Policy-makers sometimes aim to improve well-being as a policy goal, but to do this they need some way to measure well-being. Instead of relying on potentially problematic theories of well-being to justify their choice of well-being measure, Daniel Hausman proposes that policy-makers can sometimes rely on preference-based measures as evidence for well-being. I claim that Hausman’s evidential account does not justify the use of any one measure more than it justifies the use of any other measure. This (...) leaves us at a loss as to which policy should be chosen in the non-trivial cases for which there is substantial disagreement between the different measures in their assessment of policy. (shrink)

Self-authorship has been established as the basis of an influential liberal principle of legislation and public policy. Being the author of one’s own life is a significant component of one’s own well-being, and therefore is better understood from the viewpoint of the person whose life it is. However, most philosophical accounts, including Raz’s conception of self-authorship, rely on general and abstract principles rather than specific, individual psychological properties of the person whose life it is. We elaborate on the principles (...) of self-authorship on the basis of self-determination theory, an empirically based psychological theory that has been at the forefront of the study of autonomy and self-authorship for more than 45 years. Our account transcends distinctions between positive and negative freedom and attempts to pinpoint the exact properties of self-authorship within the psychological processes of intrinsic motivation and internalization. If a primary objective of public policy is to support self-authorship, then it should be devised on the basis of how intrinsic motivation and internalization can be properly supported. Self-determination theory identifies three basic psychological needs: autonomy, competence, and relatedness. The satisfaction of these needs is associated with the support and growth of intrinsic tendencies and the advancement of well-being. Through this analysis, we can properly evaluate the significance of rationality, basic goods, and the availability of options to self-authorship. Implications for law and policy are discussed with an emphasis on legal paternalism and what many theorists call “liberal perfectionism,” that is, the non-coercive support and promotion of the good life. (shrink)

The article delineates how actors invoke nationalizing accounts—accounts that turn local conditions, actions, and actors into national ones—in everyday talk. Taking the case of Japanese university scientists depicting their commercialization trajectories after the adoption of a set of policies that originated from the U.S., the article delineates how scientists stipulate what they do is Japanese. I outline the discursive practices through which they posit that the cause of others’ actions, or of they themselves, derives from some kind of ethno-national distinctiveness. (...) Interviews show how such nationalizing accounts were made through the inevitable gaps between local practices and formal global structures. Scientific and commercialization practices in Japan that deviated from the original form were explained not only through the institutional differences between the U.S. and Japan, but also through lay categories of “culture,” ethno-psychology, and readily available tropes about Japanese history. In such nationalizing accounts, what the Japanese scientists did under these new, and explicitly global policies, was argued to be fundamentally Japanese because they were rooted in and caused by the ethno-national character. As new institutional theory suggests, a decoupling between formal rules and local contingencies is a hallmark of any institution. The article further shows that such decoupling could then be used as a resource for everyday nationalism. At least in some cases, the global adoption and the localization of a global form may create an opportunity to enact the nation, contributing to a discourse that posits that an imagined community is distinct and special, precisely as the world becomes more globalized. (shrink)

This article surveys deontological retributivist thought about judgments concerning deserved punishments. A number of conceptions of desert are described: they vary with respect to their claims about consequential moral luck and the role that desert judgments play in morality. Some retributivists claim that desert claims support obligations to punish; others that they establish ceilings on permissible severity; others that they do both. Further specific conceptual issues about desert of punishment are described, for example, whether a criminal record is relevant. The (...) evidence that retributivists offer for their desert claims are critically assessed. These usually involve appeals to moral intuition. It is argued that these are often weak. The most plausible claim is that desert establishes a ceiling on permissible severity, but no retributivist has shown what amounts of punishment are deserved, so this may not be true. Retributivists might helpfully investigate if moral theory can resolve some of their disputes. (shrink)

