Volume 19, Issue 9, September 2019, Page 60-62.

There is wide agreement that communities in lower-income countries should benefit when they participate in multinational research. Debate now focuses on how and to what extent these communities should benefit. This debate has identified compelling reasons to reject the claim that whatever benefits a community agrees to accept are necessarily fair. Yet, those who conduct clinical research may conclude from this rejection that there is no reason to involve communities in the process of deciding how they benefit. Against this possibility, (...) the present manuscript argues that involving host communities in this process helps to promote four important goals: protecting host communities, respecting host communities, promoting transparency, and enhancing social value. (shrink)

An analysis of the contemporary moral debate over price gouging can advance multiple readings of the challenging biblical episode which depicts Jacob's purchase of the birthright. Ethical considerations, such as the maximization of welfare, preservation of choice, and promotion of virtue are evaluated and then applied to the biblical text recounting the sale of Esau's birthright. Did Jacob act ethically in his purchase of ravenous Esau's birthright, or did he seize a propitious opportunity to exploit Esau's predicament? Is Esau responsible (...) for spurning his birthright, or was he misled as he claims Jacob had “supplanted me these two times: he took away my birthright; and, behold, now he has taken away my blessing”? An ethical analysis of Jacob's and Esau's intentions and actions in the transaction uncovers the Bible's position on the sale and on the larger moral debate. (shrink)

In a recent paper in this journal, Richard Arneson criticizes the domination account of exploitation and attributes it to me and Allen Wood. In this paper, I defend the domination account against Arneson's criticisms. I begin by showing that the domination view is distinct from the vulnerability-based view defended by Wood. I also show that Alan Wertheimer's influential account of exploitation is congenial to the domination view. I then argue that Arneson's own fairness-based view of exploitation generates false negatives and (...) trivializes the concept of exploitation, rendering it entirely parasitic on the notion of unfairness. (shrink)

:This paper argues that, inasmuch as exploitation is a form of injustice, exploitative acts need not be performed intentionally.

(2010). International Research and Positive Obligations: Are They “Transaction Specific”? The American Journal of Bioethics: Vol. 10, No. 6, pp. 49-51.

There are two opposing views concerning intuitive cases of wage exploitation. The first denies that they are cases of exploitation at all. It is based on the nonworseness claim: there is nothing wrong with a discretionary mutually beneficial employment relationship. The second is the reasonable view: some employment relationships can be exploitative even if employers have no duty towards their employees. This article argues that the reasonable view does not completely defeat defences of wage exploitation, because these do not rely (...) solely on the nonworseness claim. They also rely on the idea, popularised by Alan Wertheimer, that exploitation is a form of disequilibrium price occurring in defective markets. The article then proceeds to criticise Wertheimer’s account through neoclassical, new institutional, and Austrian economics. It concludes that considerations for economic efficiency are irrelevant to assessing intuitions regarding exploitation. (shrink)

Offering cash payments to research subjects is a common recruiting method, but this practice continues to be controversial because of its potential to compromise the protection of human subjects. Some critics question whether researchers should be allowed to offer money at all, citing concerns about commodification of the research subject, invalidation of study results, and increased risks to subjects. Other critics are comfortable with the idea of monetary payments but question how much researchers can pay their subjects, citing concerns about (...) undue inducement, crowding out, and monetary exploitation. Focusing only on the amount researchers can pay their subjects, this paper argues that the federal regulations and guidelines should implement a standard payment formula. It argues for a wage payment model, and critically examines three candidates for a base wage: the nonfarm production wage, the FLSA minimum wage, and a living wage. (shrink)

In this paper I argue that junior doctors are morally exploited. Moral exploitation occurs where an individual’s vulnerability is used to compel them to take on additional moral burdens. These might include additional moral responsibility, making weighty moral decisions and shouldering the consequent emotions. Key to the concept of exploitation is vulnerability and here I build on Rosalind McDougall’s work on the key roles of junior doctors to show how these leave them open to moral exploitation by restricting their reasonable (...) options. I argue that there are a number of ways junior doctors are morally exploited. First, their seniors can leverage their position to force a junior to take on some discreet decision. More common is the second type of moral exploitation where rota gaps and staffing issues means junior doctors take on more than their fair share of the moral burdens of practice. Third, I discuss structural moral exploitation where the system offloads moral burdens onto healthcare professionals. Not every instance of exploitation is wrongful and so I conclude by exploring the ways that moral exploitation wrongs junior doctors. (shrink)

