In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront (...) foundational issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)

Structural Injustice advances a theory of what structural injustice is and how it works. Powers and Faden present both a philosophically powerful, integrated theory about human rights violations and structural unfairness, alongside practical insights into how to improve them.

The goal of this article is to explore how a social justice framework can help illuminate the role that consent should play in health and science policy. In the first section, we set the stage for our inquiry with the important case of Henrietta Lacks. Without her knowledge or consent, or that of her family, Mrs. Lacks’s cells gave rise to an enormous advance in biomedical science—the first immortal human cell line, or HeLa cells.

In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

: The increasing reliance upon, and perhaps the growing public and professional skepticism about, the special expertise of bioethicists suggests the need to consider the limits of moral expertise. For all the talk about method in bioethics, we, bioethicists, are still rather far off the mark in understanding what we are doing, even when we may be going about what we are doing fairly well. Quite often, what is most fundamentally at stake, but equally often insufficiently acknowledged, are inherently political, (...) essentially contested visions of the most compelling and attractive forms of life for individuals and social organization. The current situation in bioethics parallels similar debates in eighteenth-century jurisprudence, especially Jeremy Bentham's withering critique of the prevalent forms of judicial argument and his own, equally unsuccessful, attempt to develop a decision-making procedure in ethics that would operate on a plane above politics. The risk, both then and now, is that we will fail to appreciate the wide range of reasonable disagreement that will remain past the point of extended reflection and discussion. (shrink)

Many of the contemporary disagreements regarding privacy are conceptual in nature. They concern the meaning or definition of privacy and the analytic basis of distinguishing privacy rights from other kinds of rights recognized within moral, political, or legal theories. The two main alternatives within this debate include reductionist views, which seek a narrow account of the kinds of invasions or intrusions distinctly involving privacy losses, and anti-reductionist theories, which treat a much broader array of interferences with a person as separate (...) and irreducible kinds of privacy invasions. Other theorists have expressed doubts about the prospects for achieving greater analytical precision even within a fairly expansive anti-reductionist approach. However, a reductionist privacy definition is defended in this article, and its primary theoretical virtues are its ability to unify and explain the insights of several competing definitions and its role in developing an account of privacy rights that is both internally coherent and consistent with a plausible understanding of the theoretical basis for a number of related rights. (shrink)

Articles by Lyn Horn and Alison Thompson highlight several points crucial to understanding how our theory figures in wider debates about social justice as well as the particular relevance of our theory for assessing the overall practice of public health (Horn, 2013; Thompson, 2013). We begin with these two articles, first to respond to and concur with many of their central points, and second to set the stage for dealing more efficiently with some points raised in the other articles.

: The focus of questions of justice in health policy has shifted during the last 20 years, beginning with questions about rights to health care, and then, by the late 1980s, turning to issues of rationing. More recently, attention has focused on alternatives to cost-effectiveness analysis. In addition, health inequalities, and not just inequalities in access to health care, have become the subject of moral analysis. This article examines how such trends have transformed the philosophical landscape and encouraged some in (...) bioethics to seek guidance on normative questions from outside of the contours of traditional philosophical arguments about justice. (shrink)

Modern life is full of examples of environmentally-mediated “group harms” – what Derek Parfit describes as harms produced by “what we all do together.” Typically, the harms are unintended and arise from the uncoordinated actions of many individuals. Their actions ordinarily are not inherently wrong, no one’s action causes harm to an identifiable individual, and prevention of the expected harm is unlikely unless all, or nearly everyone, reduce or cease to engage in activities that collectively and cumulatively result in harm. (...) Unless the individual’s action is likely to make a difference to the outcome, it is often argued that it is not clear what, if anything, makes it wrong or a breach of personal moral responsibility. Activities that result in climate change and agricultural practices commonly employed within the global system of food production are prominent examples. There are several well-known strategies for dealing with such cases, but often they rest on idealized assumptions regarding the impact that one individual can have, provide answers suitable only in counterfactual circumstances, or rely on the kinds of principles of justice that make it difficult to identify clearly and address directly many important moral problems. The task of this chapter is to examine these strategies and propose alternative freestanding practical principles that can guide our efforts to address the world as we find it and explain the sense of wrongness individuals often experience. (shrink)

After reviewing some of the insurance-related obstacles to access to health care, some ethical criteria for evaluating proposals aimed at reforming the health insurance marketplace to achieve universal access are developed. The additional reforms needed to eliminate many of the deficiencies in the current health insurance marketplace are discussed. It is suggested that without such substantial reforms some of the other goals such as expanded consumer choice and overall societal health care cost savings may not be effectively promoted.

