New advances in neuroscience promise innovations in national security, especially in the areas of law enforcement, intelligence collection, and armed conflict. But ethical questions emerge about how we can, and should, use these innovations. This book draws on the open literature to map the development of neuroscience, particularly through funding by the Defense Advanced Research Projects Agency, in certain areas like behavior prediction, behavior modification, and neuroenhancement, and its use in the creation of novel weapons. It shows how advances in (...) neuroscience and new technologies raise ethical issues that challenge the norms of law enforcement, intelligence collection, and armed conflict, broadly grouped under the term "national security." Increasing technological sophistication without attention to ethics, this book argues, risks creating conditions for the development of "dual-use" technologies that may be prone to misuse, are grounded in an incomplete understanding of the brain, or are based on a limited view of the political contexts in which these technologies arise. A concluding section looks at policy and regulatory options that might promote the benefits of emerging neuroscience, while mitigating attendant risks. Key Features: First broad survey of the ethics of neuroscience as it applies to national security Innovative ethical analysis over a range of cross-cutting technologies including behavior prediction and modification tools, human enhancement, and novel lethal and nonlethal weapons Ethical analysis covering all stages from the development, testing, and use of these technologies; and decisions from the individual scientist to the nation state Strong policy focus at multiple levels, from self-governance to international regulation Combination of philosophical analysis with grounded, practical recommendations. (shrink)

Actions to prepare for and prevent pandemics are a common topic for bioethical analysis. However, little attention has been paid to global catastrophic biological risks more broadly, including pandemics with artificial origins, the creation of agents for biological warfare, and harmful outcomes of human genome editing. What’s more, international policy discussions often focus on economic arguments for state action, ignoring a key potential set of reasons for states to mitigate global catastrophic biological risks: moral (...) reasons. In this paper, I frame the mitigation of such risks as a global public good, and I explore three possible categories of moral reasons that might motivate states to provide this global public good: nationalism, cosmopolitanism, and interstate obligations. Whilst there are strong objections to moral nationalism as a reason for states to act, moral cosmopolitanism may provide a broad reason which is further supplemented for individual states through the elaboration of interstate moral obligations. The obligations I consider are moral leadership, fairness, and reciprocity. Moral reasons for individual states action may more effectively or more appropriately motivate states to mitigate global catastrophic biological risks. (shrink)

Like nuclear energy, most technologies could have dual use—for health and well being and disaster and terror. Some research publications have brought to the forefront the tragic consequences of the latter potential through their possible use. Monitoring life science research and development (R&D) to prevent possible misuse is a challenging task globally, more so in developing economies like India, which are emerging as major biotech hubs. As a signatory to the Biological and Toxin Weapons Convention, India has put in (...) motion a process of evolving a series of measures to manage dual-use technology. The Indian Council of Medical Research (ICMR) has taken a lead in drafting model codes of conduct, ethics and practice for use by other S&T agencies to tailor them as per their requirements. Taking cue from the discussions held by the editors of the various medical and science journals in the developed world, the Indian Journal of Medical Research, the official publication of the ICMR, is working on policy and uniform practice of publication of dual-use research results. The Government of India too has promulgated legal provisions to minimize the risks of misuse of technology, like the Weapons of Mass Destruction Act. Clearly, no single agency would be able to manage the dual-use of technology effectively. Multiple agencies have to come together to work in tandem for effective implementation of various measure and also like Janus, ensure that they are neither too restrictive nor intrusive to discourage the development of science. (shrink)

An anthropogenic global catastrophic risk is a human-induced risk that threatens sustained and wide-scale loss of life and damage to civilisation across the globe. In order to understand how new research on governance mechanisms for emerging technologies might assuage such risks, it is important to ask how perceptions, beliefs, and attitudes towards the governance of global catastrophic risk within the research community shape the conduct of potentially risky research. The aim of this study (...) is to deepen our understanding of emerging technology research culture as it relates to global catastrophic risks, and to shed new light on how new research governance mechanisms might be developed. We analyse in-depth interviews with leading AI and biotech researchers both from universities and the private sector. We develop new insights in terms of four salient themes. First, ‘engineering mindset’, which highlights the premium placed by many interviewees on pursuing interesting research about the physical world for its own sake. Second, ‘self-government’, which looks at how self-regulation of technological development currently occurs. Third, ‘pure incentives’, focussing on how career and other incentives shapes research. Fourth, ‘norms and persuasion’, which examines the role of moral considerations in guiding the research choices of scientists. We end by considering the implications of these findings for future research on governance of anthropogenic global catastrophic risk. (shrink)

