Liberal theorists of justice hardly ever study duties of Good Samaritanism. This is not to say that they regard a failure to be a Good Samaritan as morally acceptable: indeed, most of them think that it is morally wrong. But they tend not to think that it is morally wrong on the grounds that it constitutes a violation of a duty of justice. Rather, they condemn it as a failure to perform a duty of charity, or as a failure (...) to be appropriately altruistic. By contrast, they condemn as a violation of a duty of justice a failure to give to the poor the material resources they need. My aim, in this essay, is to show that if liberals are committed to the view that the needy have a right, as a matter of justice, to some of the material resources of the better off, they must endorse the view that the imperilled have a right, as a matter of justice, th the bodily services of those who are in a position to help. In short, or so I argue, Good Samaritan Duties are not a matter of Charity; nor are they a matter of altruism; rather, they firmly fall within the purview of justice. I make my case as follows. First, I rebut the claim that those are duties of charity, and not of justice. Second, I argue, pace many, that we owe it to the imperilled themselves, as a matter of justice, to rescue them: we do not owe it to society as a whole. Finally, I show, against a number of theorists, that such duty can and should be enforced by the state. (shrink)

On Christopher H. Wellman’s Samaritan account of political legitimacy, the state is justified in coercing its subjects because doing so is necessary to rescue them from the perils of the state of nature. Samaritanism – the principle that we are morally permitted to do what is necessary to rescue someone from serious peril if in doing so we do not impose unreasonable costs on others – only justifies a minimal state, in Wellman’s view. I argue contra Wellman that (...) class='Hi'>Samaritanism justifies an extensive, liberal-egalitarian state. (shrink)

In this paper, I defend the existence of a moral duty to disobey the law and engage in civil disobedience on the basis of one of the grounds of political obligation—the Samaritan duty. Christopher H. Wellman has recently offered a ‘Samaritan account’ of state legitimacy and political obligation, according to which the state is justified in coercing each citizen in order to rescue all from the perilous circumstances of the state of nature; and each of us is bound to obey (...) the law, as the state demands, because we each have a responsibility to help rescue others when this assistance is not unreasonably costly. Though Wellman recognizes that there can be reasons for disobeying the law and resisting injustice in otherwise legitimate states, he overlooks the possibility that at least some of these reasons could be Samaritan in nature, grounded in the duty to rescue people from peril. As I shall argue, the Samaritan duty supports obligations to disobey the law, when the law prohibits Samaritan rescues, and to engage in civil disobedience, when unjust laws and practices contribute to endangering people. The discussion proceeds as follows. After a brief overview of the Samaritan duty, I articulate my case for Samaritan duties to disobey the law, and duties to engage in civil disobedience when unjust laws, institutions, or practices enable what I call ‘persistent Samaritan perils’. I then examine and respond to several objections to my account: first, that the costs of law-breaking are unreasonable, and thus cannot be morally required; second, that individuals’ particular acts of protest and civil disobedience do not appear to make any difference to the rescue, and thus cannot be required; third, that I stretch the Samaritan duty beyond recognition; and fourth, that the Samaritan duty binds us to help people in need or peril anywhere, not particularly at home. I consider in conclusion the advantages and limits of my account of citizens’ Samaritan duties in the face of injustice. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2008 a young man committed suicide while his webcam was running. 1,500 people apparently watched as the young man lay dying: when people finally made an effort to call the police, it was too late. This closely resembles the case of Kitty Genovese in 1964, where 39 neighbours supposedly watched an attacker assault and did not call until it was too late. This paper examines the role of internet mediation in cases where people may or may not have been (...) good Samaritans and what their responsibilities were. The method is an intuitive one: intuitions on the various potentially morally relevant differences when it comes to responsibility between offline and online situations are examined. The number of onlookers, their physical nearness and their anonymity have no moral relevance when it comes to holding them responsible. Their perceived reality of the situation and ability to act do have an effect on whether we can hold people responsible, but this doesn’t seem to be unique to internet mediation. However the way in which those factors are intrinsically connected to internet mediation does seem to have a diminishing effect on responsibility in online situations. (shrink)

In this article I criticize a theory of political obligation recently put forward by Christopher Wellman. Wellman's “samaritan theory” grounds both state legitimacy and political obligation in a natural duty to help people in need when this can be done at no unreasonable cost. I argue that this view is not able to account for some important features of the relation between state and citizens that Wellman himself seems to value. My conclusion is that the samaritan theory can only be (...) accepted if we are ready to give up either the traditional notion of political obligation as a prima facie duty valid for every citizen, or the current view of the relationships that should exist between states, citizens and foreigners (the view according to which states should have special concerns for their own citizens). (shrink)