Persons infected with the Human Immunodeficiency Virus often experience intermittent life-threatening infections, a progressive decrease in cognitive abilities, and a loss of capacity to communicate their wishes to their family and medical care providers. Accordingly, AIDS patients are among those most likely to benefit from the increased availability of legally recognized forms of advance care planning. Although the three countries examined in this article differ greatly in the prevalence of HIV infection, the legal status of advance directives, and in the (...) attitudes toward their use, a collection of case studies is used to demonstrate that an ability to address the specific needs, values and goals of individual patients is promoted by the availability of a variety of options for implementing advance directives or health care proxies. The conclusion of the analysis is that the best option in a specific context will depend upon differences in individual values and medical objectives of the sort discussed in the case studies. Das mit der HIV-Infektion verbundene Krankheitsbild ist durch wechselnde lebensbedrohliche Infektionen und den fortschreitenden Verfall kognitiver Fähigkeiten gekennzeichnet. Es führt zudem häufig zum Verlust der Möglichkeit, Behandlungswünsche gegenüber Ärzten und Angehörigen zu äußern. Deshalb gehören besonders AIDS-Patienten zu denjenigen, die von rechtlich anerkannten vorsorglichen Patientenverfügungen profitieren werden.In diesem Artikel werden drei Länder betrachtet, die sich hinsichtlich der Häufigkeit des Auftretens der HIV-Infektion sowie des rechtlichen Status von und der Einstellung zu Patientenverfügungen erheblich unterscheiden. Fallstudien belegen allerdings, daß nicht allein die kulturellen und sozialen Bedingungen für die jeweils beste Form der Patientenverfügung ausschlaggebend sind. Voraussetzung für die Möglichkeit, den Bedingungen, Wert- und Zielvorstellungen des individuellen Patienten zu entsprechen, ist auf jeden Fall die Verfügbarkeit unterschiedlicher Formen von Patienten- und Betreuungsverfügungen. Auch innerhalb eines Kulturkreises müssen daher verschiedene Formen vorsorglicher Willensäußerungen des Patienten rechtlich anerkannt werden. Welche Art von Verfügung jeweils die beste Option darstellt, ist dabei abhängig von medizinischen Bedingungen und persönlichen Wertvorstellungen, wie sie in den Fallstudien diskutiert werden. (shrink)

: Justice is widely thought to consist in equality. For many theorists, the central question has been: Equality of what? The author argues that the ideal of equality distorts practical reasoning and has deeply counterintuitive implications. Moreover, an alternative view of distributive justice can give a better account of what egalitarians should care about than can any of the competing ideals of equality.

The coming decades will present an immense challenge for the planet: sustainably feeding nearly ten billion people that are expected to be alive by 2050. This is no small task, and one that intersects with climate change, geopolitics, the increased globalization of agricultural markets, and the emergence of new technologies. The world faces a challenge of increased demand, propelled by an expanding world population and a global shift in dietary patterns toward more resource-intensive foods. Moreover, changes in demand occur in (...) the context of declining soil fertility and freshwater availability, agriculture's growing contribution to water pollution and climate change, and the emerging threats to agricultural productivity caused by climate disruption. (shrink)

: In its response to pressures to rationalize health care resource allocation, the American health care system has embraced managed care without concurrent comprehensive health care reform, either in the form of the centralized tax-based systems found in Europe and Canada or that of the Clinton reform plan. What survives is managed care without managed competition, employer mandates, or universal access. Two problems inherent in the incentive structure of managed care plans developed in the absence of comprehensive health care reform (...) work against the public interest. First, sacrifices in terms of medical innovation and quality of care may not be offset by greater equity in the distribution of health care. Second, such managed care plans fail to address the need for long-term accountability. (shrink)

The prelims comprise: Introduction: Promise and Perils The History of Privacy as a Moral Concept Genetic Exceptionalism The Moral Basis of Medical Privacy Rights Genetic Paternalism Conclusion.

