BackgroundStructured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating (...) how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.MethodsThe ACCORD project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.DiscussionThe ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

According to proponents of the extended mind, bio-external resources, such as a notebook or a smartphone, are candidate parts of the cognitive and mental machinery that realises cognitive states and processes. The present chapter discusses three areas of ethical concern associated with the extended mind, namely mental privacy, mental manipulation, and agency. We also examine the ethics of the extended mind from the standpoint of three general normative frameworks, namely, consequentialism, deontology, and virtue ethics.

Providing the most thorough coverage available in one volume, this comprehensive, broadly based collection offers a wide variety of selections in four major genres, and also includes a section on film. Each of the five sections contains a detailed critical introduction to each form, brief biographies of the authors, and a clear, concise editorial apparatus. Updated and revised throughout, the new Fourth Edition adds essays by Margaret Mead, Russell Baker, Joan Didion, Annie Dillard, and Alice Walker; fiction by Nathaniel Hawthorne, (...) Ursula K. LeGuin, Anton Chekov, James Joyce, Katherine Mansfield, F. Scott Fitzgerald, William Faulkner, Alice Walker, Louise Erdrich, Donald Barthelme, and James McPherson; poems by John Donne, Robert Browning, Walt Whitman, Edwin Arlington Robinson, e.e. cummings, Langston Hughes, W.H. Auden, Philip Levine, and Louise Gluck; and plays by August Wilson, Marsha Norman, Wendy Wasserstein, and Vaclav Havel. The chapter devoted to film examines the relation of film to literature and gives the complete screenplay for Citizen Kane plus close analysis of a scene from the film. With its innovative structure, comprehensive coverage, and insightful and stimulating presentation of all kinds of literature, this is an anthology readers will turn to again and again. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

A revised edition of an undergraduate text for students in history of psychology courses. Designed for one semester, covers: the history of psychology in ancient philosophy, structuralism, neurophysiology, functionalism, behaviorism, psychoanalysis, and gestalt theories. The new edition has expanded.

Does the content of a physically dangerous job affect the moral permissibility of hiring for that job? To what extent may employers consider costs in choosing workplace safety measures? Drawing on Kantian ethical theory, this article defends two strong ethical standards of workplace safety. First, the content of a hazardous job does indeed affect the moral permissibility of offering it. Unless employees need hazard pay to meet basic needs, it is permissible to offer a dangerous job only if prospective employees (...) have a reason other than hazard pay to choose this job instead of safer alternatives. Second, employers typically cannot justify omitting expensive safety measures by paying employees more, even if employees prefer higher pay to greater safety. Employers offering dangerous jobs must meet these two standards to avoid treating their employees merely as means. (shrink)

Recently, dramatic price increases by several pharmaceutical companies have provoked public outrage. These scandals raise questions both about how pharmaceutical firms should be regulated and about how pharmaceutical executives ethically ought to make pricing decisions when drug prices are largely unregulated. Though there is an extensive literature on the regulatory question, the ethical question has been largely unexplored. This article defends a Kantian approach to the ethics of pharmaceutical pricing in an unregulated market. To the extent possible, pharmaceutical companies must (...) price drugs so that those who genuinely need them can get them without financial ruin. This requirement is an ethical side constraint, like the moral prohibitions on deception and theft, that takes precedence over a business’s interest in maximizing profit. That said, the requirement’s application is sensitive to the need to recoup the costs of research and to produce a return that financially justifies the original investment. It may not be either feasible or desirable for government to attempt to enforce the ethical requirements concerning just pharmaceutical pricing. Either price regulation or subsidy could fulfill government’s obligation to protect patients from being objectionably vulnerable to pricing decisions by private companies. (shrink)

Ontological Naturalism holds that our fundamental ontology contains only those generally natural objects, properties, and relations required by our best scientific theory. Logical principles are thought of as being normative of correct inference and as involving necessary truths and relations. Necessary relations are stronger than the relations described by science; norms are traditionally thought to be separate from the descriptive project of science. Yet, ontological theories, including ontological naturalism, employ logic freely without offering an account of logical normativity and necessity. (...) It appears that logical properties and relations are prima facie non-natural. If so, then ontological naturalism paradoxically presupposes the presence of non-natural properties and relations as a part of the ultimate fundamental ontology. I explore this tension between logic and ontology as a means to clarifying the standards of acceptability for ontological theories generally and as a means to clarifying the character of logical discourse. I conclude that all proposed ontological theories must provide a substantive account of logic which respects its intrinsic modal and normative character as a minimal test of meta-ontological acceptability. (shrink)

Impossible love -- Between nature and culture -- Surviving, forever foreign -- Cryptic crossing -- Touching transcendence, in the flesh -- The tragedy of Christianity.

