In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

Henry Richardson argues that we can determine our ends rationally. He constructs a rich and original theory of how we can reason about our final goals. Richardson defuses the counter-arguments for the limits of rational deliberation, and develops interesting ideas about how his model might be extended to interpersonal deliberation of ends, taking him to the borders of political theory. Along the way Richardson offers illuminating discussions of, inter alia, Aristotle, Aquinas, Sidgwick, and Dewey, as well as the work of (...) several contemporary philosophers. (shrink)

Researchers do not owe their subjects the same level of care that physicians owe patients, but they owe more than merely what the research protocol stipulates. In keeping with the dynamics of the relationship between researcher and subject, they have limited but substantive fiduciary obligations.

Henry Richardson argues that we can determine our ends rationally. He constructs a rich and original theory of how we can reason about our final goals. Richardson defuses the counter-arguments for the limits of rational deliberation, and develops interesting ideas about how his model might be extended to interpersonal deliberation of ends, taking him to the borders of political theory. Along the way Richardson offers illuminating discussions of, inter alia, Aristotle, Aquinas, Sidgwick, and Dewey, as well as the work of (...) several contemporary philosophers. (shrink)

The philosopher Henry Richardson's short book is a defense of a position on a neglected topic in medical research ethics. Clinical research ethics has been a longstanding area of study, dating back to the aftermath of the Nazi death-camp doctors and the Tuskegee syphilis study. Most ethical regulations and institutions have developed in response to those past abuses, including the stress on obtaining informed consent from the subject. Richardson points out that that these ethical regulations do not address one of (...) the key dilemmas faced by medical researchers -- whether or not they have obligations towards subjects who need care not directly related to the purpose of the study, termed 'ancillary care obligation'. (shrink)

The notion that it is useful to specify norms progressively in order to resolve doubts about what to do, which I developed initially in a 1990 article, has been only partly assimilated by the bioethics literature. The thought is not just that it is helpful to work with relatively specific norms. It is more than that: specification can replace deductive subsumption and balancing. Here I argue against two versions of reliance on balancing that are prominent in recent bioethical discussions. Without (...) meaning to address the substance or the overall merits of either view I criticize, I attack Gert, Culver and Clouser's implicit reliance on some overall dimension of balancing as a basis of resolving conflicts among norms and Beauchamp and Childress's residual acceptance of 'justified balancing'. The former authors' description of resolving conflicts depends upon a type of value commensurability that (as they otherwise seem to admit) does not obtain, while the latter authors' role for justified balancing would be better served by continued specification. (shrink)

Henry S. Richardson is Professor of Philosophy at Georgetown University. From 2008-18, he was the editor of Ethics. His previous books include Practical Reasoning about Final Ends, Democratic Autonomy, and Moral Entanglements. He has held fellowships sponsored by the Alexander von Humboldt Foundation, the National Endowment for the Humanities, and the University Center for Human Values at Princeton University.

Recent work on incidental fndings, concentrating on the difcult problems posed by the ambiguous results often generated by high-tech medicine, has proceeded largely independently from recent work on medical researchers' ancillary-care obligations, the obligations that researchers have to deal with diseases or conditions besides the one(s) under study. This paper contends that the two topics are morally linked, and specifcally that a sound understanding of ancillary-care obligations will center them on incidental fndings. The paper sets out and defends an understanding (...) of ancillary-care obligations, which is based on the idea that when participants signed up for a study they may — independently of their beliefs and expectations and of those of the researchers — be taken to have partially entrusted certain aspects of their health into the researchers' hands. This partial-entrustment model of ancillary-care obligations, in turn, has substantive implications for how to deal ethically with incidental fndings; for instance, it suggests that researchers have no moral obligation to hunt for incidental fndings. (shrink)

Moral reasoning is individual or collective practical reasoning about what, morally, one ought to do. Philosophical examination of moral reasoning faces both distinctive puzzles — about how we recognize moral considerations and cope with conflicts among them and about how they move us to act — and distinctive opportunities for gleaning insight about what we ought to do from how we reason about what we ought to do.