An important objection to many utilitarian theories is that their conceptions of utility may count as morally relevant contributions to individual well-being items which are morally or rationally suspect. For example, if the conception of utility is pleasure, or alternatively, the fulfilment of actual desire or satisfaction of preferences, then greater individual utility may be produced by whatever increases pleasure, fulfils desire, or satisfies someone's preferences. This is true no matter how disgusting or vile we may think such pleasures are, (...) or how irrational or distasteful we find the fulfilment of a desire or the satisfaction of some preference. (shrink)

New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human well-being. (...) The first aim is to achieve a sufficient level of well-being in each of six core dimensions. In the special case of healthcare systems, this aim is focally but not exclusively attentive to achieving health sufficiency as one of the core dimensions. The second aim is to combat the emergence and persistence of densely woven patterns of systematic disadvantage that tend to undermine the achievement of a sufficient level of health and the other core elements of well-being of some persons and groups. Judgments about entitlements to health related resources, including new biotechnologies, are made in light of a threshold notion of health sufficiency. What is enough or sufficient health? The answer that is defended here is that sufficient health is enough health for a decent human life, understood as enough health to live a full life course without preventable, significant functional disability or decrement in health, or treatable pain or suffering. When a state must include a new biotechnology in its national healthcare system is also influenced by ancillary concerns about the connection between health and other core dimensions of well-being. What counts as a significant functional impairment or health decrement is thus explicated, in part, in relation to the theory’s sufficiency aim for the other essential dimensions of well-being, and thus for a decent life, overall. Those elements of health that play a critical role in the experience of sufficient reasoning, affiliation, security, respect and self determination are especially important; any loss of health function or capacity that threatens the individual’s prospects for sufficiency in these other dimensions, including the relational egalitiarian concerns they entail, constitutes a significant functional impairment. Within national borders, individuals are thus entitled to those health-related goods and services that are essential for a sufficiency of each of the dimensions of well-being; with regard to self determination and respect, what is sufficient by way of guaranteed access to specific goods and services is going to depend on the implications of such access for where an individual stands in relation to her co-nationals. The content of any entitlement to health-related goods and services is also necessarily dynamic. What can be done for health and the other core dimensions of well-being as a function of technological innovation and diffusion is in constant flux. The paper concludes by considering the implications of this analysis for the conditions under which states are obligated to include access in their healthcare systems to one biotechnology, deep brain stimulation. (shrink)

John Broome’s Climate Matters is a timely, elegant, and accessible book. His book is deliberately interdisciplinary, as is much of his work in moral philosophy more generally. The discussion of what should be done, and by whom, to prevent the adverse effects of climate change is informed by many years of philosophical engagement with economic theory, especially problems arising in the conceptualization and technical implementation of cost-benefit analysis.The central arguments in the book are informed as well by a longstanding engagement (...) with climate change science. Broome brings to bear a perspective forged in the work of his role as a lead author—and occasional critic—of the report of Working Group III of the .. (shrink)

What determines whether an action is right or wrong? Morality, Rules, and Consequences: A Critical Reader explores for students and researchers the relationship between consequentialist theory and moral rules. Most of the chapters focus on rule consequentialism or on the distinction between act and rule versions of consequentialism. Contributors, among them the leading philosophers in the discipline, suggest ways of assessing whether rule consequentialism could be a satisfactory moral theory. These essays, all of which are previously unpublished, provide students in (...) moral philosophy with essential material and ask key questions on just what the criteria for an adequate moral theory might be. (shrink)