In this article, I defend a democratic form of the productivist welfare state. I argue that this form of the state can best cope, theoretically and practically, with the diversity of deeply morally pluralistic democratic societies for two reasons. First, the justification of this form of the state rests solely on general facts about human nature, basic human needs, and efficiency considerations in a world of moderately scarce resources. Second, this state does not aim to promote a specific view of (...) justice, but human flourishing more generally, expressed in terms of individual and collective productivity. The proposed democratic productivist welfare state supports its citizens up to the level that allows them to develop and exercise their talents and abilities without providing incentives for free riding. I argue that, under the specific empirical circumstances that I describe, in particular certain informational restrictions concerning the precise productive and destructive capacities of the members of society in practice and the soundness of the Aristotelian principle, this goal may best be achieved in practice by the introduction of an unconditional basic income at subsistence level, if society is sufficiently developed economically to provide such an income. On productivist grounds, such an unconditional subsistence income also addresses, pragmatically and partially, the problem of historical injustices against the weakest members of society and provides all group members with the means for democratic participation. (shrink)

The idea that payment for research participation can be coercive appears widespread among research ethics committee members, researchers, and regulatory bodies. Yet analysis of the concept of coercion by philosophers and bioethicists has mostly concluded that payment does not coerce, because coercion necessarily involves threats, not offers. In this article we aim to resolve this disagreement by distinguishing between two distinct but overlapping concepts of coercion. Consent-undermining coercion marks out certain actions as impermissible and certain agreements as unenforceable. By contrast, (...) coercion as subjection indicates a way in which someone’s interests can be partially set back in virtue of being subject to another’s foreign will. While offers of payment do not normally constitute consent-undermining coercion, they do sometimes constitute coercion as subjection. We offer an analysis of coercion as subjection and propose three possible practical responses to worries about the coerciveness of payment. (shrink)

(2010). Human Rights: The Normative Engine of Fairness and Research in Developing Countries. The American Journal of Bioethics: Vol. 10, No. 6, pp. 47-49.

A growing literature documents the existence of individuals who make a living by participating in phase I clinical trials for money. Several scholars have noted that the concerns about risks, consent, and exploitation raised by this phenomenon apply to many (other) jobs, too, and therefore proposed improving subject protections by regulating phase I trial participation as work. This article contributes to the debate over this proposal by exploring a largely neglected worry. Unlike most (other) workers, subjects are not paid to (...) produce or achieve anything but to have things done to them. I argue that this passivity is problematic for reasons of distributive justice. Specifically, it fails to enable subjects to realize what Gheaus and Herzog call “the goods of work”—a failure not offset by adequate opportunities to realize these goods outside of the research context. I also consider whether granting subjects worker-type protections would accommodate this concern. (shrink)

Journal of Social Philosophy, EarlyView.

The tradable refugee quota scheme constitutes one proposal for institutionalising the general right to asylum. The scheme allows states to purchase and sell quotas of refugees that are initially assigned to them through a collectivised status-determination process. In this paper I focus on examining the ethical dimensions of one particular component of the tradable refugee quota scheme: the market. I consider three objections against the quota trading practices: ‘the preference objection’, ‘the dignity objection’, and ‘the exploitation objection’. The first objection (...) suggests that the tradable quota scheme is problematic due to the fact that it fails to consider refugees’ desires regarding the final country in which asylum is provided. The second objection claims that the scheme demeans refugees and violates their dignity. The final objection claims that the scheme leads to the exploitation of weak countries. I argue that the objections fail to show that the tradable quota scheme is inherently problematic. I conclude that either the examined objections can be rejected or it is possible to address the concerns through specific institutional arrangements. (shrink)

In order to reach its full potential, human embryonic stem cell (hESC) research requires the use of human oocytes. There is currently a shortage of human eggs for research, and this shortage is likely to continue, as many states and countries prohibit their sale for research purposes, while at the same time condoning unregulated markets for oocytes for use in assisted reproduction. In this essay I first explore possible alternative sources of oocytes for hESC research and conclude that, at present, (...) women are the best source. I then examine arguments about exploitation and commodification that are often raised to prohibit payment to women for oocytes in both the reproductive and research contexts and find these arguments wanting. I conclude by suggesting that ethical concerns raised about a market in oocytes do not warrant a prohibition on the sale of eggs, but that a regulated market can consistently minimize ethical concerns while respecting women and providing important resources for advances in hESC research. (shrink)

Individuals with limited resources are often presumed to be vulnerable in research. Concerns include the possibility of impaired decision making, susceptibility to undue inducement, and risk of exploitation. Although each of these concerns should be considered by investigators and IRBs, none justifies categorical exclusion of individuals with limited resources.