This paper provides an overview of the various dual-use concepts applied in national and international non-proliferation and anti-terrorism legislation, such as the Biological and Toxin Weapons Convention, the Chemical Weapons Convention and United Nations Security Council Resolution 1540, and national export control legislation and in relevant codes of conduct. While there is a vast literature covering dual-use concepts in particular with regard to life sciences, this is the first paper that incorporates into such discussion the United Nations (...) Security Council Resolution 1540. In addition, recent developments such as the extension of dual-use export control legislation in the area of human rights protection are also identified and reviewed. The discussion of dual-use concepts is hereby undertaken in the context of human- and/or national-security-based approaches to security. This paper discusses four main concepts of dual use as applied today in international and national law: civilian versus military, peaceful versus non-peaceful, legitimate versus illegitimate and benevolent versus malevolent. In addition, the usage of the term to describe positive technology spin-offs between civilian and military applications is also briefly addressed. Attention is also given to the roles civil society and research ethics may play in the governance of dual-use sciences and technologies. (shrink)

The technological advances of the 20th century resulted in the creation of the Internet and its introduction into everyday life on a global scale. The Internet provides access to information and the sale and purchase of goods. Medications are also subject to trade. Their sale is conducted by online pharmacies and their global turnover amounts to hundreds of billions of dollars. Medications ordered over the Internet are sent by mail all over the world. Considering the events of recent (...) years, we cannot exclude the risk of a terrorist attack through online pharmacies. Terrorists can establish such companies, legally or illegally, or acquire ones already existing. Parcels, which are highly trusted by the customers of online pharmacies, can, for example, be contaminated with dangerous materials. The sale of online medications in the international system is potentially dangerous and requires international regulation. (shrink)

Improvements in production methods over the last two decades have resulted in aquaculture becoming a significant contributor to food production in many countries. Increased efficiency and production levels are off-setting unsustainable capture fishing practices and contributing to food security, particularly in a number of developing countries. The challenge for the rapidly growing aquaculture industry is to develop and apply technologies that ensure sustainable production methods that will reduce environmental damage, increase productivity across the sector, and respect the diverse social and (...) cultural dimensions of fish farming that are observed globally. The aquaculture industry currently faces a number of technology trajectories, which include the option to commercially produce genetically modified (GM) fish. The use of genetic modification in aquaculture has the potential to contribute to increased food security and is claimed to be the next logical step for the industry. However, the potential use of these technologies raises a number of important ethical questions. Using an ethical framework, the Ethical Matrix, this paper explores a number of the ethical issues potentially raised by the use of GM technologies in aquaculture. Several key issues have been identified. These include aspects of distributive justice for producers; use of a precautionary approach in the management of environmental risk and food safety; and impacts on the welfare and intrinsic value of the fish. There is a need to conduct a comparative analysis of the full economic cycle of the use of GM fish in aquaculture production for developing countries. There is also a need to initiate an informed dialogue between stakeholders and strenuous efforts should be made to ensure the participation of producers and their representatives from developing nations. An additional concern is that any national licensing of the first generation of GM fish, i.e., in the USA, may initiate and frame an assessment cycle, mediated by the WTO, which could dominate the conditions under which the technology will be applied and regulated globally. Therefore, an integrated analysis of the technology development trajectories, in terms of international policy, IPR, and operational implications, as well as an analysis of a broader range of ethical concerns, is needed. (shrink)

Societal evaluation of new technologies, specifically nanotechnology and genetically engineered organisms, challenges current practices of governance and science. When a governing body is confronted by a technology whose use has potential environmental risks, some form of risk analysis is typically conducted to help decision makers consider the range of possible benefits and harms posed by the technology. Environmental risk assessment is a critical component in the governance of nanotechnology and genetically engineered organisms because the uncertainties and complexities (...) surrounding these technologies pose such risk potential. However, GEOs are unique technologies, and there is widespread, international recognition that many traditional forms of ERA are not well-suited for evaluating them. Nanotechnology products are also likely to need different models of risk assessment, as there is very little information on their fate, transport, and impacts in the environment. (shrink)