In this paper, I introduce a special case of epistemic injustice that I call ‘structural contributory injustice’. This conception aims to capture some dimensions of how policy—separately from individual agential interactions—can generate epistemic injustice at a group level. I first locate the case within Kristie Dotson’s original conception of contributory injustice. I then consider one potential case of structural contributory injustice—namely, the policy problem of significant financial risk burden on students considering university in the USA. Finally, I consider (...) potential policy reforms in response to this injustice. (shrink)

National greenhouse-gas accounting should reflect how countries’ policies and behaviours affect global emissions. Actions that contribute to reduced global emissions should be credited, and actions that increase them should be penalized. This is essential if accounting is to serve as accurate guidance for climate policy. Yet this principle is not satisfied by the two most common accounting methods. Production-based accounting used under the Kyoto Protocol does not account for carbon leakage — the phenomenon of countries (...) reducing their domestic emissions by shifting carbon-intensive production abroad1. Consumption-based accounting2,3 does not credit countries for cleaning up their export industries, and it also punishes some types of trade that could contribute to more carbon efficient production worldwide. We propose an improvement to consumption-based carbon accounting that takes technology differences in export sectors into account and thereby tends to more correctly reflect how national policy changes affect total global emissions. We also present empirical results showing how this new measure redraws the global emissions map. (shrink)

This volume analyses the moral and legal foundations of privacy, security, and accountability along with the tensions that arise between these important individual and social values.

There are many general economic policies I favour such that I would feel significantly ashamed were I to succumb to bribery, or to institutional pressure short of physical threat, to publicly support their opposites. Here are a few of these policies: (1) Rich countries should not impose trade barriers, including subsidies for their own producers, against imports from poor countries. (2) Leaders of poor countries should be regarded as irresponsible when they imply to their people that their economic difficulties arise (...) principally from wickedness and exploitative behavior on the part of rich countries – the moral urgency of (1) notwithstanding. (3) Much freer movement of people across national borders for purposes of labour should be allowed everywhere. (4) Destitution is an unduly severe penalty for laziness, lack of talent or intelligence, or bad luck. More productive people should provide the lazy, the unskilled and the unlucky with as large a basic income grant as is compatible with maximizing net social productivity (which no present society comes very close to doing, partly due to confused social morality and partly due to incentive-distorting tax systems). (shrink)

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (shrink)

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (shrink)

We suggest that policies will be less popular when individuals personally have to pay for them rather than when others have to pay (i.e., a Not Out of My Bank Account or NOMBA effect). Dual process models of persuasion suggest that personally having to pay would motivate scrutiny of persuasive messages making it essential to use effective science communication tactics when using climate science to support climate change policies. A pilot experiment (N = 186) and main study (N = 758) (...) support a NOMBA effect with less policy support (Pilot study) and lower recommended fees (Main study) for a policy that would require participants, rather than another group, to pay a fee for community solar panels. Consistent with dual process models and suggesting systematic processing, only when participants would have to pay the fee, messages using strong (vs. weak) science communication tactics increased support for policies (Pilot study), increased the favorability of thoughts about the policy (Main study) and these thoughts subsequently predicted policy support (Main study). Inconsistent with propositions that information about expert sources would be a heuristic or bolster science messages, expert consensus information did not influence thoughts or policy support in any study condition. Efforts to understand climate change policy support would benefit from attending to research on dual process models of persuasion, including understanding how different types and degree of outcome relevance can alter how people process science information used to bolster support for climate change policies. (shrink)

The United States juvenile justice system has primary oversight of youth who come into contact with legal authorities. This system is purposefully distinct from the adult system given the presumption of youths’ reduced culpability for delinquent behavior and increased potential for rehabilitation. Some juvenile court policies and practices are supportive of youth while others may drive youth further into the juvenile justice system. Today, we are at a point in which we can—and should—use information technology to accrue data to unpack (...) the impact of these policies and practices on and across youth. Moreover, technology-driven policies and practices such as electronic monitoring may be detrimental to the well-being of youth, whereas others such as video conferencing could be more widely used to benefit youth. While juvenile courts hold youth accountable for their behavior, courts also need to be accountable to youth by employing data-informed policies and practices that advance the health and well-being of youth. (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)

