products and other potentially breakthrough experimental therapies with the ethical task of prioritizing requests from scientific investigators when production capacity is limited.
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  13.  15
    Can we wrong a robot?Nancy S. Jecker - forthcoming - AI and Society:1-10.
    With the development of increasingly sophisticated sociable robots, robot-human relationships are being transformed. Not only can sociable robots furnish emotional support and companionship for humans, humans can also form relationships with robots that they value highly. It is natural to ask, do robots that stand in close relationships with us have any moral standing over and above their purely instrumental value as means to human ends. We might ask our question this way, ‘Are there ways we can act towards robots (...)
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  14.  11
    From Protection to Entitlement: Selecting Research Subjects for Early Phase Clinical Trials Involving Breakthrough Therapies.Nancy S. Jecker, Aaron G. Wightman, Abby R. Rosenberg & Douglas S. Diekema - 2017 - Journal of Medical Ethics 43 (6):391-400.
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  15.  6
    Does Zero-COVID Neglect Health Disparities?Nancy S. Jecker & Derrick K. S. Au - 2022 - Journal of Medical Ethics 48 (3):169-172.
    Since the World Health Organization first declared the novel coronavirus a pandemic, diverse strategies have emerged to address it. This paper focuses on two leading strategies, elimination and mitigation, and examines their ethical basis. Elimination or ‘Zero-COVID’ dominates policies in Pacific Rim societies. It sets as a goal zero deaths and seeks to contain transmission using stringent short-term lockdowns, followed by strict find, test, trace and isolate methods. Mitigation, which dominates in the US and most European nations, sets targets for (...)
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  16.  8
    The time of one's life: views of aging and age group justice.Nancy S. Jecker - 2021 - History and Philosophy of the Life Sciences 43 (1):1-14.
    This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group (...)
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  17.  8
    What’s Yours is Ours: Waiving Intellectual Property Protections for COVID-19 Vaccines.Nancy S. Jecker & Caesar A. Atuire - 2021 - Journal of Medical Ethics 47 (9):595-598.
    This paper gives an ethical argument for temporarily waiving intellectual property protections for COVID-19 vaccines. It examines two proposals under discussion at the World Trade Organization : the India/South Africa proposal and the WTO Director General proposal. Section I explains the background leading up to the WTO debate. Section II rebuts ethical arguments for retaining current IP protections, which appeal to benefiting society by spurring innovation and protecting rightful ownership. It sets forth positive ethical arguments for a temporary waiver that (...)
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  18.  12
    Global Sharing of COVID‐19 Vaccines: A Duty of Justice, Not Charity.Nancy S. Jecker - forthcoming - Developing World Bioethics.
  19.  9
    Towards a New Model of Global Health Justice: The Case of COVID-19 Vaccines.Nancy S. Jecker, Caesar A. Atuire & Susan D. Bull - forthcoming - Journal of Medical Ethics.
    This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad range of global actors up and down the chain of vaccine development who contribute to global vaccine inequities. Section 1 presents an overview of moments in which diverse global actors, each with their own priorities and aims, shaped subsequent vaccine distribution. Section 2 characterises collective action failures at each phase of (...)
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  20.  45
    A Broader View of Justice.Nancy S. Jecker - 2008 - American Journal of Bioethics 8 (10):2 – 10.
    In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came (...)
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  21.  78
    Are Filial Duties Unfounded?Nancy S. Jecker - 1989 - American Philosophical Quarterly 26 (1):73 - 80.
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  22.  89
    Medical Futility: The Duty Not to Treat.Nancy S. Jecker & Lawrence J. Schneiderman - 1993 - Cambridge Quarterly of Healthcare Ethics 2 (2):151.
    Partly because physicians can “never say never,” partly because of the seduction of modern technology, and partly out of misplaced fear of litigation, physicians have increasingly shown a tendency to undertake treatments that have no realistic expectation of success. For this reason, we have articulated common sense criteria for medical futility. If a treatment can be shown not to have worked in the last 100 cases, we propose that it be regarded as medically futile. Also, if the treatment fails to (...)
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  23.  25
    Knowing When to Stop: The Limits of Medicine.Nancy S. Jecker - 1991 - Hastings Center Report 21 (3):5-8.
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  24.  19
    Endangerment of the iPSC Stock Project in Japan: On the Ethics of Public Funding Policies.Akira Akabayashi, Eisuke Nakazawa & Nancy S. Jecker - 2018 - Journal of Medical Ethics 44 (10):700-702.
    We examined the ethical justification for a national policy governing public funding for the induced pluripotent stem cell stock project in Japan and argue that the initiation of the iPSC stock project in 2012, when no clinical trial using iPSC-derived products had yet succeeded, was premature and unethical. Our analysis considers a generally accepted justice criterion and shows it fails to justify public funding of the iPSC stock project. We also raise concerns related to the massive amounts of public funding (...)
