Lockdown measures in response to the COVID-19 pandemic involve placing huge burdens on some members of society for the sake of benefiting other members of society. How should we decide when these policies are permissible? Many writers propose we should address this question using cost-benefit analysis, a broadly consequentialist approach. We argue for an alternative non-consequentialist approach, grounded in contractualist moral theorising. The first section sets up key issues in the ethics of lockdown, and sketches the apparent appeal of addressing (...) these problems in a CBA frame. The second section argues that CBA fundamentally distorts the normative landscape in two ways: first, in principle, it allows very many morally trivial preferences—say, for a coffee—might outweigh morally weighty life-and-death concerns; second, it is insensitive to the core moral distinction between victims and vectors of disease. The third section sketches our non-consequentialist alternative, grounded in Thomas Scanlon’s contractualist moral theory. On this account, the ethics of self-defence implies a strong default presumption in favour of a highly restrictive, universal lockdown policy: we then ask whether there are alternatives to such a policy which are justifiable to all affected parties, paying particular attention to the complaints of those most burdened by policy. In the fourth section, we defend our contractualist approach against the charge that it is impractical or counterintuitive, noting that actual CBAs face similar, or worse, challenges. (shrink)

In this article, we aim to map out the complexities which characterise debates about the ethics of vaccine distribution, particularly those surrounding the distribution of the COVID-19 vaccine. In doing so, we distinguish three general principles which might be used to distribute goods and two ambiguities in how one might wish to spell them out. We then argue that we can understand actual debates around the COVID-19 vaccine – including those over prioritising vaccinating the most vulnerable – as reflecting disagreements (...) over these principles. Finally, we shift our attention away from traditional discussions of distributive justice, highlighting the importance of concerns about risk imposition, special duties, and social roles in explaining debates over the COVID-19 vaccine. We conclude that the normative complexity this article highlights deepens the need for decision-making bodies to be sensitive to public input. (shrink)

In recent years, the argument from inductive risk against value free science has enjoyed a revival. This paper investigates and clarifies this argument through means of a case-study: neonicitinoid research. Sect. 1 argues that the argument from inductive risk is best conceptualised as a claim about scientists’ communicative obligations. Sect. 2 then shows why this argument is inapplicable to “public communication”. Sect. 3 outlines non-epistemic reasons why non-epistemic values should not play a role in public communicative contexts. Sect. 4 analyses (...) the implications of these arguments both for the specific case of neonicitinoid research and for understanding the limits of the argument from inductive risk. Sect. 5 sketches the broader implications of my claims for understanding the “Value Free Ideal” for science. (shrink)

In a recent paper, Gregor Betz has defended the value-free ideal: “the justification of scientific findings should not be based on non-epistemic values”against the methodological critique, by reference to the work of the International Panel on Climate Change . This paper argues that Betz’s defence is unsuccessful. First, Betz’s argument is sketched, and it is shown that the IPCC does not avoid the need to “translate” claims. In Section 2, it is argued that Betz mischaracterises the force of the methodological (...) critique. Section 3 shows why the methodological critique still applies to the work of the IPCC even on a refined version of Betz’s argument. Section 4 then considers an alternative way of defending the work of the IPCC which is in-line with, but does not clearly vindicate, the value-free ideal. (shrink)

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

In many countries and regions across the world, the initial response to the massive health risks posed by COVID-19 has been the institution of lockdown measures. Although they vary from place to place, these measures all involve trade-offs between ethical goods and imperatives, imposing significant restrictions on central human capabilities—including citizens’ ability to work, socialize, exercise democratic rights, and access education—in the name of protecting population health. As such, it seems imperative for philosophers to ask whether lockdown measures are ethical.This (...) is a difficult question. We are deeply uncertain about the possible effects of COVID-19 and of lockdown policies, raising questions about... (shrink)

In this article I ask two questions prompted by the phenomenon of ‘politically patterned’ climate change denial. First, can an individual's political commitments provide her with good reasons not to defer to cognitive experts’ testimony? Building on work in philosophy of science on inductive risk, I argue they can. Second, can an individual's political commitments provide her with good reasons not to defer to the Intergovernmental Panel on Climate Change's testimony? I argue that they cannot, because of the high epistemic (...) standards which govern that body's assertions. The conclusion discusses the theoretical and practical implications of my arguments. (shrink)

In the first part of the paper, three objections to the precautionary principle are outlined: the principle requires some account of how to balance risks of significant harms; the principle focuses on action and ignores the costs of inaction; and the principle threatens epistemic anarchy. I argue that these objections may overlook two distinctive features of precautionary thought: a suspicion of the value of “full scientific certainty”; and a desire to distinguish environmental doings from allowings. In Section 2, I argue (...) that any simple distinction between environmental doings and allowings is untenable. However, I argue that the appeal of such a distinction can be captured within a relational account of environmental equity. In Section 3 I show how the proposed account of environmental justice can generate a justification for distinctively “precautionary” policy-making. (shrink)