Suppose that disgust can provide evidence of moral wrongdoing. What account of disgust might make sense of this? A recent and promising theory is the social contagion view, proposed by Alexandra Plakias. After criticizing both its descriptive and normative claims, I draw two conclusions. First, we should question the wisdom of drawing so straight a line from biological poisons and pathogens to social counterparts. Second, we don’t need to explain the evidential value of disgust by appealing to what the response (...) tracks. These lessons point toward an alternative: namely, that disgust is a moral heuristic. On the heuristic view, disgust is a trigger for the subconscious use of a particular rule: I show how this view fits with a plausible hypothesis about the social function of disgust, and then apply it to Leon Kass’s famous use of repugnance to criticize cloning. (shrink)

AI systems play an increasingly important role in shaping and regulating the lives of millions of human beings across the world. Calls for greater _transparency_ from such systems have been widespread. However, there is considerable ambiguity concerning what “transparency” actually means, and therefore, what greater transparency might entail. While, according to some debates, transparency requires _seeing through_ the artefact or device, widespread calls for transparency imply _seeing into_ different aspects of AI systems. These two notions are in apparent tension with (...) each other, and they are present in two lively but largely disconnected debates. In this paper, we aim to further analyse what these calls for transparency entail, and in so doing, clarify the sorts of transparency that we should want from AI systems. We do so by offering a taxonomy that classifies different notions of transparency. After a careful exploration of the different varieties of transparency, we show how this taxonomy can help us to navigate various domains of human–technology interactions, and more usefully discuss the relationship between technological transparency and human agency. We conclude by arguing that all of these different notions of transparency should be taken into account when designing more ethically adequate AI systems. (shrink)

Marx’s Inferno reconstructs the major arguments of Karl Marx’s Capital and inaugurates a completely new reading of a seminal classic. Rather than simply a critique of classical political economy, William Roberts argues that Capital was primarily a careful engagement with the motives and aims of the workers’ movement. Understood in this light, Capital emerges as a profound work of political theory. Placing Marx against the background of nineteenth-century socialism, Roberts shows how Capital was ingeniously modeled on Dante’s Inferno, and how (...) Marx, playing the role of Virgil for the proletariat, introduced partisans of workers’ emancipation to the secret depths of the modern “social Hell.” In this manner, Marx revised republican ideas of freedom in response to the rise of capitalism. Combining research on Marx’s interlocutors, textual scholarship, and forays into recent debates, Roberts traces the continuities linking Marx’s theory of capitalism to the tradition of republican political thought. He immerses the reader in socialist debates about the nature of commerce, the experience of labor, the power of bosses and managers, and the possibilities of political organization. Roberts rescues those debates from the past, and shows how they speak to ever-renewed concerns about political life in today’s world. (shrink)

Government’s use of imprisonment raises distinctive moral issues. Even if government has broad authority to make and to enforce law, government may not be entitled to use imprisonment as a punishment for all the criminal laws it is entitled to make. Indeed, there may be some serious crimes that it is wrong to punish with imprisonment, even if the conditions of imprisonment are humane and even if no adequate alternative punishments are available.

When a business has competitors that break a burdensome law, is it morally required to obey this law, or may it break the law to avoid an unfair competitive disadvantage? Though this ethical question is pervasive in the business world, many non-skeptical theories of the obligation to obey the law cannot give it a clear answer. A broadly Kantian account, by contrast, can explain why businesspeople ought to obey laws of a certain type even under competitive pressure, namely laws that (...) play a direct role in defining rights to use physical or financial resources free from substantial interference. Businesspeople must obey these laws even at the cost of allowing their businesses to fail and even when the acts proscribed are mala prohibita. This argument for obeying the law in competitive contexts has limited scope. Considerations of fairness or self-preservation may justify violating laws of other types under competitive pressure. (shrink)

Many assume that whenever government is entitled to make a law, it is entitled to enforce that law coercively. I argue that the justification of legal authority and the justification of governmental coercion come apart. Both in ideal theory and in actual human societies, governments are sometimes entitled to make laws that they are not entitled to enforce coercively.