The dual-use issue is often framed as a series of paralyzing ‘dilemmas’ facing the scientific community as well as institutions which support innovation. While this conceptualization of the dual-use issue can be useful in certain contexts its usefulness is more limited when reflecting on the governance and politics of the dual-use issue. Within this paper, key shortcomings of the dilemma framing are outlined. It is argued that many of the issues raised in the most recent debates about (...) ‘dual-use’ bird flu research remain unresolved. This includes questions about the trajectories of certain lines of research, as well as broader trends in the practice and governance of science. This leads to difficult questions about current approaches to the dual-use issue within the US, as well as internationally. (shrink)

The problem of dual use is characterized by a wide range of activities or types of research and technology utilization. In this article, I explore the phenomenon of dual use in several steps to make it accessible for ethical inquiries: first, I examine the phenomenon in more detail; is it a genuine property of technologies and methods, a fundamental problem for research ethics, or a specific precondition for trade-off situations? Second, I show that various factors contribute to a (...) certain good becoming a real dual use good. Third, I propose to develop a three-dimensional classification and evaluation system for dual use risks. (shrink)

A central problem for the international governance of heritable germline gene editing is that there are important differences in attitudes and values as well as ethical and health care considerations around the world. These differences are reflected in a complicated and diverse regulatory landscape. Several publications have discussed whether reproductive uses would be legally permissible in individual countries and whether clinical applications could emerge in the context of regulatory gaps and gray areas. Systematic comparative studies that explore issues related (...) to the governance of this technology from different national and international perspectives are needed to address the lack of knowledge in this area. In this research report, we contribute to filling this gap by presenting views of stakeholders in the United Kingdom on challenges to the governance of heritable genome editing. We present findings from a multistakeholder study conducted in the United Kingdom between October 2016 and January 2018 and funded by the Wellcome Trust. This research included interviews, literature analysis, and a workshop. We involved leading U.K. scientists, in vitro fertilization clinicians, and representatives from regulatory bodies, patient organizations, and other civil societal organizations, as well as fertility companies. Part one of this article explores stakeholder perceptions of possible global developments in heritable genome editing and associated risks and governance challenges. Part two presents a range of policy options that were generated during the workshop in relation to the challenges discussed in part one. (shrink)

Since a couple of decades, the notion of a precautionary principle plays a central and increasingly influential role in international as well as national policy and regulation regarding the environment and the use of technology. Urging society to take action in the face of potential risks of human activities in these areas, the recent focus on climate change has further sharpened the importance of this idea. However, the idea of a precautionary principle has also been problematised and criticised by (...) scientists, scholars and policy activists, and been accused of almost every intellectual sin imaginable: unclarity, impracticality, arbitrariness and moral as well as political unsoundness. In that light, the very idea of precaution as an ideal for policy making rather comes out as a dead end. On the basis of these contrasting starting points, Christian Munthe undertakes an innovative, in-depth philosophical analysis of what the idea of a precautionary principle is and should be about. A novel theory of the ethics of imposing risks is developed and used as a foundation for defending the idea of precaution in environmental and technological policy making against its critics, while at the same time avoiding a number of identified flaws. The theory is shown to have far-reaching consequences for areas such as bio-, information- and nuclear technology, and global environmental policy in areas such as climate change. The author argues that, while the price we pay for precaution must not be too high, we have to be prepared to pay it in order to act ethically defensible. A number of practical suggestions for precautionary regulation and policy making are made on the basis of this, and some challenges to basic ethical theory as well as consumerist societies, the global political order and liberal democracy are identified. (shrink)

Despite a common agenda of normative analysis of the international order, philosophical work on international political morality and international law and legal scholarship have, until recently, worked at a distance from one another.The mutual suspicion can be traced to different aims and methodologies, including a divide between work on matters of deep structure, on the one hand, and practical institutional analysis and prescription, on the other. Yet international law is a key part of the (...) normative practices ofstates, has a direct effect on state behavior, and, as a meth-odological matter, can contribute to good theorizing onmatters of international ethics. Recently, philosophical workhas demonstrated a greater engagement with the moral aspects of international law. One strand of scholarship has treated the rules of international law as a proper subject for philosophical inquiry. Another has used international legal rules to support moral arguments about aspects of the international order. Future dialogue and cooperation would benefit both fields, in particular on the challenges to global cooperation from nationalism and on strategies for allocating responsibilities among global actors for rectifying global harms. (shrink)