Like many, I find the idea of relying on patient preference predictors in life-or-death cases ethically troubling. As part of his stimulating discussion, Sharadin1 diagnoses such unease as a worry that using PPPs disrespects patients’ autonomy, by treating their most intimate and significant desires as if they were caused by their demographic traits. I agree entirely with Sharadin’s ‘debunking’ response to this concern: we can use statistical correlations to predict others’ preferences without thereby assuming any causal claim. However, I suspect (...) that, for at least some of us, our unease about PPPs stems from a different kind of ‘autonomy’ concern. In this commentary, then, I will explore this concern, and show how it relates to Sharadin’s work. Very many of our preferences are caused, ultimately, by facts which are outside our control, such as our demographic features. However, I suggest that we can still act autonomously on the basis of such preferences, when they are preferences which we endorse. Imagine, for example, that Jane has grown up in a church-growing environment, which has shaped many of her preferences, …. (shrink)

This paper re-interprets the precautionary principle as a ‘social epistemic rule’. First, it argues that sometimes policy-makers should act on claims which have not been scientifically established....

Objectivity is a key concept both in how we talk about science in everyday life and in the philosophy of science. This Element explores various ways in which recent philosophers of science have thought about the nature, value and achievability of objectivity. The first section explains the general trend in recent philosophy of science away from a notion of objectivity as a 'view from nowhere' to a focus on the relationship between objectivity and trust. Section 2 discusses the relationship between (...) objectivity and recent arguments attacking the viability or desirability of 'value free' science. Section 3 outlines Longino's influential 'social' account of objectivity, suggesting some worries about drawing too strong a link between epistemic and ethical virtues. Section 4 turns to the value of objectivity, exploring concerns that notions of objectivity are politically problematic, and cautiously advocating in response a view of objectivity in terms of invariance. (shrink)

This paper argues for a novel account of deceitful scientific communication, as “wishful speaking”. This concept is of relevance both to philosophy of science and to discussions of the ethics of lying and misleading. Section 1 outlines a case-study of “ghost-managed” research. Section 2 introduces the concept of “wishful speaking” and shows how it relates to other forms of misleading communication. Sections 3–5 consider some complications raised by the example of pharmaceutical research; concerning the ethics of silence; how research strategies—as (...) well as the communication of results—may be misleading; and questions of multiple authorship. The conclusion suggests some more general conclusions. (shrink)

There are many analogies between medical and judicial practice. This article explores one such analogy, between “medicalization” and “criminalization.” Specifically, drawing on an analogy between a judge’s speech act of delivering a verdict and a physician’s speech act of giving a diagnosis, it suggests a novel account of the phenomenon of “overdiagnosis.” Using this approach, we can make some headway in understanding debates over the early detection of cancer. The final section outlines the relationship between this approach and familiar debates (...) in philosophy of medicine on the nature of disease and in philosophy of science on the “value-free ideal.”. (shrink)

This paper investigates whether being “physically insecure” (being at risk of not continuing to meet one's physical needs in the future) should be thought of as a constituent of current wellbeing. In §1, it is argued that we cannot understand the value of security in terms of “freedom from fear”. In §2, it is argued that the reliablist approach to epistemology can help us to construct an account of why physical security is valuable, by relating security to the conditions of (...) agency for practically and epistemically limited animals. In §3, this argument is compared with other attempts to understand the value of physical security. In §4, the relationship between security and threats of rights violation is clarified. In §5, the epistemic analogy of §2 is used to suggest a difference between the concepts of “security” and “capability”. (shrink)

This paper explores some of the ethical issues around offering COVID-19 vaccines to children. My main conclusion is rather paradoxical: the younger we go, the stronger the grounds for justified parental hesitancy and, as such, the stronger the arguments for enforcing vaccination. I suggest that this is not thereductio ad absurdumit appears, but does point to difficult questions about the nature of parental authority in vaccination cases. The first section sketches the disagreement over vaccinating teenagers, arguing that the UK policy (...) was permissible. The second section outlines a problem for this policy, that it faces justified vaccine hesitancy. The third section discusses three strategies for responding to this problem, arguing that there may be no simple way of overcoming parents’ reasons to resist vaccinations. (shrink)

Pre-natal-diagnosis technologies allow parents to discover whether their child is likely to suffer from serious disability. One argument for state funding of access to such technologies is that doing so would be “cost-effective”, in the sense that the expected financial costs of such a programme would be outweighed by expected “benefits”, stemming from the births of fewer children with serious disabilities. This argument is extremely controversial. This paper argues that the argument may not be as unacceptable as is often assumed. (...) In doing so, it sets out a more general framework for assessing the relevance of efficiency calculations to policy-making. The final section also investigates the relationship between the paper’s arguments and claims about parental responsibility for child-bearing and rearing, with reference to Scanlon’s work on “substantive responsibility”. (shrink)