Accounts of modal knowledge are many and varied. How should we choose between them? I propose that we employ inference to the best explanation, and I suggest that there are three desiderata that we should use to rank hypotheses: conservatism, simplicity, and the ability to handle disagreement. After examining these desiderata, I contend that they can’t be used to justify belief in the modal epistemology that fares best, but that they can justify our accepting it in an epistemically significant sense. (...) Finally, I outline a modal epistemology that seems to do well by the standards I’ve recommended. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Elephants Teach: Creative Writing Since 1880Robert GrudinThe Elephants Teach: Creative Writing Since 1880, by D. G. Myers; 224 pp. Englewood Cliffs, New Jersey: Prentice Hall, 1996, $30.40 paper.D. G. Myers opens his history of creating writing instruction in America with an anecdote: When Vladimir Nabokov was proposed for a chair in literature at Harvard, Roman Jakobson objected. “What’s next?” he said. “Shall we appoint [End Page 529] (...) elephants to teach zoology?” This question not only provides Myers’s book with its title but also suggests a major issue of literary pedagogy: is the teaching of literature the province of philologists and theorists who interpret books, or is it the province of authors who write them? Jakobson the philologist implies that writers, who just produce the stuff, lack knowledge of interpretive method and thus have little business in the classroom. Others—writers and teachers alike—have thought differently and have over the past century fostered the growth of creative writing at American colleges and high schools.The Elephants Teach is a comprehensive and coherent effort to deal with a ponderous mass of history and discourse: the development of writing curricula since 1880 and the ongoing professional dialogue about the proper relationship between writing and teaching. The first four of his seven chapters deal with roots and preliminaries: the rise of literature instruction as philology after the Civil War, the inception of English composition at Harvard (championed by Adams Sherman Hill, Barrett Wendell, Dean Le Baron Briggs, and Charles Townsend Copeland), and the professional, cultural, and financial forces drawing writers to campuses in the early twentieth century. These chapters establish three major forces leading to the rise of the creative writing curriculum: the consensus that writing experience is of value to the individual and society, the reiterated conviction that literary instruction should consider the perspective of the writer, and the broad recognition by “serious” writers, who had little or no access to the mass market, that they could agreeably support themselves in the classroom. These forces would lead to what Myers correctly sees as a massive compromise: a complex of writing programs simultaneously satisfying students’ needs and allowing thousands of writers to pursue, if only by fits and starts, their professional calling.Myers then serves up the main course: a three-chapter narrative, stretching from the 1920s down to the present, of the history of creative writing as a so-named and self-conscious institution in American education. The opening of this section is not only informative but characteristic of the overall lucidity of Myers’s style: “Creative writing was first taught under its own name in the 1920s. It began in junior high school where it was originally conducted as an experiment to replace traditional English—grammar, spelling, penmanship, even literature classes—with something more appealing to young people. As such it was part of a broader movement to reform American education in the first half of the twentieth century. The cry was that subjects should not be taught, students should; the reform movement called itself progressive education. Creative writing was invented to transport progressive methods and materials into a junior-high-school English classroom. The man who invented it was a progressive educator—once well known, now largely forgotten—named Hughes Mearns” (p. 101). William Hughes Mearns (1875–1965) was himself a disciple of John Dewey, whose ideas formed the basis for progressive education in general. Adapting the Deweyan concept of learning as a spur to personal [End Page 530] development, Mearns saw writing “as the efficient cause of an education in which the final cause was personal growth” (pp. 104–11).After Mearns, Myers considers a somewhat more familiar chapter in history: the appearance of creative writing as a self-contained discipline on the college campus. Credit for the original initiative goes to Norman Foerster (1887–1972), who in 1930 took over the newly-founded School of Letters at the University of Iowa. A follower of Irving Babbitt and the “new humanism,” Foerster set out (in his own words) “to give all types of literary students a rigorous and appropriate discipline” (p. 126). Foerster’s “discipline” was a varied curriculum including... (shrink)