Human rights discourse has been likened to a global lingua franca, and in more ways than one, the analogy seems apt. Human rights discourse is a language that is used by all yet belongs uniquely to no particular place. It crosses not only the borders between nation-states, but also the divide between national law and international law: it appears in national constitutions and international treaties alike. But is it possible to conceive of human rights as a (...) class='Hi'>global language or lingua franca not just in a figurative or metaphorical sense, but in a literal or linguistic sense as a legal dialect defined by distinctive patterns of word choice and usage? Does there exist a global language of human rights that transcends not only national borders, but also the divide between domestic and international law? Empirical analysis suggests that the answer is yes, but this global language comes in at least two variants or dialects. New techniques for performing automated content analysis enable us to analyze the bulk of all national constitutions over the last two centuries, together with the world’s leading regional and international human rights instruments, for patterns of linguistic similarity and to evaluate how much language, if any, they share in common. Specifically, we employ a technique known as topic modeling that disassembles texts into recurring verbal patterns. The results highlight the existence of two species or dialects of rights talk—the universalist dialect and the positive-rights dialect—both of which are global in reach and rising in popularity. The universalist dialect is generic in content and draws heavily on the type of language found in international and regional human rights instruments. It appears in particularly large doses in the constitutions of transitional states, developing states, and states that have been heavily exposed to the influence of the international community. The positive-rights dialect, by contrast, is characterized by its substantive emphasis on positive rights of a social or economic variety, and by its prevalence in lengthier constitutions and constitutions from outside the common law world, especially those of the Spanish-speaking world. Both dialects of rights talk are truly transnational, in the sense that they appear simultaneously in national, regional, and international legal instruments and transcend the distinction between domestic and international law. Their existence attests to the blurring of the boundary between constitutional law and international law. (shrink)

In debates over the regulation of communication related to dual-use research, the risks that such communication creates must be weighed against against the value of scientific autonomy. The censorship of such communication seems justifiable in certain cases, given the potentially catastrophic applications of some dual-use research. This conclusion however, gives rise to another kind of danger: that regulators will use overly simplistic cost-benefit analysis to rationalize excessive regulation of scientific research. In response to this, we show (...) how institutional design principles and normative frameworks from free speech theory can be used to help extend the argument for regulating dangerous dual-use research beyond overly simplistic cost-benefit reasoning, but without reverting to an implausibly absolutist view of scientific autonomy. (shrink)

The emergence of the global administrative sector and its new forms of knowledge production, expert rationality, and standardization, remains an understudied topic in science studies. Using a coproductionist theoretical framework, we argue tha the mutual construction of epistemic and legal authority across international organizations has been critical for constituting and stabilizing a global regime for the regulation of food safety. The authors demonstrate how this process has also given rise to an authoritative framework for risk (...) class='Hi'>analysis touted as ‘‘scientifically rigorous’’ but embodying particular value choices regarding health, environment, and the dispensation of regulatory power. Finally, the authors trace how enrollment of the Codex Alimentarius in World Trade Law has heightened institutional dilemmas around legitimacy and credibility in science advice at the global level. Taken together, the case illustrates the importance of attending to the iterative construction of law and science in the constitution of new global administrative regimes. (shrink)

The trend toward the “humanization” of international law reflects a greater emphasis on individuals rather than simply states as objects of concern. The advance of human rights law (HRL) has been an important impetus for this trend. Some observers suggest that humanization can be furthered even more by applying HRL rather than international humanitarian law (IHL) to hostilities between states and nonstate armed groups, unless a state explicitly declares that it is engaged in an armed conflict. This essay (...) argues, however, that a court should not defer to a state's characterization of hostilities, but should base its analysis on whether hostilities meet the criteria for an armed conflict. Applying HRL to hostilities that effectively are an armed conflict but not acknowledged as such risks diluting the legitimacy and normative force of HRL. On the one hand, if a court applies conventional stringent HRL standards, this body of law may be seen as unrealistic and is likely to be ignored. On the other hand, a court that adapts HRL standards to armed conflict may need to take a consequentialist approach at odds with HRL's deontological foundations. Clearly differentiating between HRL and IHL may thus best promote the humanization of warfare. (shrink)