This paper explores the convergence of two recent and growing streams of bioethical work and concern. Each has originated independently, but each arises from the fact that the Common Rule that has shaped medical research ethics, as institutionalized in the United States and also abroad, is largely silent about what needs to be done in response to researchers’ positive obligations. One stream concerns what to do about the sometimes vast range of findings that may arise incidentally to performing research procedures. (...) The other asks whether medical researchers owe their study participants any “ancillary care” — that is, medical care that their study participants need but that goes beyond what is required to do the science safely. (shrink)

Martha Nussbaum has powerfully argued in Frontiers ofJustice and elsewhere that John Rawls’s sort of social-contract theory cannot usefully be deployed to deal with issues pertaining to justice for the disabled. To counter this claim, this article deploys Rawls’s sort of social-contract theory in order to deal with issues pertaining to justice for the disabled—or, since, as Nussbaum stresses, we all have some degree of disability—for the severely disabled. In this way, rather than questioning one by one Nussbaum’s interpretive claims (...) about Rawls’s view, one can simply see how the Rawlsian framework can work in application to this issue. Following Rawls’s lead, the paper utilizes the idealized “initial choice situation” as an analytic and comparative device for examining alternative principles of justice, developing three different interpretations of the initial choice situation that each correspond to a different set of principles that apply to people of all levels of disability. One of these sets of principles is a simple extension of Rawls’s, one is very close to what Nussbaum herself recommends, and the third is a kind of hybrid. In this way, it is shown not only that Rawls’s social-contract device can usefully be applied to these issues, but also that it is helpful for exploring the deep commitments underlying each of these competing sets of principles. (shrink)

A collection of critical essays by English and American scholars, including such controversial academic political theorists as Gutmann, Barry and Nussbaum, that raises questions about the current theoretical reassessment of political liberalism.

I am going to be discussing a mode of moral responsibility that anglophone philosophers have largely neglected. It is a type of responsibility that looks to the future rather than the past. Because this forward-looking moral responsibility is relatively unfamiliar in the lexicon of analytic philosophy, many of my locutions will initially strike many readers as odd. As a matter of everyday speech, however, the notion of forward-looking moral responsibility is perfectly familiar. Today, for instance, I said I would be (...) responsible for watching my nieces while they swam. Neglecting this responsibility would have been a moral fault. When people marry, they undertake responsibilities, of moral import, of fidelity and mutual support. When people have children, they accrue moral responsibilities to feed, rear, and educate them. Not all forward-looking responsibilities are moral. While finishing this essay, I have had to keep an eye on a number of my administrative responsibilities, and, while reading it, you may well be occasionally distracted by some of your own. The notion of a responsibility that we accrue or take on, to look out for some range of concerns over some range of the future, is, then, perfectly familiar. Because this common notion of forward-looking responsibility has not been integrated into recent moral theory, however, my philosophical discussion of it will initially seem strange. (shrink)

Morain and Largent’s (2023) thorough and thoughtful article concludes that the partial-entrustment model of medical researchers’ ancillary-care obligations (Richardson and Belsky 2004; Belsky and R...

A Theory of Freedom and Government has provided a systematic basis for republican theory in the idea of freedom as non-domination. Can a pure republican view, which confines itself to the normative resources thus afforded, adequately address the full range of issues of social justice? This article argues that while there are many sorts of structural injustice with which a pure republican view can well cope, unfair disparities in political influence, of the kind that Rawls labeled failures of the ‘fair (...) value’ of the equal political liberties, cannot be well addressed by a pure republican view. In arguing the point, the article assesses the reach not only of the core ideal of freedom as non-domination itself, but also of three further layers in Pettit’s republican theory: its suggestion that domination is to be minimized, its account of a set of institutions needed to restrict domination, and its requirement that, to prevent governments from having the power to act arbitrarily and so to dominate, they be made responsive to the common good. Some of these further conceptual resources are shown to be of no help in addressing unfair disparities in political influence, while the ones that are promising are so only because they rely on distinctively liberal ideals, and so depart from a pure republican basis. Key Words: republicanism • liberalism • justice • common good • non-domination • fair value • Philip Pettit • John Rawls. (shrink)

