There is an ongoing debate about whether multifetal pregnancy reduction from twins to singletons (2-to-1 MFPR) is morally permissible. By applying the all or nothing problem to the cases of reducing twin pregnancies to singletons, Räsänen argues that an implausible conclusion seems to follow from two plausible claims: (1) it is permissible to have an abortion and (2) it is wrong to abort only one fetus in a twin pregnancy. The implausible conclusion is that women considering 2-to-1 MFPR for social (...) reasons ought to abort both fetuses rather than just one. To avoid the conclusion, Räsänen suggests that it is best to carry both fetuses to term and give one for adoption. In this article, I argue that Räsänen’s argument fails for two reasons: the inference from (1) and (2) to the conclusion rests on a bridge principle that does not work in certain circumstances, and there is good reason to reject the claim that it is wrong to abort only one fetus. (shrink)

Why should a lottery be used in the allocation of an indivisible good to which participants in the lottery have an equally strong claim? Stone argues that when indeterminacy arises, in which it is impossible to satisfy the equality condition requiring like cases to be treated alike, the impartiality principle suggests that the agent responsible for the allocation task should not intend to favor one over another on the basis of invalid reasons. In this article, I argue that the impartiality (...) principle is neither sufficient nor necessary to explain the fairness of lotteries. Instead, the fairness of lotteries is explained by the sanitizing effect that lotteries generate to screen out the reactive attitudes of resentment and indignation that claimants might otherwise have if they do not obtain the good in question. (shrink)

There is ongoing debate on how to fairly allocate scarce critical care resources to patients with COVID-19. The debate revolves around two views: those who believe that priority for scarce resources should primarily aim at saving the most lives (SML) or at saving the most life-years, and those who believe that public health should focus on health equity to address health disparities and social determinants of health. I argue that maximizing medical outcomes by saving the greatest number of patients is (...) not a plausible strategy for combating COVID-19. There are reasons of fairness to give each patient who can meet general eligibility requirements a chance of being saved. Rather than focusing on outcome maximization, a better solution would be the individualist lottery that takes account of probability of survival and duration of treatment. Although the individualist lottery allocates scarce resources in a fair way that is responsive to health equity concerns, it still gives considerable weight to the concern of SML. Thus, this procedure can be reasonably accepted by all key stakeholders. (shrink)

In this article, I critique a moral argument developed in Frances Kamm’s Intricate Ethics: Rights, Responsibilities, and Permissible Harm. The argument, which I label the Best Outcome Argument, aims to criticize the Taurekian idea that it is not worse if more people die than if fewer do in conflict situations, where it is hard to distinguish individuals from one another solely by reference to the relative strength of their claims. I argue that the Best Outcome Argument is flawed for three (...) reasons: the symmetry feature defined by the impartiality principle holds only in a limited class of conflict situations; individuals should be treated in a consistent way throughout the whole process of reasoning; comparative evaluations gained in different contexts, at least in some cases, cannot be used in one and the same argument. (shrink)