Though political philosophers often presuppose that coercive enforcement is fundamental to law, many legal philosophers have doubted this. This article explores doubts of two types. Some legal philosophers argue that given an adequate account of coercion and coerciveness, the enforcement of law in actual legal systems will generally not count as coercive. Others accept that actual legal systems enforce many laws coercively, but they deny that law has a necessary connection with coercion. There can be individual laws that lack coercive (...) sanctions, and it is at least conceptually possible for there to be a legal system that lacks coercive enforcement altogether. This article then examines why most political philosophers and some legal philosophers have been reluctant to treat the conceptual possibility of non-coercive law as significant. (shrink)

It is widely agreed that foreign sponsors of research in low- and middle-income countries (LMICs) are morally required to ensure that their research benefits the broader host community. There is no agreement, however, about how much benefit or what type of benefit research sponsors must provide, nor is there agreement about what group of people is entitled to benefit. To settle these questions, it is necessary to examine why research sponsors have an obligation to benefit the broader host community, not (...) only their subjects. Justifying this claim is not straightforward. There are three justifications for an obligation to benefit host communities that each apply to some research, but not to all. Each requires a different amount of benefit, and each requires benefit to be directed toward a different group. If research involves significant net risk to LMIC subjects, research must provide adequate benefit to people in LMICs to avoid an unjustified appeal to subjects’ altruism. If research places significant burdens on public resources, research must provide fair compensation to the community whose public resources are burdened. If research is for profit, research sponsors must contribute adequately to the upkeep of public goods from which they benefit in order to avoid the wrong of free-riding, even if their use of these public goods is not burdensome. (shrink)

In response to Frederick Schauer's book The Force of Law, I argue that the available evidence indicates that non-coercive law could influence many people's behavior. It may sometimes be best to forgo coercive enforcement of an important law.

This essay seeks to bring into focus the latent political theory of CLR James’s World Revolution, 1917-1936, and to show, on this basis, how World Revolution explains certain difficult aspects of The Black Jacobins. The core of James’s theory is the thesis that social classes are organically and internally identified, and that each has a preformed and unitary interest, which can be articulated as a set of political principles. A class is called to act by the voice that expresses the (...) class’s interest in the terms of its political principles. Once these points are made clear, several problems regarding the interpretation of The Black Jacobins disappear. First, James’s claim that the slaves of San Domingo were “closer to a modern proletariat than any group of workers in existence at the time” follows from his organic concept of the proletariat. Second, James’s revision of his account of the Haitian Revolution over the decades does not signify a move in the direction of “history from below” but a changed estimation of the conditions under which the mirroring operation he assigned to political leadership might take place. What seems to be James’s inordinate interest in the individual leader, finally, is more properly understood to be his antipathy to institutions and organizations. (shrink)

This essay seeks to bring into focus the latent political theory of CLR James’s World Revolution, 1917-1936, and to show, on this basis, how World Revolution explains certain difficult aspects of The Black Jacobins. The core of James’s theory is the thesis that social classes are organically and internally identified, and that each has a preformed and unitary interest, which can be articulated as a set of political principles. A class is called to act by the voice that expresses the (...) class’s interest in the terms of its political principles. Once these points are made clear, several problems regarding the interpretation of The Black Jacobins disappear. First, James’s claim that the slaves of San Domingo were “closer to a modern proletariat than any group of workers in existence at the time” follows from his organic concept of the proletariat. Second, James’s revision of his account of the Haitian Revolution over the decades does not signify a move in the direction of “history from below” but a changed estimation of the conditions under which the mirroring operation he assigned to political leadership might take place. What seems to be James’s inordinate interest in the individual leader, finally, is more properly understood to be his antipathy to institutions and organizations. (shrink)