Judith Jarvis Thomson concludes “A Defense of Abortion” with a discussion of samaritanism. Whereas her rights-based arguments demonstrate the moral permissibility of virtually all abortions, this new consideration of samaritanism provides grounds for morally objecting to certain abortions that are otherwise morally pemissible given strictly rights-based considerations. I argue, first, that this samaritanism constraint on the moral permissibility of abortion involves an appeal to virtue-theoretical considerations. I then show why this hybridization of rights-based considerations and virtue-theoretical considerations (...) has advantages over responses to the moral status of abortion that are either exclusively rights-based, or else exclusively virtue-theoretical. I conclude by offering some thoughts on how to utilize this hybrid strategy outside of Thomson’s particular context, as well as why we might generally favor such a strategy in our moral reasoning. (shrink)

Judith Jarvis Thomson concludes “A Defense of Abortion” with a discussion of samaritanism. Whereas her rights-based arguments demonstrate the moral permissibility of virtually all abortions, this new consideration of samaritanism provides grounds for morally objecting to certain abortions that are otherwise morally pemissible given strictly rights-based considerations. I argue, first, that this samaritanism constraint on the moral permissibility of abortion involves an appeal to virtue-theoretical considerations. I then show why this hybridization of rights-based considerations and virtue-theoretical considerations (...) has advantages over responses to the moral status of abortion that are either exclusively rights-based, or else exclusively virtue-theoretical. I conclude by offering some thoughts on how to utilize this hybrid strategy outside of Thomson’s particular context, as well as why we might generally favor such a strategy in our moral reasoning. (shrink)

Africa has always been viewed as a land of the world’s greatest potential. It has been described ad nauseam as a land of abundant natural and human resources, the cradle of civilization and the bastion of man’s natural spirituality. In spite of this apparent superlative richness, the present African condition is also well documented as a paradox. If Africa is this resource rich, why is it so backward and economically poor? In line with the existentialist notion of solicitude and care, (...) this paper argues for a case of global ‘Samaritanism’, that is, an unsolicited care for the other that is nonetheless morally obligatory by virtue of a shared world and common existence. Drawing insight from the submission of Peter Singer, this paper posits that, if we have the capacity to intervene and prevent something bad from happening, without sacrificing anything of comparable moral importance, we ought morally to do it. This paper’s contribution to existing knowledge rests on the extension of Singer’s principle of ‘Samaritanism’ to include solicitude and actionable intervention on life-threatening human conditions of whatever kind. Key words : Africa, Cultural Menaces, Singer, Samaritanism, Existentialism, Fursorge. (shrink)

For over a century now, American scholars (among others) have been debating the merits of “bad Samaritan” laws — laws punishing people for failing to attempt easy and safe rescues. Unfortunately, the opponents of bad Samaritan laws have mostly prevailed. In the United States, the “no-duty-to-rescue” rule dominates. Only four states have passed bad Samaritan laws, and these laws impose only the most minimal punishment — either sub-$500 fines or short-term imprisonment. -/- This Article argues that every state should criminalize (...) bad Samaritanism. There are three main reasons. First, criminalization is required by the supreme value that we place on protecting human life, a value that motivates laws against both homicide and manslaughter. Second, criminalization is recommended by the “proportionality principle” — i.e., the principle that a law’s level of punishment should be directly proportional to the moral severity of the offense. Third, criminalization would yield a number of significant benefits, including helping to minimize needless deaths and injuries and providing society with an institutional outlet for its outrage against bad Samaritans. -/- Still, many objections have been leveled against bad Samaritan laws. This Article will argue that while some of these objections — for example, the objections involving foundational criminal law principles such as the actus-reus requirement, the harm principle, and causation — are all easily refuted, five other objections are not. These five objections involve pragmatic considerations such as the difficulties with obtaining evidence against bad Samaritans and psychological considerations such as people’s understandable reasons for not wanting to “get involved.” This Article will then put these five objections into reflective equilibrium with the moral arguments for bad Samaritan laws and conclude that while bad Samaritanism should indeed be criminalized, the punishment that convicted bad Samaritans receive should be mild — certainly milder than the level of punishment recommended by the “proportionality principle.” The corollary of this conclusion is that the criminal law should sometimes abandon the proportionality principle. (shrink)

