BackgroundPatient advocacy organizations (PAOs) have an increasing influence on health policy and biomedical research, therefore, questions about the specific character of their responsibility arise: Can PAOs bear moral responsibility and, if so, to whom are they responsible, for what and on which normative basis? Although the concept of responsibility in healthcare is strongly discussed, PAOs particularly have rarely been systematically analyzed as morally responsible agents. The aim of the current paper is to analyze the character of PAOs’ responsibility to provide (...) guidance to themselves and to other stakeholders in healthcare.MethodsResponsibility is presented as a concept with four reference points: (1) The subject, (2) the object, (3) the addressee and (4) the underlying normative standard. This four-point relationship is applied to PAOs and the dimensions of collectivity and prospectivity are analyzed in each reference point.ResultsUnderstood as collectives, PAOs are, in principle, capable of intentionality and able to act and, thus, fulfill one prerequisite for the attribution of moral responsibility. Given their common mission to represent those affected, PAOs can be seen as responsible for patients’ representation and advocacy, primarily towards a certain group but secondarily in a broader social context. Various legal and political statements and the bioethical principles of justice, beneficence and empowerment can be used as a normative basis for attributing responsibility to PAOs.ConclusionsThe understanding of responsibility as a four-point relation incorporating collective and forward-looking dimensions helps one to understand the PAOs’ roles and responsibilities better. The analysis, thus, provides a basis for the debate about PAOs’ contribution and cooperation in the healthcare sector. (shrink)

A growing number of technologies are currently being developed to improve and distribute thinking and decision-making. Rapid progress in brain-to-brain interfacing and swarming technologies promises to transform how we think about collective and collaborative cognitive tasks across domains, ranging from research to entertainment, and from therapeutics to military applications. As these tools continue to improve, we are prompted to monitor how they may affect our society on a broader level, but also how they may reshape our fundamental understanding of agency, (...) responsibility, and other key concepts of our moral landscape.In this paper we take a closer look at this class of technologies – Technologies for Collective Minds – to see not only how their implementation may react with commonly held moral values, but also how they challenge our underlying concepts of what constitutes collective or individual agency. We argue that prominent contemporary frameworks for understanding collective agency and responsibility are insufficient in terms of accurately describing the relationships enabled by Technologies for Collective Minds, and that they therefore risk obstructing ethical analysis of the implementation of these technologies in society. We propose a more multidimensional approach to better understand this set of technologies, and to facilitate future research on the ethics of Technologies for Collective Minds. (shrink)

Governments, physicians, media and academics have all called for individuals to bear responsibility for their own health. In this article, I argue that requiring those with adverse health outcomes to bear responsibility for these outcomes is a bad basis for policy. The available evidence strongly suggests that the capacities for responsible choice, and the circumstances in which these capacities are exercised, are distributed alongside the kinds of goods we usually talk about in discussing distributive justice, and this distribution significantly explains (...) why people make bad health choices. These facts suggest that we cannot justifiably hold them responsible for these choices. We do better to hold responsible those who determine the ways in which capacities and circumstances are distributed: they are indirectly responsible for these adverse health outcomes and possess the capacities and resources to take responsibility for these facts. (shrink)

The contributions collected in this special issue explore the phenomenology of joint action from a broad range of different disciplinary and methodological angles, including philosophical investigation (both in the analytic and the phenomenological tradition), computational modeling, experimental study, game theory, and developmental psychology. They also vastly expand the range of discussed cases beyond the standard examples of house-painting and sauce-cooking, addressing, for example, collective musical improvisations, dancing, work at the Diversity and Equity office of a university, and historical examples of (...) collective violence such as the revolutionary Terror in France and the Nazis. In our introduction to this special issue, we group the contributions into three thematic areas – 1) the phenomenological fine-structure of joint action, 2) underlying mechanisms for joint action and 3) phenomenal preconditions for joint action. The first theme is discussed under a number of issues – a) components of the phenomenology of joint action, b) the I and the we in joint action, c) the effect of group size, structure and nature on the phenomenology of joint action and d) how do phenomenal relate to normative aspects of joint action? (shrink)

Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...) at school or day-care by default, without requiring parental authorization, but with parents retaining the right to opt their children out of vaccination. We show that such a policy is likely to be effective, at least in cases in which non-vaccination is due to practical obstacles, rather than to strong beliefs about vaccines, ethically acceptable and less controversial than some alternatives because it is not coercive and affects individual autonomy only in a morally unproblematic way, and likely to receive support from the UK public, on the basis of original empirical research we have conducted on the lay public. (shrink)

We often praise and blame groups of people like companies or governments, just like we praise and blame individual persons. This makes sense. Because some of the most important problems in our society, like climate change or mass surveillance, are not caused by individual people, but by groups. Philosophers have argued that there exists such a thing as group responsibility, which does not boil down to individual responsibility. This type of responsibility can only exist in groups that are organized with (...) joint knowledge, actions and intentions. However, often disorganized groups without joint knowledge, actions and intentions are precisely the kinds of groups that cause problems. Therefore, in such cases, it becomes difficult, according to traditional accounts of collective responsibility to attribute responsibility to such groups. This has problematic implications. Therefore, I propose a new way of seeing collective responsibility, which is able to attribute the vice of irresponsibility to such disorganized groups. This involves seeing responsibility not as a relationship between the group and some action, but rather, as a virtue. In cases where it is difficult to establish whether a group is responsible for something, we should ask ‘is this group responsible, or irresponsible?’ This line of questioning is likely to be a more productive and philosophically legitimate way of holding groups morally responsible in such cases. (shrink)

What is the moral significance of the contrast between acting together and strategic interaction? We argue that while collective moral responsibility is not uniquely tied to the former, the degree to which the participants in a shared intentional wrongdoing are blameworthy is normally higher than when agents bring about the same wrong as a result of strategic interaction. One argument for this claim focuses on the fact that shared intentions cause intended outcomes in a more robust manner than the intentions (...) involved in strategic interaction. We argue, however, that this in itself is not significant. The significant difference is rather volitional: The parties to a shared intention are mutually implicated in each other’s will in a distinct way. Since degree of blameworthiness depends on the quality of will an agent displays in her actions, this explains the higher degree of collective blameworthiness associated with shared intentional wrongdoing. (shrink)