Public reason demands that policies are justified to all reasonable citizens. Public health aims at protecting or improving aggregated health outcomes. Since health is not an uncontroversial value, an insurmountable chasm between public reason and public health seems to preclude any viable synthesis between the two outlooks. For any given public health policy, some reasonable citizen seems to have a reason to support ‘no policy’ over ‘some policy’, meaning that the policy cannot be justified to all. (...) The paper first spells out what exactly this conflict is about. Then, using smoking as a case, the paper outlines a model of reconciliation between public reason and public health that should give us some optimism if we want to have public health policies that are compatible with treating citizens as free and equal in the public reason sense. (shrink)

Accountability is a cornerstone of the governance of artificial intelligence (AI). However, it is often defined too imprecisely because its multifaceted nature and the sociotechnical structure of AI systems imply a variety of values, practices, and measures to which accountability in AI can refer. We address this lack of clarity by defining accountability in terms of answerability, identifying three conditions of possibility (authority recognition, interrogation, and limitation of power), and an architecture of seven features (context, range, agent, forum, standards, process, (...) and implications). We analyse this architecture through four accountability goals (compliance, report, oversight, and enforcement). We argue that these goals are often complementary and that policy-makers emphasise or prioritise some over others depending on the proactive or reactive use of accountability and the missions of AI governance. (shrink)

Federal credit policies toward agriculture reflect the human values of maintaining the farm production sector largely as an industry characterized by small-scale, family farms. The Farmers Home Administration has implemented various credit programs designed to carry out this policy objective. As a result of the prolonged financial crisis in the farm economy, the agricultural community is becoming more aware of the controversies surrounding the mission of FmHA and its debt restructuring program. This paper discusses the debt restructuring program administered (...) by the Farmers Home Administration (FmHA), as authorized by the Agricultural Credit Act of 1987, and amended by the recently enacted Farm Bill of 1990. It discusses the key provisions of the Agricultural Credit Act authorizing FmHA to establish a debt restructuring and debt forgiveness program aimed at achieving the public policy objective of keeping financially stressed farmers in business, whenever possible.In the course of reviewing the restructuring program, FmHA officials and congressional committees reviewed the FmHA's mission and its program implementation. This review indicated that several unintended negative consequences resulted from several abuses stemming from inadequate administrative mechanisms and controls and conflicting legislative objectives of debt forgiveness and federal tax policy. In enacting the 1990 Farm Bill, Congress sought to reorient FmHA's mission to a temporary source of credit and to eliminate various abuses associated with the implementation of FmHA's debt restructuring program. The 1990 Farm Bill reflects an effort by Congress to address some the controversies surrounding federal credit policies toward agriculture. Although Congress placed limits on debt restructuring, the overall public policy objective of maintaining a family-farm posture in the agricultural sector continues to be an important social value. (shrink)

This study presented the policy of functional integration of the product planning team as a strategy for the development of the pharmaceutical industry in Palestine. The study population consists of all the workers in companies operating in the field of medicine in Palestine, which are (5) companies producing in the West Bank only for pharmaceuticals used by these companies, which are (296) employees, and was used a simple random sample to choose the sample and size (87) employees of the (...) study population, and to achieve the objectives of the study (87) questionnaires were distributed. The descriptive analytical method was used, and SPSS was used to answer and discuss the study's questions. The results showed that there is a significant relationship between the effectiveness of the policy of product development and the competitiveness of pharmaceutical companies in Palestine (West Bank), where the policy of product development efficiency accounts for 56.6% of the total change in the competitiveness of companies. The product quality component was most influential at all levels of product development effectiveness policy, followed by product identification, product cost reduction, packaging and product deletion. The weakest areas of strategic direction in pharmaceutical companies in Palestine (West Bank) are 67%. The weakest aspects of job integration are: non-regular meetings of representatives of different positions to participate in any project related to product development, to achieve spatial convergence of members of the product planning policy team in offices, laboratories and workplaces. (shrink)