In recent years, a robust body of scholarship has emerged that examines ethical challenges facing the learning health organization model. In “Bystander Ethics and Good Samaritanism,” James Sabin and colleagues make a valuable addition to this scholarship, identifying and exploring the important question of what researchers' obligations are to patients receiving “usual care” if “that care is seen as suboptimal.” The central issue that Sabin et al. faced was whether it would be acceptable for researchers to identify patients with (...) untreated atrial fibrillation but then assign them to a control group that would not receive education about the importance of oral anticoagulation. The authors present this challenge as an issue of “bystander ethics.” To avoid being “bystanders” to identified instances of suboptimal care, the research team decided to instead identify a “delayed intervention” group for which they would not determine the members' anticoagulation status, thereby preventing them from knowing that specific patients met the criteria for oral anticoagulants but were not using them. This “workaround” approach strikes me as disingenuous. (shrink)

In late 2012, Hurricane Sandy hit the East Coast of the U.S., causing much suffering and devastation. Those who could have easily helped Sandy’s victims had a duty to do so. But was this a rightfully enforceable duty of justice, or a non-enforceable duty of beneficence? The answer to this question is often thought to depend on the kind of help offered: the provision of immediate bodily services is not enforceable; the transfer of material resources is. I argue that this (...) double standard is unjustified, and defend a version of what I call “Social Samaritanism.” On this view, within political communities, the duty to help the needy—whether via bodily services or resource transfers—is always an enforceable demand of justice, except when the needy are reckless; across independent political communities, it is always a matter of beneficence. I defend this alternative double standard, and consider its implications for the case of Sandy. (shrink)

In this book, Christopher Heath Wellman offers original theories of political legitimacy and our obligation to obey the law, and then, building upon these accounts, defends a number of distinctive positions concerning the rights and responsibilities individual citizens, separatist groups, and political states have regarding one another.

American criminal law reflects the absence of any general duty of Good Samaritanism. Nonetheless, there are some circumstances in which it imposes affirmative duties to aid others. In those circumstances, however, the duty to aid is canceled whenever aiding subjects the actor to a certain level of risk or sacrifice, a level that can be less than the risk or sacrifice faced by the beneficiary if not aided. In this article, I demonstrate that this approach to limiting affirmative duties (...) to aid encounters the same problem of moral arbitrariness as does a moral catastrophe override of deontological side-constraints. (shrink)

There are various ways of attempting to defend an extreme liberal view on abortion, according to which a woman always has the right to control what happens inside her own body. First of all, there is the popular view that appeals to the idea that there is a fundamental, underived right that women have to control what occurs within their own bodies. Secondly, there is a related type of philosophical argument advanced by Judith Jarvis Thomson in her famous and oft-reprinted (...) article “A Defense of Abortion” for the slightly weaker claim that while abortion is not always permissible, since, as she says near the end of her essay, it is impermissible in, and only in, the following circumstances: “There may well be cases where carrying the child to term requires only Minimally Decent Samaritanism of the mother, and this is a standard w must not fall below.” Subsequently, Thomson’s type of argument was then developed and defended at much greater length by David Boonin in his very carefully argued book A Defense of Abortion, though Boonin does not discuss the case of the Minimally Decent Samaritan. I believe that there is a strong objection to the Thomson/Boonin approach to justifying abortion. It was set out in an article by Richard Langer, namely, in ‘Silverstein and the “Responsibility Objection”’, Social Theory and Practice 19/3. 345-58. Langer’s discussion is not, in general, very strong, but in a very important paragraph, on pages 351-2, Langer argues that if the responsibility objection to Thomson is unsound, then it follows that there will also be circumstances in which allowing one’s children to die, simply because one no longer wishes to care for them, will also be morally permissible. David Boonin replies to Langer’s objection in his A Defense of Abortion, but in discussing, on pages 182-3, Langer’s point about a parent’s responsibility to his or her children, Boonin relies upon a tacit consent argument that appears open to decisive objections. It seems to me, then, that the only possibility for a successful defense of an extreme liberal view concerning the justification of abortion will have to involve setting out a plausible account of what it is that gives something a right to life, and I think that the right answer is that neo-Lockean persons, and only neo-Lockean persons, have a right to continued existence. This leaves one with the scientific question of when developing humans become neo-Lockean persons. The answer to that question is perhaps still not firmly settled, although the extensive research that I carried out back in the 1970s seemed to me to support the conclusion that it is not until sometime that humans acquire the capacity for thought, a capacity that is necessary if a developing human is to be a neo-Lockean person. The upshot is that if one defends an extreme liberal view on abortion in the only way that seems to be satisfactory – that is, by setting out an account of what it is that gives something a right to life, and arguing that humans before birth do not have the relevant property, one must also address the question of infanticide, and that to fail to do so is intellectually unacceptable. (shrink)