A growing body of literature argues that achieving radical change in the agri-food system requires a radical renegotiation of our relationship with the environment alongside a change in our thinking and approach to transformational food politics. This paper argues that relational approaches such as a more-than-human ethic of care (MTH EoC) can offer a different and constructive perspective to analyse agri-food system transformation because it emphasises social structures and relationships as the basis of environmental change. A MTH EoC has not (...) yet been applied to regenerative agriculture, yet other literature on regenerative agriculture suggests that care may be present in these spaces and calls for the need for social science analysis of the regenerative movement. This paper uses a MTH EoC lens to reveal a diverse array of ways in which power is and can be deployed for change in the regenerative agriculture movement in Aotearoa, New Zealand. Globally, regenerative agriculture tends to be analysed through positivist, scientific approaches that focus on biophysical markers of ecological improvement. Yet, a relational approach reveals how engagement in regenerative agriculture is creating significant shifts in mindset towards more holistic and relational understandings of biological and social ecosystems. A regenerative mindset framework is suggested as a method of understanding the connection between a regenerative form of thinking, being and doing for farmers. Interviews suggested that this shift in farmers’ socio-ecological relations is crucial to the transformational potential of regenerative agriculture. This paper argues that relational analyses such as the MTH EoC approach used to analyse regenerative agriculture in this research, refresh the way we analyse agri-food system change. They also are critical to guiding and supporting on-the-ground socio-ecological shifts that are necessary to see agricultural transformation. (shrink)

In general, epistemic internalists hold that an individual’s justification for a belief is exhausted by her reflectively accessible reasons for thinking that the contents of her beliefs are true. Applying this to the epistemology of testimony, a hearer’s justification for beliefs acquired through testimony is exhausted by her reflectively accessible reasons to think that the contents of the speaker’s testimony is true. A consequence of internalism is that subjects that are alike with respect to their reflectively accessible reasons are alike (...) with respect to what they have justification to believe. Testimony should be thought no different: hearers that are alike with respect to reflectively accessible reasons to think that a speaker’s testimony is true are alike with respect to their justification for beliefs based upon that testimony. But it has been recently argued that this view faces powerful counterexamples. So the central question is this: assuming that a hearer can acquire justification to believe a proposition through the testimony of a speaker, can epistemic internalism provide the resources to explain how such justification is possible? My aim in this paper is to address these counterexamples, and in so doing, defend epistemic internalist accounts of testimony. (shrink)

The social impacts of computer technology are often glorified in public discourse, but there is growing concern about its actual effects on society. In this article, we ask: how does “consent” as an analytical framework make visible the social dynamics and power relations in the capture, extraction, and labor of data science knowledge production? We hypothesize that a form of boundary violation in data science workplaces—gender harassment—may correlate with the ways humans’ lived experiences are extracted to produce Big Data. The (...) concept of consent offers a useful way to draw comparisons between gender relations in data science and the means by which machines are trained to learn and reason. Inspired by how Big Tech leaders describe unsupervised machine learning, and the co-optation of “revolutionary” rhetoric they use to do so, we introduce a concept we call “techniques of invisibility.” Techniques of invisibility are the ways in which an extreme imbalance between exposure and opacity, demarcated along fault lines of power, are fabricated and maintained, closing down the possibility for bidirectional transparency in the production and applications of algorithms. Further, techniques of invisibility, which we group into two categories—epistemic injustice and the Brotherhood—include acts of subjection by powerful actors in data science designed to quell resistance to exploitative relations. These techniques may be useful in making further connections between epistemic violence, sexism, and surveillance, sussing out persistent boundary violations in data science to render the social in data science visible, and open to scrutiny and debate. (shrink)

This collection is a powerful statement about the many directions a post-metaphysical ethics might take.