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  25.  47
    Doing What We Shouldn't: Medical Futility and Moral Distress.Nancy S. Jecker - 2017 - American Journal of Bioethics 17 (2):41-43.
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  26.  2
    Three for Me and None for You? An Ethical Argument for Delaying COVID-19 Boosters.Nancy S. Jecker & Zohar Lederman - 2022 - Journal of Medical Ethics 48 (10):662-665.
    This paper argues in support of the WHO’s proposal to forego COVID-19 booster shots until 10% of people in every country are fully vaccinated. The Ethical Argument section shows that we save the most lives and ensure the least amount of suffering by allocating doses first to unvaccinated people. It also argues that there is a duty to support decent lives and to promote health equity, which establish that refraining from boosters is a requirement of justice, not charity. The Replies (...)
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  27.  14
    What Money Can’T Buy: An Argument Against Paying People to Get Vaccinated.Nancy S. Jecker - 2022 - Journal of Medical Ethics 48 (6):362-366.
    This paper considers the proposal to pay people to get vaccinated against the SARS-CoV-2 virus. The first section introduces arguments against the proposal, including less intrusive alternatives, unequal effects on populations and economic conditions that render payment more difficult to refuse. The second section considers arguments favouring payment, including arguments appealing to health equity, consistency, being worth the cost, respect for autonomy, good citizenship, the ends justifying the means and the threat of mutant strains. The third section spotlights long-term and (...)
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  28.  35
    Rethinking Rescue Medicine.Nancy S. Jecker - 2015 - American Journal of Bioethics 15 (2):12-18.
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  29.  59
    Caring for Patients in Cross‐Cultural Settings.Nancy S. Jecker, Joseph A. Carrese & Robert A. Pearlman - 1995 - Hastings Center Report 25 (1):6-14.
  30.  35
    Age‐Related Inequalities in Health and Healthcare: The Life Stages Approach.Nancy S. Jecker - 2018 - Developing World Bioethics 18 (2):144-155.
    How should healthcare systems prepare to care for growing numbers and proportions of older people? Older people generally suffer worse health than younger people do. Should societies take steps to reduce age-related health inequalities? Some express concern that doing so would increase age-related inequalities in healthcare. This paper addresses this debate by presenting an argument in support of three principles for distributing scarce resources between age groups; framing these principles of age group justice in terms of life stages; and indicating (...)
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  31. Should a Criminal Receive a Heart Transplant? Medical Justice Vs. Societal Justice.Lawrence J. Schneiderman & Nancy S. Jecker - 1996 - Theoretical Medicine and Bioethics 17 (1).
    Should the nation provide expensive care and scarce organs to convicted felons? We distinguish between two fields of justice: Medical Justice and Societal Justice. Although there is general acceptance within the medical profession that physicians may distribute limited treatments based solely on potential medical benefits without regard to nonmedical factors, that does not mean that society cannot impose limits based on societal factors. If a society considers the convicted felon to be a full member, then that person would be entitled (...)
     
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  32.  3
    Too Old to Save? COVID‐19 and Age‐Based Allocation of Lifesaving Medical Care.Nancy S. Jecker - 2022 - Bioethics 36 (7):802-808.
    Bioethics, Volume 36, Issue 7, Page 802-808, September 2022.
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  33.  92
    The Ascription of Rights in Wrongful Life Suits.Nancy S. Jecker - 1987 - Law and Philosophy 6 (2):149-165.
    Wrongful life is an action brought by a defective child who sues to recover for pecuniary or emotional damages suffered as a result of being conceived or born with deformities. In such cases, plaintiff alleges that the negligence of a responsible third party,1 such as physician, hospital, or medical laboratory, is the proximate cause of plaintiff's being born or conceived and thus being compelled to suffer the debilitating effects of a deformity. The child does not sue to recover for the (...)
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  34.  36
    Is There a ‘Right to Try’ Experimental Therapies? Ethical Criteria for Selecting Patients With Spinal Muscular Atrophy to Receive Nusinersen in an Expanded Access Program.Nancy S. Jecker - 2017 - American Journal of Bioethics 17 (10):70-71.
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  35.  4
    Bioethics in Africa: A Contextually Enlightened Analysis of Three Cases.Nancy S. Jecker & Caesar Atuire - 2022 - Developing World Bioethics 22 (2):112-122.
    Developing World Bioethics, Volume 22, Issue 2, Page 112-122, June 2022.
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  36.  3
    Shaming and Stigmatizing Healthcare Workers in Japan During the COVID-19 Pandemic.Nancy S. Jecker & Shizuko Takahashi - 2021 - Public Health Ethics 14 (1):72-78.
    Stigmatization and sharming of healthcare workers in Japan during the coronavirus 2019 pandemic reveal uniquely Japanese features. Seken, usually translated as ‘social appearance or appearance in the eyes of others,’ is a deep undercurrent woven into the fabric of Japanese life. It has led to providers who become ill with the SARS-CoV-2 virus feeling ashamed, while concealing their conditions from coworkers and public health officials. It also has led to healthcare providers being perceived as polluted and their children being told (...)