This essay explores the trope of sleep in Peter Sloterdijk’s philosophy of anthropotechnics. Sleep is shown to be important for our understanding of Sloterdijk’s project as an index of his subject’s larger, hidden complex of inertias, habits, and corporeal requirements and processes that dominate subjective life and that exist outside the mastery of ego and consciousness. The essay explores this thesis by considering a series of figures that appear in Sloterdijk’s writings and interviews: the philosopher Heraclitus with his dismissive remarks (...) on sleep, the insomniac Emil Cioran, the sleepwalker in Romantic thought. As the essay develops, it shows how, given such a subject formation, anthropotechnics is properly conceived as a management of the subject’s automatic processes to trick or repurpose or redirect them to work in concert or coincidence with the anthropotechnical project, rather than against it. (shrink)

Many business transactions and employment contracts are wrongfully exploitative despite being consensual and beneficial to both parties, compared with a nontransaction baseline. This form of exploitation can present governments with a dilemma. Legally permitting exploitation may send the message that the public condones it. In some economic conditions, coercively enforced antiexploitation law may harm the people it is intended to help. Under these conditions, a way out of the dilemma is to enact laws with provisions that lack coercive enforcement. Noncoercive (...) law would convey the state’s condemnation of wrongful exploitation without risking the harmful effects of coercively enforced law. It would also give firms and their agents a way of explaining nonexploitative pricing decisions to investors, and it may help give precise content to the moral duty to set prices and wages fairly. Governments should thus consider noncoercive law a viable component of their responses to exploitation. (shrink)

Cost effectiveness. Economics. This is an introduction, accessible to non-economists as well as to economists, to the practice of cost benifit analysis. It begins from a discussion of financial appraisal. The distinguishing features of cost benifit analysis are then introduced progressively. Practical examples are used whenever possible to aid the exposition. Economic theory is introduced only where it is immediately relevant to practice. Nonetheless the approach is firmly grounded in economic principles and considerable space is devoted to those ideas that (...) are central to practical cost benefit analysis - shadow prices, consumers' surplus, and valuation of unmarked goods. The additional needs of economically trained readers are catered for by a number of appendices which relate the ideas expounded in the book to mainstream economic theory. (shrink)

At many slaughterhouses, if a pregnant cow is killed, then medical companies pay to harvest the fetus's blood. When you communicate the details of this process to people, many of them are disgusted. I submit that those who are repulsed thereby acquire a reason to believe that this practice is morally wrong. However, it is controversial to maintain that disgust can provide moral guidance. So, I develop a theory of disgust’s moral salience that fits with the empirical work that’s been (...) done on it, and I apply it to the collection of bovine fetal blood. I conclude by suggesting how this theory may be of use in animal ethics generally. (shrink)

A potential explanation of a fact is a hypothesis such that, if it were true, it would explain the fact in question. Let’s suppose that we become aware of a fact and some potential explanations thereof. Let’s also suppose that we would like to believe the truth. Given this aim, we can ask two questions. First, is it likely that one of these hypotheses is true? Second, given an affirmative answer to the first question, which one is it likely to (...) be? Inference to the best explanation (IBE) offers answers to both questions. To the first, it says ‘Yes’—assuming that at least one of the hypotheses would, if true, provide a satisfactory explanation of the fact under consideration. To the second, it says that the hypothesis most likely to be true is the one that scores best on the explanatory virtues: conservatism, modesty, simplicity, generality, and predictive power. Many philosophers have argued against IBE’s answer to the first question. I am interested in an objection to its answer to the second. Many philosophers seem to think that it is unsustainable: they seem to think that even if we assume that one of the competing hypotheses is true, we should not think that IBE will help us to identify it. Or, more carefully, if these philosophers are doing what they appear to be doing—namely, offering critiques of IBE that don’t depend on assumptions about the field of competing hypotheses—then their claim is that IBE will not help us to identify the truth. I believe that this is mistaken: the argument for believing it assumes a model of IBE that we have no reason to accept. (shrink)

Some philosophers think that a person can justifi ably believe that p is possible even though she has no theory according to which p is possible. They think, for example, that she can justifiably believe that there could be naturally purple elephants even though she lacks (inter alia) a theory about the factors germane to elephant pigmentation. There is a certain optimism about this view: it seems to assume that people are fairly good at ferreting out problems with proposed modal (...) claims; so, if a person doesn’t detect one, then she’s within her rights to assume that there is no problem to be found. I am suspicious of this optimism, but I do not have space to challenge it here. Instead, I want to outline the more pessimistic alternative. Suppose that a person is not justified in believing that p is possible unless she has a theory according to which p is possible. How might such an account be developed? My aim is to map out this neglected option. (shrink)