This article presents two related challenges to the idea that, to ensure policy evaluation is comprehensive, all costs and benefits should be aggregated into a single, equity-weighted wellbeing metric. The first is to point out how, even allowing for equity-weighting, the use of a single metric limits the extent to which we can take distributional concerns into account. The second challenge starts from the observation that in this and many other ways, aggregating diverse effects into a single metric of (...) evaluation necessarily involves settling many moral questions that reasonable people disagree about. This raises serious questions as to what role such a method of policy evaluation can and should play in informing policy-making in liberal democracies. Ultimately, to ensure comprehensiveness of policy evaluation in a wider sense, namely, that all the diverse effects that reasonable people might think matter are kept score of, we need multiple metrics as inputs to public deliberation. (shrink)

This article takes the role of provocateur to ‘queer(y)’ the rules of intelligibility surrounding new schooling accountabilities. Butler’s work is seldom used outside the arena of gender and sexualities research. A ‘queer(y)ing’ methodology is subsequently applied in a context very different to where it is frequently associated. Empirical data from a case study secondary school in Australia are used to contextualise the use of queer theory in thinking differently about new schooling accountabilities and how they can unfold in ways that (...) are unforeseen and unexpected. By applying Butlerian theory in a manner very different to what is commonly expected, the author also destabilises the use of queer theory as well. (shrink)

If philosophers of science advise government on science policy, it will have to be from a descriptive theory of scientific validity taken as hypothetically normative, as in naturalized epistemology. While logical positivism denied any normative import for the practice of science, in the area of "operational definitions" it had an unfortunate influence in psychology and sociology, and one that persists in the accountability movement. Not all philosophy of science issues have implications for the justificatory practice of scientists. For example, (...) both anti-realists and realists condone scientific quarreling about unobserved particles. Many young philosophers of science are now contributing to a sociology of scientific validity which, taken in a hypothetically normative manner, will produce recommendations on science policy. (shrink)

This article addresses the complexities of institutional transfer by exploring the case of EMILY's List and WIN WIN, two women's organizations in the US and Japan respectively that seek to increase the number of women in office by providing funds early in candidatescultures of giving’ exist, they do not necessarily preclude the success of an EMILY's List-type organization in Japan. Instead, WIN WIN made significant strategic organizational decisions that have impeded its ability to have a significant impact on female candidacy (...) at the national level. Specifically, WIN WIN's lack of accountability to its members combined with its broader commitment to gender consciousness have limited its success. (shrink)

Drawing on the SAGE minutes and other documents, I consider the wider lessons for norms of scientific advising that can be learned from the UK’s initial response to coronavirus in the period January-March 2020, when an initial strategy that planned to avoid total suppression of transmission was abruptly replaced by an aggressive suppression strategy. I introduce a distinction between “normatively light advice”, in which no specific policy option is recommended, and “normatively heavy advice” that does make an explicit recommendation. (...) I argue that, although scientific advisers should avoid normatively heavy advice in normal times in order to facilitate democratic accountability, this norm can be permissibly overridden in situations of grave emergency. SAGE’s major mistake in early 2020 was not that of endorsing a particular strategy, nor that of being insufficiently precautionary, but that of relying too heavily on a specific set of “reasonable worst-case” planning assumptions. I formulate some proposals that assign a more circumscribed role to “worst-case” thinking in emergency planning. In an epilogue, I consider what the implications of my proposals would have been for the UK’s response to the “second wave” of late 2020. (shrink)

Revealing flaws in both 'green' and market-based approaches to environmental policy, O'Neill develops an Aristotolian account of well-being. He examines the implications for wider issues involving markets, civil society an.

