Bioethics, Volume 36, Issue 3, Page 260-266, March 2022.

COVID-19 vaccine uptake among healthcare workers (HCWs) remains of significant public health concern due to the ongoing COVID-19 pandemic. As a result, many healthcare institutions are considering or have implemented COVID-19 vaccine mandates for HCWs. We assess defenses of COVID-19 vaccine mandates for HCWs from both public health and professional ethics perspectives. We consider public health values, professional obligations of HCWs, and the institutional failures in healthcare throughout the COVID-19 pandemic which have impacted the lived experiences of HCWs. We argue (...) that, despite the compelling urgency of maximizing COVID-19 vaccine uptake among HCWs, the ethical case for COVID-19 vaccine mandates for HCWs in the United States is complex, and, under current circumstances, inconclusive. Nevertheless, we recognize that COVID-19 vaccine mandates for HCWs have already been and will continue to be implemented across many healthcare institutions. Given such context, we provide suggestions for implementing COVID-19 vaccine mandates for HCWs. (shrink)

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The “data protection model” emphasizes privacy protections at the expense of public health benefit, while the “emergency response model” sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use of (...) DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health.”. (shrink)

Many religious freedom laws provide exemptions to persons who refuse to comply with certain laws on religious grounds. But these exemptions are increasingly used (by claimants and others) to advance political goals. For example, religious freedom lawsuits helped to undermine the Affordable Care Act’s guarantee of coverage for contraceptives. And the recent Masterpiece Cakeshop case was part of a broader effort to protest the right to same-sex marriage. This paper argues that the state should not grant religious exemptions when they (...) are used to advance political goals. A religious exemption creates a legal inequality between citizens that can only be justified if the protection is not used politically. As such, the state should ensure that laws providing religious exemptions are written, interpreted, and enforced so as to prevent their political misuse. (shrink)

Compromise is surprisingly common in the context of religious freedom. In Holt v. Hobbs, for example, a Muslim prison inmate challenged his prison’s no-beards policy on religious freedom grounds. He proposed, and was eventually granted, a compromise that allowed him to grow a half-inch beard rather than the full beard normally required by his beliefs. Some have argued that such a compromise is inconsistent with the purpose of religious freedom, which is to guard against interference with an individual’s religious practices. (...) Accepting a compromise, after all, may require a significant modification to one’s default practices. But this paper argues that compromise can be appropriate if the purpose of religious freedom is to foster the inclusion and acceptance of all people in a diverse political community. Moreover, the benefits of compromise may lend support to the inclusion-based conception of religious freedom as against the more traditional non-interference conception. (shrink)

This essay uses a specific example—proposals to exclude sugary drinks from the Supplemental Nutrition Assistance Program —to explore some features of the contemporary U.S. administrative state. Dating back to the Wilsonian origins of the U.S. administrative state there has been uncertainty about whether we can and should separate politics and administration. On the traditional view, the agencies are to be kept separate from politics—technocratic and value-neutral—although they are indirectly accountable to the president and Congress. The SNAP exclusions example shows, however, (...) that agencies often must make complex and controversial decisions on their own, decisions that go beyond value-neutral technocratic administration. When authorizing legislation has multiple goals, as we’ll argue is the case in the SNAP example, an agency will have to choose between conflicting statutory mandates. Moreover, as the SNAP example shows, agencies often face complex normative questions of ethics and justice that go beyond the question of how to balance competing aims. The appropriate response to the SNAP exclusions example is not to keep politics out of administrative decision-making, but to develop procedures that allow ethical and political questions to be addressed in agency policy-making, consistent with overarching commitments to fairness and democracy. (shrink)