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

This article develops a uniform interpretation of "pursuit for the sake of an end", explaining what an "unqualified final" end (sought solely for its own sake) offers that a (merely) final one does not and providing an improved account of what Aristotle means by an "ultimate end". This interpretation sheds light on (1) the regress argument at the outset of "N.E." I.2, (2) the way Aristotle argues for the existence of a highest good, (3) the special contribution of "self-sufficiency" (autarkeia) (...) within that good, and (4) the potential flexibility of Aristotle's view about the content of the highest good. (shrink)

Frances Kamm has for some time now been a foremost champion of non-consequentialist ethics. One of her most powerful non-consequentialist themes has been the idea of inviolability. Morality's prohibitions, she argues, confer on persons the status of inviolability. This thought helps articulate a rationale for moral prohibitions that will resist the protean threat posed by the consequentialist argument that anyone should surely be willing to violate a constraint if doing so will minimize the overall number of such violations. As Kamm (...) put it in a 1992 article, ‘If morality permitted minimizing violations of persons by violating other persons, then each of those saved as well as those persons used to save others would be less inviolable. It is the permission, not any actual violation of persons, that makes this so.’ Now, as thus baldly asserted, this claim borders on the conclusory. It is almost as if the claim were that morality conferred on persons the following status: that of being protected from consequentialism. One wants to hear in what inviolability consists, in more detail, so that we can understand it independently of the negation of consequentialism. And there is also an opposite problem: if inviolability is a good, then why can't consequentialism take it into account? Hence, one also wants to hear why this would not be the case. (shrink)

This paper develops and explores the idea of moral entanglements: the ways in which, through innocent transactions with others, we can unintendedly accrue special obligations to them. More particularly, the paper explains intimacy-based moral entanglements, to which we become liable by accepting another's waiver of privacy rights. Sometimes, having entered into others' private affairs for innocent or even helpful reasons, one discovers needs of theirs that then become the focus of special duties of care. The general duty to warn them (...) of their need cannot directly account for the full extent of these duties, but does indicate why a silent retreat is impermissible. The special duties of care importantly rest on a transfer of responsibilities that accompanies the privacy waivers. The result is a special obligation of beneficence that, while grounded in a voluntary transaction, was never voluntarily undertaken. Impartialist views of beneficence cannot capture the relevant phenomena well. (shrink)

In various contexts, it is thought to be important that we reason together. For instance, an attractive conception of democracy requires that citizens reach lawmaking decisions by reasoning with one another. Reasoning requires that reasoners survey the considerations that they take to be reasons, proceed by a coherent train of thought, and reach conclusions freely. De facto reliance on experts threatens the possibility of collective reasoning by making some reasons collectively unsurveyable, raising questions about the coherence of the resulting train (...) of thought. De jure reliance on experts threatens the possibility of collective reasoning by seeming to make some conclusions irreversible. The paper argues that collective reasoning that relies on experts would nonetheless be possible if the unsurveyable reasons "mesh," if the expert considerations are at least in principle publicly recoverable, and if de jure authority of expert decision is always subject to appeal. (shrink)

Frances Kamm has for some time now been a foremost champion of non-consequentialist ethics. One of her most powerful non-consequentialist themes has been the idea of inviolability. Morality's prohibitions, she argues, confer on persons the status of inviolability. This thought helps articulate a rationale for moral prohibitions that will resist the protean threat posed by the consequentialist argument that anyone should surely be willing to violate a constraint if doing so will minimize the overall number of such violations. As Kamm (...) put it in a 1992 article, ‘If morality permitted minimizing violations of persons by violating other persons, then each of those saved as well as those persons used to save others would be less inviolable. It is the permission, not any actual violation of persons, that makes this so.’ Now, as thus baldly asserted, this claim borders on the conclusory. It is almost as if the claim were that morality conferred on persons the following status: that of being protected from consequentialism. One wants to hear in what inviolability consists, in more detail, so that we can understand it independently of the negation of consequentialism. And there is also an opposite problem: if inviolability is a good, then why can't consequentialism take it into account? Hence, one also wants to hear why this would not be the case. (shrink)