The capability approach was developed as a response to the ‘equality of what?’ question, which asks what the metric of equality should be. The alternative answers are, broadly, welfare, resources or capabilities. G.A. Cohen has raised influential criticisms of this last response. He suggests that the capability approach’s focus on individuals’ freedom – their capability to control their own lives – renders its view of well-being excessively ‘athletic’, ignoring benefits achieved passively, without the active involvement of the benefitted individual. However, (...) positing ‘capabilities’ as the appropriate metric of distributive justice need not commit capability theorists to a comprehensive account of well-being, and so not to the athletic conception Cohen ascribes to them. Their aim can, instead, be to delineate legitimate government action and guide egalitarian public policy. Capabilities, in this context, are not just components of individual well-being; they must also be the appropriate goal of just distributive policies. When understood in this way, as a guide to policy, I will argue that the capability approach’s focus on ‘athletic’ individual freedom and control is justified: in the public domain, it is important not just that individuals receive ‘benefits’, but that they participate in their achievement. (shrink)

Revealing flaws in both 'green' and market-based approaches to environmental policy, O'Neill develops an Aristotolian account of well-being. He examines the implications for wider issues involving markets, civil society an.

This paper critically analyses the concept of evidence in evidence-based-policy arguing that there is key problem: that there is no existing practicable theory of evidence, one which is philosophically grounded and yet applicable for evidencebased policy. The paper critically considers both philosophical accounts of evidence and practical treatments of evidence in evidence-based-policy. It argues that both fail in different ways to provide a theory of evidence that is adequate for evidence-basedpolicy. The paper is a valuable contribution to (...) the part of the research project that explores how evidence can and should be used to reduce contingency in science, and policy based on science. (shrink)

Several presidents have created bioethics councils to advise their administrations on the importance, meaning and possible implementation or regulation of rapidly developing biomedical technologies. From 2001 to 2005, the President's Council on Bioethics, created by President George W. Bush, was under the leadership of Leon Kass. The Kass Council, as it was known, undertook what Adam Briggle describes as a more rich understanding of its task than that of previous councils. The council sought to understand what it means to advance (...) human flourishing at the intersection of philosophy, politics, science, and technology within a democratic society. Briggle's survey of the history of U.S. public bioethics and advisory bioethics commissions, followed by an analysis of what constitutes a "rich" bioethics, forms the first part of the book. The second part treats the Kass Council as a case study of a federal institution that offered public, ethical advice within a highly polarized context, with the attendant charges of inappropriate politicization and policy irrelevance. The conclusion synthesizes the author's findings into a story about the possible relationships between philosophy and policy making. "Adam Briggle has written a rich and sympathetic account of the President's Council on Bioethics led by Leon Kass. It puts in historical context the efforts of this council to move beyond the limited 'instrumentalist' approaches to bioethics taken by earlier commissions, toward a more philosophically serious effort to deliberate on the human goods put in play by modern biomedicine. In the process it answers many of the charges of politicization and corrects the record concerning the council's work." --_Francis Fukuyama, The Johns Hopkins School of Advanced International Studies_ "What an eloquent, humane, and wise book. Briggle discovers an imperfect yet fascinating effort to bring the world of biomedical research into the domain of public philosophy. His scholarship and generosity make clear that a democratic society need not be morally shackled to the realm of the possible that science is constantly expanding." --_Daniel Sarewitz, Consortium for Science, Policy, and Outcomes, Arizona State University _ "This is the most persuasive and thoughtful reconstruction of the Kass Council's goals and rationale that I have seen. Adam Briggle's account of the notion of a 'richer' bioethics is comprehensive an well-reasoned." --_Jonathan D. Moreno, University of Pennsylvania _ "Adam Briggle has written a fine book on a complex, controversial topic. He shows the wisdom of the approach to bioethics taken by the Kass Council, sets right the unfair and often nasty attacks on the council and Kass himself, and offers a perceptive and wide-ranging look at the terrain of ethics." --_Daniel Callahan, The Hastings Center _. (shrink)