It is widely agreed that medical researchers who conduct studies in low- and middle-income countries (LMICs) are morally required to ensure that their research benefits the broader host community, not only the subjects. The justification for this moral requirement has not been adequately examined. Most attempts to justify this requirement focus on researchers' interaction with the community as a whole, not on their relationship with their subjects. This paper argues that in some cases, research must benefit the broader host community (...) for researchers to treat subjects and prospective subjects ethically. If research presents substantial net risks to subjects, researchers can ethically ask LMIC citizens to participate only if people in LMICs, normally including people in the host community, stand to benefit. (shrink)

Some sharing economy firms have adopted a strategy of “regulatory entrepreneurship,” openly violating regulations with the aim of rendering them dead letters. This article argues that in a democracy, regulatory entrepreneurship is a presumptively unethical business strategy. In all but the most corrupt political environments, businesses that seek to change their regulatory environment should do so through the democratic political process, and they should do so without using illegal business practices to build a political constituency. To show this, the article (...) defends a qualified moral obligation for businesspeople to obey the law even in societies that fall short of ideal democracy and that are rife with economic injustice. Owners and managers of successful businesses have strong moral reasons to obey laws concerning resource allocation. Such laws include not only property law, but also tax laws, environmental regulations, and other laws that regulate businesses in competitive markets. The moral reasons to obey such laws apply even to laws that business leaders think unfair or inefficient, provided that the laws in question have reasonable, good faith defenders. (shrink)

For-profit managed care organizations face decisions about cost sharing that can involve a tradeoff between the interests of investors and the interests of patients. No successful business can ignore the interests of its investors, but moral philosophy points to ethical reasons for managed care organizations to make patients’ health, rather than investors’ profit, their primary goal. One reason is the ethical obligation of all businesses to avoid wrongful exploitation of vulnerable customers. An insurance company’s cost-sharing policy can exploit customers either (...) by collecting an unfairly large amount of money from them or by unfairly deterring them from making claims for resources they medically need. Another reason stems from the fact that managed care organizations’ profits derive in part from the existence of artificial barriers to access to medicine, notably including patents. Putting a fence around a water well in the desert is legitimate only if doing so facilitates a financial arrangement that maximizes people’s access to water they need. Likewise, patents and other artificial barriers to access to medically necessary drugs are legitimate only if they are used to help finance access to medical resources people need. For these reasons, managed care organizations should make cost-sharing decisions that maximize the sustainable availability of effective drugs to patients who need them. (shrink)

This paper defends a new argument for enabling citizen participation in government: individuals must have genuine opportunities to try to change the law in order to be able to satisfy duties of conscience. Without such opportunities, citizens who regard systems of related laws as partially unjust face a moral dilemma. If they comply with these laws willingly without also trying to change them, they commit a pro tanto wrong by willingly participating in injustice . If they disobey, or if they (...) obey only to avoid sanction, they respond inadequately to the morally important purposes that the laws advance despite their injustice. Government should help citizens avoid this dilemma. This argument bolsters the non-instrumentalist view that responsiveness in the political process is desirable even if it does not promote just legislative outcomes. It also helps to explain what governments owe to citizens with minority political views. (shrink)

One of the central controversies in normative business ethics is the question whether transactions and economic relationships can be wrongfully exploitative despite being mutually beneficial and consensual. This article argues that anyone who accepts a shareholder theory of business ethics should accept deontological constraints on mutually beneficial, consensual exploitation.