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  37. Taking Care of One's Own: Justice and Family Caregiving.Nancy S. Jecker - 2002 - Theoretical Medicine and Bioethics 23 (2):117-133.
    This paper asks whether adult children have aduty of justice to act as caregivers for theirfrail, elderly parents. I begin (Sections I.and II.) by locating the historical reasons whyrelationships within families were not thoughtto raise issues of justice. I argue that thesereasons are misguided. The paper next presentsspecific examples showing the relevance ofjustice to family relationships. I point outthat in the United States today, the burden ofcaregiving for dependent parents fallsdisproportionately on women (Sections III. andIV.). The paper goes on to (...)
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  38.  3
    Bioethics in Africa: A Contextually Enlightened Analysis of Three Cases.Nancy S. Jecker & Caesar Atuire - 2022 - Developing World Bioethics 22 (2):112-122.
    Developing World Bioethics, Volume 22, Issue 2, Page 112-122, June 2022.
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  39.  25
    Justice and Global Care Chains: Lessons From Singapore.Nancy S. Jecker & Jacqueline Joon‐Lin Chin - 2019 - Developing World Bioethics 19 (3):155-168.
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  40.  17
    What Do We Owe the Newly Dead? An Ethical Analysis of Findings From Japan's Corpse Hotels Workers.Nancy S. Jecker & Eriko Miwa - 2019 - Bioethics 33 (6):691-698.
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  41.  46
    Exploiting Subjects in Placebo-Controlled Trials.Nancy S. Jecker - 2002 - American Journal of Bioethics 2 (2):19 – 20.
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  42.  18
    Health Care Systems: Moral Conflicts in European and American Public Policy.Nancy S. Jecker, Lynn Payer, Hans-Martin Sass & Robert U. Massey - 1989 - Hastings Center Report 19 (6):46.
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  43.  75
    Medical Futility: A Paradigm Analysis. [REVIEW]Nancy S. Jecker - 2007 - HEC Forum 19 (1):13-32.
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  44.  10
    Advance Care Planning: What Gives Prior Wishes Normative Force?Nancy S. Jecker - 2016 - Asian Bioethics Review 8 (3):195-210.
    The conventional wisdom about advance care planning holds that the normative force of my prior wishes is simply that they are mine. It is their connection to me that matters. This paper challenges conventional thinking. I propose that the normative force of prior wishes does not depend exclusively on personal identity. Instead, it sometimes depends on a special relationship that exists between a prior, capacitated person and a now incapacitated person. I consider what normative guidance governs persons who stand in (...)
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  45.  22
    Pfizer’s Corporate Citizenship.Nancy S. Jecker - 2018 - American Journal of Bioethics 18 (11):18-20.
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  46.  22
    The Abuse of Futility.Lawrence J. Schneiderman, Nancy S. Jecker & Albert R. Jonsen - 2018 - Perspectives in Biology and Medicine 60 (3):295-313.
    Two recent policy statements by providers of critical care representing the United States and Europe have rejected the concept and language of “medical futility,” on the ground that there is no universal consensus on a definition. They recommend using “potentially inappropriate” or “inappropriate” instead. As Bosslet and colleagues state: The term “potentially inappropriate” should be used, rather than futile, to describe treatments that have at least some chance of accomplishing the effect sought by the patient, but clinicians believe that competing (...)
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  47.  6
    Realizing Ubuntu in Global Health: An African Approach to Global Health Justice.Nancy S. Jecker, Caesar A. Atuire & Nora Kenworthy - forthcoming - Public Health Ethics.
    The COVID-19 pandemic has highlighted the question, ‘What do we owe each other as members of a global community during a global health crisis?’ In tandem, it has raised underlying concerns about how we should prepare for the next infectious disease outbreak and what we owe to people in other countries during normal times. While the prevailing bioethics literature addresses these questions drawing on values and concepts prominent in the global north, this paper articulates responses prominent in sub-Saharan Africa. The (...)
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  48.  75
    The Role of Standpoint in Justice Theory.Nancy S. Jecker - 2008 - Journal of Value Inquiry 42 (2):165-182.
  49.  56
    Protecting the Vulnerable.Nancy S. Jecker - 2004 - American Journal of Bioethics 4 (3):60-62.
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  50.  25
    What We Have Reason to Value: Human Capabilities and Public Reason.Nancy S. Jecker - 2021 - In Hon-Lam Li & Michael Campbell (eds.), Public Reason and Bioethics: Three Perspectives. Springer Verlag. pp. 337-357.
    This chapter sets forth an interpretation of public reason that appeals to our central capabilities as human beings. I argue that appealing to central human capabilities and to the related idea of respect for threshold capabilities is the best way to understand public reason. My defense of this position advances stepwise: first, I consider a central alternative to a capability account, which regards public reason as a matter of contracting; next, I describe central concerns with contract views and show how (...)
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