Given the evolution of the public health (PH) and the changes from the phenomenon of globalization, this area has encountered new ethical challenges. In order to find a coherent approach to address ethical issues in PH policy, this study aimed to identify the evolution of public health ethics (PHE) frameworks and the main moral values and norms in PH practice and policy. According to the research questions, a systematic search of the literature, in English, with no time limit (...) was performed using the main keywords in databases Web of Science (ISI) and PubMed. Finally, the full text of 56 papers was analyzed. Most of the frameworks have common underpinning assumptions and beliefs, and the need to balance PH moral obligation to prevent harm and health promotion with respect for individual autonomy has been specified. As such, a clear shift from liberal values in biomedical ethics is seen toward the community’s collective values in PHE. The main moral norms in PH practice and policy included protecting the population against harm and improving PH benefits, utility and evidenced-based effectiveness, distributive justice and fairness, respect for all, privacy and confidentiality, solidarity, social responsibility, community empowerment and participation, transparency, accountability and trust. Systematic review of PHE frameworks indicates utilization of the aforementioned moral norms through an practical framework as an ethical guide for action in the PH policy. The validity of this process requires a systematic approach including procedural conditions. (shrink)

The European policies acknowledge greenways and “Green Infrastructure” as strategically planned and delivered networks comprising the broadest range of green spaces and other environmental features. The Aniene River, linking the eastern suburbs of Rome to the City of Tivoli, has been envisaged in a multi-level approach as a Green-Blue Infrastructure able to hinder land use fragmentation and provide new continuity to remainders of open space. In turn, landscape is taken into account as a biodiversity reservoir, the scenery of outstanding cultural (...) heritage and the relevant backdrop of ordinary life. (shrink)

Cultural rights of minority groups are recognized in international human rights law. These rights include the right of minority groups to adopt various measures to protect their cultural identity, which may include closure of the group’s community from outsiders. The state in which such groups reside has a concurrent duty to respect these rights and sometimes even to take positive measures to ensure their implementation. The consideration of demographic factors, then, is regarded as legitimate when designed to protect minority groups. (...) The rights of majority groups, on the other hand, are often ensured by the mere fact that they constitute a majority within the state and as such do not require special measures. This state of affairs is challenged, however, in face of mass immigration that could change the relation existing between majority and minority groups within the state. Under these circumstances, does a majority have the right to preserve its own culture through an immigration policy that takes into account demographic factors? I argue that the duty of states under international human rights law to protect rights of minority groups might serve as an incentive to restrict immigration endangering the character of the state. This character—the state’s public culture—is the outcome of collective preferences of the majority of its citizens, which is assumed ought to be respected. (shrink)

In this paper we offer a critical assessment of the politics of the Christian Right and question the degree to which the religious values of the Christian Right are compatible with a democratic political culture. If religious values are equally political values making the separation of religious belief and political action a fraught exercise, then a number of issues arise. Political action inspired by religious faith should not prevent critical scrutiny of the underlying values, or more importantly, their influence in (...) shaping public debate and public policy. If religious values are indeed political values, then do protections of freedom of religious expression privilege forms of faith-based politics over secular forms? And if so, to what end? We argue that a more nuanced analysis of the intersection of religion and politics is required to ensure that public politics is not threatened by particular forms of religious political activism that exhibit totalitarian tendencies. At the very least, close attention needs to be focused on particular policy advocates and the agenda they seek to advance with little accountability or transparency despite claims to represent the public interest. It is to these ends that this paper makes a contribution. (shrink)

About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to the (...) normative principles of medical ethics and reproductive justice, centreing patients and their individual reproductive intentions and desires. Abortion regulations, through their influence on patients and providers, may facilitate or impede such ethical care at the bedside. In this paper, we present a framework to model how abortion legislation should fit into the patient–provider relationship and to clarify the dynamics by which legislation may affect healthcare encounters. Our proposed framework serves as a tool to analyse the ethical impact of abortion regulations. We propose a model for assessing abortion policies based not on legislators’ or advocates’ individual moral claims, but on the shared, normative framework of clinical medical ethics. Through contrasting case studies, we demonstrate how a robust normative ethical framework can recentre patients and their reproductive needs. Our model is one way to account for—and safeguard—patients’ diverse viewpoints and needs in the development of abortion policy, and it can serve to ground narratives for advocacy by healthcare workers and their professional organisations. (shrink)