Vulnerability in research is often understood as a diminished ability to protect one's own interests, manifested by a compromised capacity to give informed or voluntary consent. Certain groups of people are thought to be more vulnerable than others and therefore are at risk of being exploited or mistreated in research. Accordingly, the federal regulations call for additional safeguards to protect vulnerable groups.There remains some ambiguity and contradiction, however, regarding what groups are vulnerable in research and why,3 since the available codes (...) of research ethics and regulations describe many groups as vulnerable. When so many groups are considered vulnerable, but no specification is offered as to how they are vulnerable or what particular protections are appropriate, the possibility of meaningful safeguards is diminished. In addition, current concepts of vulnerability are usually applied to whole groups of people, without distinguishing between individuals in a group who might truly have a compromised capacity to protect their own interests from those who do not. (shrink)

ABSTRACTGlobal demand for human ova in in vitro fertilization has led to its expansion in countries with falling average incomes and rising female unemployment. Paid egg donation in the context of national, regional, and global inequalities has the potential to exploit women who are socioeconomically vulnerable, and indeed there is ample evidence that it does. Structural injustices that render women in middle-income countries – and even some high-income countries – economically vulnerable contribute to a context of ‘omissive coercion’ that is (...) morally troubling. When egg brokers or fertility clinics take advantage of these background structural injustices and prospective ova providers’ vulnerability in order to pay them less than they need to meet their livelihood needs, they engage in exploitation. Analyzing paid egg donation as a form of reproductive labor, however, can direct our attention to reforms that would reduce exploitative instances of this practice. In contrast to those who see... (shrink)

This article focuses on ethical issues surrounding the selling and buying of human organs. The author argues that most people who sell their organs in India do so in order to pay already existing debts. The transaction is only temporarily an exchange of “life for life,” and most “donors” are back in debt soon after the operation. The author discusses the flexible ethics that reduce reality to dyadic transactions and the purgatorial ethics that collapse real and imaginary exploitation in the (...) service of complex interests. He also offers a sophisticated discussion of the ethics of publicity and public ethics. He emphasizes the lack of factual information, intentional manipulation of information, and the dissemination of kidney panics and kidney scandals, especially by the new developing bioauthorities and bioethical brokers. (shrink)

It is widely thought that firms that employ workers in “sweatshop” conditions wrongfully exploit those workers. This claim has been challenged by those who argue that because companies are not obligated to hire their workers in the first place, employing them cannot be wrong so long as they voluntarily accept their jobs and genuinely benefit from them. In this article, I argue that we can maintain that at least many sweatshop employees are wrongfully exploited, while accepting the plausible claim at (...) the core of many defenses of sweatshops, namely that engaging in a voluntary and mutually beneficial transaction with a person in need cannot constitute morally worse treatment of that person than doing nothing at all to benefit her. We can do this, I claim, by accepting that wealthy multinational corporations have positive duties to employ or otherwise benefit the global poor. I argue that these duties can be plausibly grounded in the fact that potential sweatshop workers are victims of global structural injustice, from which multinational corporations typically benefit. (shrink)

ABSTRACTThis paper begins with the assumption that it is morally problematic when people in need are offered money in exchange for research participation if the amount offered is unfair. Such offers are called ‘coercive’, and the degree of coerciveness is determined by the offer's potential to cause exploitation and its irresistibility. Depending on what view we take on the possibility to compensate for the sacrifices made by research participants, a wish to avoid ‘coercive offers’ leads to policy recommendations concerning payment (...) for participation. For sacrifices considered compensable, we ought to offer either no payment or payment at a level deemed fair, while for sacrifices deemed incompensable, we always ought to offer no payment because as compensation appears and increases, so too does coercion. This article provides a model for thinking of the way in which degrees of exploitativeness, irresistibility, and coerciveness interact with the size of the reward for compensable and incompensable cases. T... (shrink)

It has been a common claim that surrogacy is morally problematic since it involves harm to the child or the surrogate—the harm argument. Due to a growing body of empirical research, the harm argument has seen a decrease in popularity, as there seems to be little evidence of harmful consequences of surrogacy. In this article, two revised versions of the harm argument are developed. It is argued that the two suggested versions of the harm argument survive the current criticism against (...) the standard harm argument. The first version argues that the child is harmed by being separated from the gestational mother. The second version directs attention to the fact that surrogacy involves great incentives to keep the gestational mother’s level of maternal-fetal attachment low, which tend to increase the risk of harm to the child. While neither of the two arguments is conclusive regarding the moral status of surrogacy, both constitute important considerations that are often ignored. (shrink)