In The Ethics of Postmodernity, Gary B. Madison and Marty Fairbairn have collected instructive and illuminating essays that address the dilemmas left in the wake of the postmodern attack on foundationalism. This collection is a powerful statement on the many directions a postmetaphysical ethics might take. Contributors include Barry Allen, Caroline Bayard, Robert Bernasconi, Thomas W. Busch, M.C. Dillon, Marty Fairbairn, Paul Fairfield, Morny Joy, Richard Kearney, Gary B. Madison, Joseph Margolis, Tom Rockmore, Charles E. Scott, Evan Simpson, (...) and Mark Williams. (shrink)

Madison Powers raises the difficult problem of repugnant desires. The problem is not only difficult but pervasive, more pervasive even than Powers says. He notes that it affects hedonist, eudaimonist, and desire-fulfilment forms of utilitarianism; but it also affects the form of utilitarianism that uses a list of irreducibly plural values, so long as one of the values on the list is pleasure or happiness, and it can affect non-utilitarian positions as well for the same reason.

In this editorial we introduce the special Public Health Ethics symposium on social justice in public health. We present here a select set of papers arising from an international workshop, organized on 4–5 June 2012 by the Institute of Biomedical Ethics, in collaboration with the University Research Priority Program for Ethics at the University of Zurich. Meeting the Author is a series of international workshops organized by the Ethics Center of the University of Zurich. In this workshop format, a selected (...) group of junior and senior researchers discusses a seminal work in ethics together with the authors. (shrink)

David Wootton has written an engaging book about the emergence of the theory that all human action is self-interested and that believes societies should be structured in ways that satisfy our “insa...

It has been remarked that there is a tendency in all Governments to an augmentation of power at the expense of liberty. But the remark as usually understood does not appear to me well founded.... It is a melancholy reflection that liberty should be equally exposed to danger whether the Government have too much or too little power, and that the line which divides the extremes should be so inaccurately drawn by experience. -/- Madison, letter to Jefferson, October 17, (...) 1788. (shrink)

ABSTRACTThis study explores, historically and conceptually, the idea of separating governmental powers to institute a system that superintends the legitimate acquisition and exercise of those power...

David Wootton’s latest book is an attempt to show how “Power, Pleasure and Profit” – each related in turn to Machiavelli, Hobbes and Smith’s works – have shaped our modern world because they are “three goods which can be pursued without limits”. Based on a series of six Carlyle Lectures entitled “Power and Pleasure, 1513-1776”, given at the University of Oxford in 2014, the book attempts a major reinterpretation of the ideas of the thinkers of the period from 1500 to (...) 1800. David Woot... (shrink)

Heralded as the “Father of the Constitution,” James Madison was, besides one of the most influential architects of the U.S. Constitution, a man of letters, a politician, a scientist and a diplomat who left an enduring legacy for American philosophical thought. As a tireless advocate for the ratification of the Constitution, Madison advanced his most groundbreaking ideas in his jointly authoring The Federalist Papers with John Jay and Andrew Hamilton. Indeed, two of his most enduring ideas—the large republic (...) thesis and the argument for government separation-of-powers/checks-and-balances—are contained in there. In his life’s work, Madison fused together the three dominant philosophies in post-revolutionary, antebellum America: Lockean liberalism, classical republicanism and Christian Protestantism. (shrink)

Although eighteenth-century Federalists, including James Madison, have been associated with the very contemporary idea of a transnational political order, the argument that the modern state with its centralised authority and supreme power poses a threat to liberty was already a subject of discussions during the period. The American Constitution was intended to establish a new political order, rather than a loose federation or an enlarged state. The Framers were not alone in their preoccupation with a transnational order; the German (...) philosopher Immanuel Kant struggled with the same issues of liberty and security in his political essays. This chapter examines how Madison and Kant grapppled with the problem of transnational order in the context of democracy and republicanism. It looks at the issues addressed by Kant and Madison that are closely related to those discussed today, including diversity, popular sovereignty and political violence. The chapter suggests that Kant and Madison, along with many other republicans of the time, explored the idea of government without resorting to the models of small-scale, ancient republics. (shrink)