Do we have the right to deny others access to our body? What if this would harm those who need personal services or body parts from us? Ccile Fabre examines the impact that arguments for distributive justice have on the rights we have over ourselves, and on such contentious issues as organ sales, prostitution, and surrogate motherhood.

In this paper I review and provide a qualified defence of Samaritanism—Christopher Heath Wellman's novel approach to the old-fashioned problem of political obligation. I outline Wellman's theory, clarifying the details, and defend an amended version against a variety of objections concerning, successively, an alleged conflation of duties of care and beneficence, a difficulty concerning the distinction of perfect and imperfect duties, a problem deriving from the 'particularity requirement', and related issues deriving from the international applications of Samaritan values.

This is a Swedish translation of the complete text of "In Defense of Abortion and Infanticide" from Moral Issues, edited by Jan Narveson, Oxford University Press, Toronto and New York, 1983, 215-233. -/- There are various ways of attempting to defend an extreme liberal view on abortion, according to which a woman always has the right to control what happens inside her own body. First of all, there is the popular view that appeals to the idea that there is a (...) fundamental, underived right that women have to control what occurs within their own bodies. Secondly, there is a related type of philosophical argument advanced by Judith Jarvis Thomson in her famous and oft-reprinted article “A Defense of Abortion” for the slightly weaker claim that while abortion is not always permissible, since, as she says near the end of her essay, it is impermissible in, and only in, the following circumstances: “There may well be cases where carrying the child to term requires only Minimally Decent Samaritanism of the mother, and this is a standard w must not fall below.” Subsequently, Thomson’s type of argument was then developed and defended at much greater length by David Boonin in his very carefully argued book A Defense of Abortion, though Boonin does not discuss the case of the Minimally Decent Samaritan. I believe that there is a strong objection to the Thomson/Boonin approach to justifying abortion. It was set out in an article by Richard Langer, namely, in ‘Silverstein and the “Responsibility Objection”’, Social Theory and Practice 19/3. 345-58. Langer’s discussion is not, in general, very strong, but in a very important paragraph, on pages 351-2, Langer argues that if the responsibility objection to Thomson is unsound, then it follows that there will also be circumstances in which allowing one’s children to die, simply because one no longer wishes to care for them, will also be morally permissible. David Boonin replies to Langer’s objection in his A Defense of Abortion, but in discussing, on pages 182-3, Langer’s point about a parent’s responsibility to his or her children, Boonin relies upon a tacit consent argument that appears open to decisive objections. It seems to me, then, that the only possibility for a successful defense of an extreme liberal view concerning the justification of abortion will have to involve setting out a plausible account of what it is that gives something a right to life, and I think that the right answer is that neo-Lockean persons, and only neo-Lockean persons, have a right to continued existence. This leaves one with the scientific question of when developing humans become neo-Lockean persons. The answer to that question is perhaps still not firmly settled, although the extensive research that I carried out back in the 1970s seemed to me to support the conclusion that it is not until sometime that humans acquire the capacity for thought, a capacity that is necessary if a developing human is to be a neo-Lockean person. The upshot is that if one defends an extreme liberal view on abortion in the only way that seems to be satisfactory – that is, by setting out an account of what it is that gives something a right to life, and arguing that humans before birth do not have the relevant property, one must also address the question of infanticide, and that to fail to do so is intellectually unacceptable. (shrink)

Christopher Wellman and some allied scholars argue that a ‘samaritan theory’ can justify state coercion. They also suppose that states may provide robust, social egalitarian welfare provisions for a variety of reasons that would arise within samaritan states. However, the most promising reasons—samaritanism itself, natural socialism, relational equality, and anti-crime paternalism—cannot support robust provision without discarding the strong presumption favoring individual liberty which must motivate the samaritan theory. Consequently, a samaritan state cannot be a robust social welfare state.