Considerations of autonomy and independence, properly understood, support strictly egalitarian provision of necessary medical treatment. If the financially better-off can purchase access to necessary medical treatments that the financially less well-off cannot purchase without help, then their discretionary power to give or to withhold monetary gifts indirectly gives them the power to make life-and-death or sickness-and-health decisions for others. To prevent private citizens from having this objectionable form of power, government must ensure that citizens’ finances do not affect their access (...) to medical treatments that significantly prolong life, relieve suffering, or cure or mitigate disabilities. Government should ensure this even if doing so involves leveling down and even if it is unclear whether egalitarian provision of necessary treatment would provide better care to the poor than a less egalitarian health care system would. (shrink)

Many ethicists maintain that medical research on human subjects that presents no prospect of direct medical benefit must have a prospect of social benefit to be ethical. Payment is not the sort of benefit that justifies exposing subjects to risk. Alan Wertheimer has raised a serious challenge to this view, pointing out that in industry, social value is not considered necessary to make dangerous jobs ethical. This article argues that Wertheimer was correct to think that the ethics of hazard pay (...) should be the same in medical research and in business. Nevertheless, a qualified social benefit requirement should apply in both fields. For a study or a job with significant net physical risk to be ethical, it must have social value beyond the satisfaction of ordinary preferences, including the preference for money. The requirement derives from a non-absolutist version of the doctrine of double effect. If a risky study or a dangerous job has no distinctive social value, and hazard pay is subjects' or workers’ only reason to undergo risks, the very fact that they undergo risk is intended as a means to a financial end. Inviting people to enrol in such a study or to take such a job wrongfully treats people as mere means. By contrast, if a study or a job has social value, people can participate with a primary end other than money, even if they accept compensation. Researchers or employers do not intend but merely foresee risks to subjects or workers. (shrink)

Many accounts of the moral duty to obey the law either restrict the duty to ideal democracies or leave the duty’s application to non-ideal societies unclear. This article presents and defends a partial account of the moral duty to obey the law in non-ideal societies, focusing on the duty to obey judicial orders. We need public judicial authority to prevent objectionable power relationships that can result from disputes about private agreements. The moral need to prevent power imbalances in private relationships (...) grounds a qualified moral duty to obey judicial decisions. The parties to a dispute are morally required to comply with a judicial order in their dispute if all of the following conditions obtain: the parties’ dispute was in good faith, the court’s resolution of the dispute is more impartial than either party’s own judgment, the order does not call for violation of important natural duties or important artificial duties that the duty-bearer incurred involuntarily, and the primary aim of disobeying the court order would be to advance an ordinary, non-political project, not to call public attention to an injustice. The moral duty to obey judicial decisions can survive significant departures from ideal fairness. (shrink)

Many scholars believe that it is procedurally undemocratic for the judiciary to have an active role in shaping the law. These scholars believe either that such practices as judicial review and creative statutory interpretation are unjustified, or that they are justified only because they improve the law substantively. This Article argues instead that the judiciary can play an important procedurally democratic role in the development of the law. Majority rule by legislatures is not the only defining feature of democracy; rather, (...) a government is democratic to the extent to which it provides egalitarian forms of political participation. One such form of participation can be the opportunity to influence the law through the courts, either directly by participating in a case or indirectly by advocating litigation. Arguing from several examples, this Article shows that judicial decision-making allows different voices to be heard that may not necessarily have influence or power in majoritarian legislative structures or popular initiatives. Giving citizens the opportunity to change, to preserve, and to obtain authoritative clarification of the law through the courts can thus make a government procedurally more democratic. (shrink)

There is something amiss about post-Rawlsian efforts to bring political theory down to earth by insisting upon the political primacy of the question of legitimacy, peace, or order. The intuition driving much realism seems to be that we must first agree to get along, and only then can we get down to the business of pursuing justice. I argue that the ideological narratives of the powerful pose a political problem for this primacy of legitimacy thesis. To prioritize the achievement of (...) democratic legitimacy seems to make sense only to the extent that we already live in a world in which systematic domination—and its ideological baggage—has been stamped out. I draw on the social study of domination for the sake of combatting in political theory the temptation to focus on the static design of the constitutional state at the expense of ignoring or even condemning the social processes that motivate legal and constitutional changes. (shrink)

Meat-eating has been the norm in most human societies. Historically, it has not had many defenders, but this is probably because few thought that it was in need of defense. In the contemporary philosophical literature, however, the pro-vegetarian arguments are usually taken to be quite strong, and omnivores have assumed the burden of proof. The purpose of this entry is to explain this shift by surveying the various frameworks that offer neutral or positive moral assessments of meat-eating. After briefly tracing (...) the evolution of these frameworks from the ancient to modern period, the entry outlines the three most prominent contemporary approaches. It closes by considering possibilities for future research. (shrink)