We are just beginning to understand the power of local history to enhance our understanding of ourselves, our cities, and our culture. It is, after all, that stratum of history that touches our lives most closely. Madison answers the basic questions of when, where, why, how, and by whom Madison, Wisconsin was developed. The book is richly detailed, fully documented, inclusive in coverage, and delightfully readable. More than 300 illustrations provide a vivid feeling for what life was like (...) in Madison during the formative years. David Mollenhoff's unique interpretive framework emphasizing public policies and community values, gives the book a consistent interpretive quality and reveals major themes that flow through time. This combination will allow you to see the city's growth and development with unusual clarity and coherence--almost as if you were watching time-lapse photography. When Mollenhoff began to study Madison's history, he was delighted by his early discoveries but frustrated because no one had written a book-length history of Madison since 1876. Finally, in 1972 he decided to write that book. His research required him to read five miles of microfilm, piles of theses and dissertations, shelves of reports, boxes of manuscripts and letters, and to study thousands of photographs. Soon after the first edition was published in 1982, readers declared it to be a classic. For this second edition Madison has been extensively revised and updated with new maps and photos. If you want to know the fascinating story of how Madison got to be the way it is, this book belongs on your bookshelf. It will change the way you see the city and your role in it. (shrink)

A stunning collection of color photographs by Brent Nicastro showcasing the dynamic power and sheer beauty of the city of Madison, Wisconsin. Includes images of the Farmer's Market, the State Capitol building, Monona Terrace, and the University of Wisconsin campus in all seasons.

The Framers understood the Constitution to be the fundamental expression of the rule of law over against the arbitrary, intemperate, and unjust “rule of men” that all too frequently existed in the political world, unfortunately both democratic as well as monarchical. Accordingly, the rule of law requires a well functioning political and legal system that includes legislative checks and balances, the separation of power between the President and Congress, an independent judiciary, federalism, etc. What happens when this “Madisonian” constitutional system, (...) designed to express “the deliberate sense of the community,” runs into a Judicial branch that, in effect, claims we live under a Constitution, but the Constitution is what we say it is. Must the Judiciary itself be subject to the rule of law, and the decisions of a constitutional majority, or does their “independence” extend to being independent of the constraints of the rule of law and, thus, decent majority rule? How did the original John Marshall Court answer these questions, and what light do the leading cases and controversies shed on the relationship between the Marshall Court and the Madisonian System? Are we facing a situation of Marshall v. Madison? (shrink)

Combines documents and analytical essays timed for the bicentennial in 2003. It explains the constitutional, political, philosophical background to judicial review, the historical record leading to this landmark case and the impact of the decision since 1803.

James Madison is the thinker most responsible for laying the groundwork of the American commercial republic. But he did not anticipate that the propertied class on which he relied would become extraordinarily politically powerful at the same time as its interests narrowed. This and other flaws, argues Stephen L. Elkin, have undermined the delicately balanced system he constructed. In Reconstructing the Commercial Republic , Elkin critiques the Madisonian system, revealing which of its aspects have withstood the test of time (...) and which have not. The deficiencies Elkin points out provide the starting point for his own constitutional theory of the republic—a theory that, unlike Madison’s, lays out a substantive conception of the public interest that emphasizes the power of institutions to shape our political, economic, and civic lives. Elkin argues that his theory should guide us toward building a commercial republic that is rooted in a politics of the public interest and the self-interest of the middle class. He then recommends specific reforms to create this kind of republic, asserting that Americans today can still have the lives a commercial republic is intended to promote: lives with real opportunities for economic prosperity, republican political self-government, and individual liberty. (shrink)

The New Evil Demon problem has been hotly debated since the case was introduced in the early 1980’s (e.g. Lehrer and Cohen 1983; Cohen 1984), and there seems to be recent increased interest in the topic. In a forthcoming collection of papers on the New Evil Demon problem (Dutant and Dorsch, forthcoming), at least two of the papers, both by prominent epistemologists, attempt to resist the problem by appealing to the distinction between justification and excuses. My primary aim here is (...) to critically evaluate this new excuse maneuver as a response to the New Evil Demon problem. -/- Their response attempts to give us reason to reject the idea that victims of the New Evil Demon have justification for believing as they do. I shall argue that this approach is ultimately unsuccessful, however much of value can be learned from these attempts. In particular, progress in the debate can be made by following those who advance the excuse maneuver and make explicit the connection between epistemic justification and epistemic norms. By doing so, the questions being debated are clarified, as is the methodology being used to attempt to answer them. (shrink)