There is a need for all industries, including healthcare, to reduce their greenhouse gas emissions. In anaesthetic practice, this not only requires a reduction in resource use and waste, but also a shift away from inhaled anaesthetic gases and towards alternatives with a lower carbon footprint. As inhalational anaesthesia produces greenhouse gas emissions at the point of use, achieving sustainable anaesthetic practice involves individual practitioner behaviour change. However, changing the practice of healthcare professionals raises potential ethical issues. The purpose of (...) this paper is twofold. First, we discuss what moral duties anaesthetic practitioners have when it comes to practices that impact the environment. We argue that behaviour change among practitioners to align with certain moral responsibilities must be supplemented with an account of institutional duties to support this. In other words, we argue that institutions and those in power have second-order responsibilities to ensure that practitioners can fulfil their first-order responsibilities to practice more sustainably. The second goal of the paper is to consider not just the nature of second-order responsibilities but the content. We assess four different ways that second-order responsibilities might be fulfilled within healthcare systems: removing certain anaesthetic agents, seeking consensus, education and methods from behavioural economics. We argue that, while each of these are a necessary part of the picture, some interventions like nudges have considerable advantages. (shrink)

Deliberative democracy entails a commitment to deciding political questions on their merits. To that end, people engage in an exchange of reasons in a shared endeavour to arrive at the right answer or the best judgement they can make in the circumstances. Of course, in practice a shared judgement may be impossible to reach. Yet while compromise may seem a natural way of dealing with the disagreement that deliberation leaves unresolved – for example, some deliberative theorists argue that a willingness (...) to compromise manifests respect for the considered views of others, even as we continue to disagree with them – the relationship between deliberation and compromise is not as straightforward as one might think. To explain why, this paper contrasts conflicts of judgement with conflicts of preference, interest and value to show why greater attention needs to be paid to the character of the decision to be made. (shrink)

Journal of Social Philosophy, EarlyView.

Journal of Social Philosophy, EarlyView.

Journal of Social Philosophy, EarlyView.

The normative and metanormative pluralism that figures among core self-descriptions of democratic theory, which seems incompatible with democratic theorists’ practical ambitions, may stem from the internal logic of research traditions in the social sciences and humanities and in the conceptual structure of political theory itself. One way to deal productively with intradisciplinary diversity is to appeal to the idea of a meta-consensus; another is to appeal to the argument from cognitive diversity that fuels recent debates on epistemic democracy. For different (...) reasons, both strategies fail, such that a metatheoretical step aside may be desirable, one that entails modeling democratic theory after the public justification approach. (shrink)

I argue in this paper that the process of compromising needs to be deliberative if a fair compromise is the goal. More specifically, I argue that deliberation is structurally necessary in order to achieve a fair compromise. In developing this argument, this paper seeks to overcome a problematic dichotomy that is prevalent in the literature on deliberative democracy, which is the dichotomy between compromise and deliberation. This dichotomy entails the view that the process preceding the achievement of a compromise is (...) essentially a process of negotiating or bargaining, which, I claim, should not be the case if a fair compromise is the goal. The reason for this claim is, in a nutshell, that negotiation or bargaining processes do not provide for an in-depth understanding of the reasons that each party has for holding their respective position. However, an in-depth understanding of each other’s reasons, is, as I will show, a necessary condition for achieving a fair compromise. In contrast to negotiation or bargaining, the deliberative process, by its very structure, provides for mutual understanding and is therefore a necessary condition for achieving a fair compromise. (shrink)