Sometimes, states face emergencies: situations where many individuals face an imminent threat of serious harm. Some believe that in such cases certain sorts of actions which are normally morally prohibited might be permissible. In this paper, I discuss this view as it applies in both the contexts of war and of public health policy. I suggest that the deontologist can best understand emergencies by analogy with the distinction between act- and rule consequentialism. In real world cases, we must often make (...) decisions in ‘epistemically murky’ situations, such that the application of deontological principles to particular cases is unclear. I suggest that we develop conventions to deal with such cases in a manner which we think is most likely to approximate the demands of abstract deontological principles across time. I claim that we can best understand ‘supreme emergencies’ as situations which ‘epistemic murkiness’ is resolved. In such cases, there may be a conflict between what would be valid application of abstract deontological principles and the conventions which normally guide us in epistemically murky situations. (shrink)

Pre-natal-diagnosis technologies allow parents to discover whether their child is likely to suffer from serious disability. One argument for state funding of access to such technologies is that doing so would be “cost-effective”, in the sense that the expected financial costs of such a programme would be outweighed by expected “benefits”, stemming from the births of fewer children with serious disabilities. This argument is extremely controversial. This paper argues that the argument may not be as unacceptable as is often assumed. (...) In doing so, it sets out a more general framework for assessing the relevance of efficiency calculations to policy-making. The final section also investigates the relationship between the paper’s arguments and claims about parental responsibility for child-bearing and rearing, with reference to Scanlon’s work on “substantive responsibility”. (shrink)

Screening for asymptomatic disease is a routine aspect of contemporary public health practice. However, it is also controversial, because it leads to overdiagnosis and overtreatment, with many arguing that programmes are “ineffective,” i.e., the “costs” outweigh the “benefits.” This paper explores a more fundamental objection to screening programmes: that, even if they are effective, they are ethically impermissible because they breach the principle of non-maleficence. In so doing, it suggests a new approach to the ethics of risk, justifying a concern (...) with how policies affect individuals’ absolute ex-ante prospects. Part 1 sets up the tension between screening and non-maleficence. Part 2 introduces and motivates a novel interpretation of the non-maleficence principle, “ex-ante Do No Harm,” which resolves this tension. Part 3 defends and clarifies this principle by discussing its relationship to the ex-ante Pareto principle. Part 4 discusses the worry that risk estimates are too “subjective.”. (shrink)

Many public debates over policies aimed at curbing alcohol consumption start from an assumption that policies should not affect ‘responsible’ drinkers. In this article, I examine this normative claim, which I call prudentialism. In the first part of the article, I argue that prudentialism is both a demanding and distinctive doctrine, which philosophers should consider seriously. In the middle sections, I examine the relationship between prudentialism and two familiar topics in public health ethics: the prevention paradox and the relationship between (...) responsibility and solidarity. I argue that standard positions in these debates do not necessarily undermine prudentialism. In the final part of the article, I outline an alternative, more successful, argument against prudentialism: that the categories of ‘responsible’ and ‘irresponsible’ drinking behaviour are not ‘apt’ for use in policy. I show how this objection relates to Elizabeth Anderson's arguments against the more familiar doctrine of ‘luck egalitarianism’. (shrink)

We normally think that public health policy is an important political activity. In turn, we normally understand the value of public health policy in terms of the promotion of health or some health-related good (such as opportunity for health), on the basis of the assumption that health is an important constituent or determinant of wellbeing. In this paper, I argue that the assumption that the value of public health policy should be understood in terms of health leads us to overlook (...) important benefits generated by such policy. To capture these benefits we need to understand the ends of public health policy in terms of the promotion of 'physical safety'. I then go on to argue that the idea that 'health' is an important category for evaluating or estimating individuals' wellbeing in the normative context of social policy is confused. I then clarify the relationship between my arguments and QALY-based accounts of health assessment. In the final section of the paper, I defend this surprising conclusion against various attacks. (shrink)

During the COVID-19 pandemic, there was disagreement over whether the science supported facemask mandates. This paper interrogates debates over this question, paying particular attention to an ambiguity between two scientific virtues: epistemic caution and epistemic responsiveness. I suggest that there is an argument from each virtue to reasons to trust scientists’ claims in policy debate. However, as the case of facemask debates illustrates, it is not clear that scientists can possess both virtues simultaneously: the two virtues are in tension. After (...) showing how this general framework can help us better understand debate, I turn to consider some possible ways of resolving this tension, arguing that none of them is entirely satisfactory. (shrink)

Professional responsibility -- Social justice -- Professional development -- Actionable knowledge -- Expert knowledge and skills -- Strategy and artistry -- Professional effectiveness -- Critical social challenges -- Transformational practice -- Conclusions.

This paper uses the case-study of controversy over the MMT vaccine to suggest that non-expert audiences might have a fairness-based "political" obligation to defer to expert scientific consensus. The first part of the paper notes various reasons why it is implausible to argue that non-experts are epistemically obliged to defer to the consensus. The second draws on the literature on vaccination ethics more generally to argue for the alternative political obligation to defer. The third section considers some objections, and the (...) conclusion discusses how recognising such an obligation might alter contemporary debates. (shrink)

In this article, I respond to ‘Fighting Status Inequalities’. I first note a niggle about the paper’s assumption that lowering socio-economic inequalities will lower the social gradient in health. I then suggest two further ways in which neorepublicanism may relate to social epidemiology: in terms of ‘moral physiology’ and through analysing which inequalities are unjust.