There are more refugees than many states have a duty to accept. As a result, many states are permitted to accept only some refugees and not others. This raises the question of how states should select these refugees. I defend the claim that states should resettle the worst‐off refugees, and maximize the number of refugees gaining a sufficiently decent life. When resettling the worst off conflicts with maximising the number gaining a sufficiently decent life, states should select refugees to maximise (...) aggregate benefits, with benefits holding greater weight the further refugees are from a sufficiency threshold. The only exception to this rule is when it entails wrongful discrimination, in which case states should only follow this rule if victims of discrimination benefit and consent to its implementation. (shrink)

Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese (...) parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

It is widely accepted that states have a right to control immigration, but must accept refugees at risk in their home countries. If this is true, perhaps states have a right to deport refugees once their lives are no longer at risk in their home countries. I raise three types of arguments against this claim, and in support of refugees’ right to remain. Citizenship-based arguments hold that refugees have a right to obtain citizenship, and with citizenship comes the right to (...) remain. Plans-based arguments hold that refugees have a right to plan their lives, and they will struggle to plan without the right to remain. Reciprocity-based arguments hold that refugees have a right to reciprocal relationships with citizens, far easier if they know they can remain. I reject the first two arguments, and defend the third. (shrink)

It is commonly claimed that when X coerces Y into consenting to Z φ-ing, Y’s consent is invalid, and Z is only permitted to φ if this reduces harm or increases optionality for Y. This article demonstrates that Y’s consent in such cases is valid if Y is choosing between options that include all those Z has a duty to offer Y and no autonomy-reducing options Z has a duty to not offer Y. When these conditions are met, Z acts (...) permissibly in φ-ing even if φ-ing does not reduce harm for Y or increase Y’s optionality. (shrink)

It is widely accepted that states have a right to control immigration, but must accept refugees at risk in their home countries. If this is true, perhaps states have a right to deport refugees once their lives are no longer at risk in their home countries. I raise three types of arguments against this claim, and in support of refugees’ right to remain. Citizenship-based arguments hold that refugees have a right to obtain citizenship, and with citizenship comes the right to (...) remain. Plans-based arguments hold that refugees have a right to plan their lives, and they will struggle to plan without the right to remain. Reciprocity-based arguments hold that refugees have a right to reciprocal relationships with citizens, far easier if they know they can remain. I reject the first two arguments, and defend the third. (shrink)

This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, (...) existing clinical ethics support within UK hospitals, as well as extracts from our own proposal submitted to the Trust Board. We aim for this paper to support other ethicists and/or health care staff contemplating introducing clinical ethics support into hospitals, to facilitate the process of making the case for clinical ethics support, and to contribute to the key debates in the literature around clinical ethics support. We conclude that there is a real need for investment in clinical ethics in the UK in order to build the evidence base required to support the wider introduction of clinical ethics support into UK hospitals. Furthermore, our perceptions of the purpose of, and perceived needs met through, clinical ethics support needs to shift to one of hospitals investing in their staff. Finally, we raise concerns over the optional nature of clinical ethics support available to practitioners within UK hospitals. (shrink)

Our knowledge of the human brain and the influence of pharmacological substances on human mental functioning is expanding. This creates new possibilities to enhance personality and character traits. Psychopharmacological enhancers, as well as other enhancement technologies, raise moral questions concerning the boundary between clinical therapy and enhancement, risks and safety, coercion and justice. Other moral questions include the meaning and value of identity and authenticity, the role of happiness for a good life, or the perceived threats to humanity. Identity and (...) authenticity are central in the debate on psychopharmacological enhancers. In this paper, I first describe the concerns at issue here as extensively propounded by Carl Elliott. Next, I address David DeGrazia’s theory, which holds that there are no fundamental identity-related and authenticity-related arguments against enhancement technologies. I argue, however, that DeGrazia’s line of reasoning does not succeed in settling these concerns. His conception of identity does not seem able to account for the importance we attach to personal identity in␣cases where personal identity is changed through enhancement technology. Moreover, his conception of authenticity does not explain the reason why we find inauthentic values objectionable. A broader approach to authenticity can make sense of concerns about changes in personal identity by means of enhancement technologies. (shrink)

This article examines what happens when local gender rights activism is taken up by international allies and appropriators, using case studies of activism in Saudi Arabia and India. The relationship between local and transnational activists is shaped by histories of Euro-Americans writing about the gendered organisation of Eastern societies. In an economic system where nongovernmental activist groups compete for donor support, political causes are commodities with value, and value is generated through representations (e.g. of patriarchal oppression). These representations of the (...) sexuality and gender organisation of other societies are fetishes in the Marxian sense, essential to the commodity-cause that generates value in circulation. These representations gain value through the accretion of cultural images and texts that adhere to the cause, e.g. the stereotype of the violent brown man and oppressed woman. Such images in the cultural repository allow transnational consumers to make sense of issues they are called to support. But such images also reify stereotypes that activists seek to undermine, even at the same time that these representations generate an international audience. We analyse this process and identify strategies for how transnational allies can show solidarity without overshadowing or devaluing the voices of local activists, with primary focus on the case of activism against male guardianship laws in Saudi Arabia. (shrink)

The aim of this study was to synthesize the concepts from empirical studies and analyze, compare and interrelate them with normative ethics. The International Council of Nurses (ICN) and the Health and Medical Service Act are normative ethics. Five concepts were used in the analysis; three from the grounded theory studies and two from the theoretical framework on normative ethics. A simultaneous concept analysis resulted in five outcomes: interconnectedness, interdependence, corroboratedness, completeness and good care are all related to the empirical (...) perspective of the nurse’s interaction with the older patient, and the normative perspective, i.e. that found in ICN code and SFS law. Empirical ethics and normative ethics are intertwined according to the findings of this study. Normative ethics influence the nurse’s practical performance and could be supporting documents for nurses as professionals. (shrink)

States are increasingly paying other states to host refugees. For example, in 2010 the EU paid Libya € 50 million to continue hosting the refugees within its borders, and five years later Australia offered Cambodia $31.16 million to accept asylum seekers living in Naru. These exchanges, which I call ‘refugees markets,’ have faced criticism by philosophers. Some philosophers claim the markets fail to ensure true protection, and are demeaning, expressing just how much refugees are unwanted. In response, some have defended (...) refugee markets, claiming they can ensure refugees have protection and are not demeaned. I argue that many markets do demean refugees, and therefore have moral costs, but can still be all-things-considered preferable to alternative schemes if they protect refugees more than these alternative schemes. (shrink)