David Estlund’s Democratic Authority develops a novel doctrine of “normative consent,” according to which the nonconsent of those with a duty to consent is null. This article suggests that this doctrine can be defended by confining it to contexts involving consent to an authority, which raise distinctive normative challenges, but argues that Estlund’s attempt to deploy the doctrine fails, for it does not provide convincing reasons to think that citizens have any duty to consent. In closing, the article suggests that (...) the doctrine of normative consent might yet do some useful work in a quite different theoretical setting. (shrink)

First Published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.

Sittlichkeit seduces: Hegel’s third category of Right, intended to synthesize impartially derived rights with a subjectively centered morality of the good, understandably piques the hopes of his modern readers. How could it not? Sittlichkeit, Ethical Life, holds out the prospect of so much that we still seek. It promises to reconcile welfare and autonomy while guaranteeing concrete content for their product. By combining legal duty with a place for conscience and freedom, it could solve a central problem of politics. Most (...) broadly, Sittlichkeit would graft Enlightenment individualism onto a more Aristotelian conception of social order, merging the benefits of ancient virtue and modern liberty. Who would not want to have their cake and eat it in this way? (shrink)

David Estlund’s Democratic Authority develops a novel doctrine of “normative consent,” according to which the nonconsent of those with a duty to consent is null. This article suggests that this doctrine can be defended by confining it to contexts involving consent to an authority, which raise distinctive normative challenges, but argues that Estlund’s attempt to deploy the doctrine fails, for it does not provide convincing reasons to think that citizens have any duty to consent. In closing, the article suggests that (...) the doctrine of normative consent might yet do some useful work in a quite different theoretical setting. (shrink)

Journal of Social Philosophy, EarlyView.

Sittlichkeit seduces: Hegel’s third category of Right, intended to synthesize impartially derived rights with a subjectively centered morality of the good, understandably piques the hopes of his modern readers. How could it not? Sittlichkeit, Ethical Life, holds out the prospect of so much that we still seek. It promises to reconcile welfare and autonomy while guaranteeing concrete content for their product. By combining legal duty with a place for conscience and freedom, it could solve a central problem of politics. Most (...) broadly, Sittlichkeit would graft Enlightenment individualism onto a more Aristotelian conception of social order, merging the benefits of ancient virtue and modern liberty. Who would not want to have their cake and eat it in this way? (shrink)

It is often debated whether what we ought, politically, to do is determined by standards that are independent of any actual political process or whether, by contrast, judgments reached in actual democratic processes have constitutive importance in determining what we should do. This paper argues that this is not an exclusive disjunction and that, consistently with there being independent standards, constitutively authoritative judgments can enter into the truth-conditions pertaining to claims about what we ought, politically, to do. The crucial objection (...) to constitutive judgment is that it involves an unacceptable form of bootstrapping, according to which reasons arise out of nothing. To circumvent this objection, the paper deploys John Broome's notion of a wide-scope 'normative requirement'. Normative requirements affect what ought to be done without altering the balance of reasons and defuse the bootstrapping objection by blocking the derivation of all-things-considered conclusions. To show that politics involves constitutive authority of this kind, the paper defends two illustrative normative requirements applicable to the political process that give constitutive roles to political judgments of various kinds. Throughout, the discussion is enlivened by comparisons to the judgments of a baseball umpire, which have been illuminatingly discussed by Robert Brandom. (shrink)

As one of the most important ethicists to emerge since the Second World War, Alan Gewirth continues to influence philosophical debates concerning morality. In this ground-breaking book, Gewirth's neo-Kantianism, and the communitarian problems discussed, form a dialogue on the foundation of moral theory. Themes of agent-centered constraints, the formal structure of theories, and the relationship between freedom and duty are examined along with such new perspectives as feminism, the Stoics, and Sartre. Gewirth offers a picture of the philosopher's theory and (...) its applications, providing a richer, more complete critical assessement than any which has occurred to date. (shrink)