This article outlines and compares current and proposed global institutional mechanisms to increase equitable access to COVID-19 vaccines, focusing on their institutional and operational complementarities and overlaps. It specifically considers the World Health Organization's (WHO’s) COVAX (COVID-19 Vaccines Global Access) model as part of the Access to COVID-19 Tools Accelerator (ACT-A) initiative, the WHO’s COVID-19 Technology Access Pool (C-TAP) initiative, the proposed TRIPS (Trade-Related Aspects of Intellectual Property Agreement) intellectual property waiver and other proposed WHO and World Trade (...) Organization technology transfer proposals. We argue that while various individual mechanisms each have their specific individual merits—and in some cases weaknesses—overall, many of these current and proposed mechanisms could be highly complementary if used together to deliver equitable global access to vaccines. Nonetheless, we also argue that there are risks posed by the proliferation of proposals in this context, including the potential to disperse stakeholder attention or to delay decisive action. Therefore, we argue that there is now a clear need for concerted global multilateral action to recognise the complementarities of specific models and to provide a pathway for collaboration in attaining global equitable access to vaccines. The institutional infrastructure or proposals to achieve this amply exist at this point in time—but much greater cooperation from industry and clear, decisive and coordinated action from states and international organisations are urgently needed. (shrink)

The term dual use technologies refers to research and technology with the potential both to yield valuable scientific knowledge and to be used for nefarious purposes with serious consequences for public health or the environment. There are two main approaches to assessing dual use technologies: pragmatic and metaphysical. A pragmatic approach relies on ethical principles and norms to generate specific guidance and policy for dual use technologies. A metaphysical approach exhorts us to the deeper study of human (...) nature, our intentions, goals, values ideals and social relations when considering dual use technology. Use of science and technology (S and T) is determined by two components of human nature: human intentions and choices. We have drawn a distinction between specific measures, goals and intentions with respect to technologies in order to show that moral judgment about technologies must precede their use. Understanding of our intentionality and values, and our moral ideals, as a measurable, tangible part of the real world is important for the prevention of any possible harm from S and T. In the context of dual use technologies, we stress the importance of three main understandings of human nature: vulnerability, responsibility and narrative identity. These can become a strong ontological “antidote” to technology’s poisoning of modern man. Each new technology can be measured and compared with man’s values, traditions and societal norms. This can be done bearing in mind the concept that human nature is not dualistic, but pluralistic. A system of ethical principles that includes the principles of good intentions, the correspondence of goals and means, the balancing of risks and benefits, simplicity, and contextuality, will help ensure that technologies are more humanistic and friendly to human beings. (shrink)

As we can see, the side effects caused by the continuous development of science and economy have gradually brought human society into a risk society. While currently, the power of globalization is unceasingly forming a world risk society. German renowned philosopher and sociologist Ulrich Beck has opened a unique and novel researching angle to review science difficulty and abuse of modern world risk society, and has made comprehensive and profound analysis. World risk society has three (...) main characters: First, the emergence of the world risk society is linked to the two fundamental changes still influencing our lives, which is the so-called “end of nature” and “end of tradition”. Second, in world risk society, mankind lose their dependence on “expert system”. The religion is replaced by the concept uncertainty and uncontrollable. In addition, there are other series of problems and abuses between world risk society and traditional society. The prime mover of social changes in world risk society exists in the side effects instead of the instrumental ration in traditional times, etc. The problem in world risk society’s science ethics are as follows: First, expansion of ration. It is mankind’s extreme confidence in ration that causing unlimited development of technology and exploitation of resources. Thus almost everywhere in nature becomes man‐made nature. Second, rupture of knowledge. From “knowledge is virtue and virtue isknowledge” (Socrates) to “knowledge is power” (Bacon), now “knowledge is money” (Bacon). Third, displacement of science value. In traditional society, science research is scientists’ personal interests. Now science research turns its target to meeting social needs, and scientists gain more profits from the technologicalproducts directly. Beck has raised the theory of risk society, and attempted to use “reflexive modernity” as the strategic plan to respond the global consequence of modern science crisis, and expressed revelatory viewpoint on diagnosis of the essential of “reflexive modernity”. Similarly, Lash emphasizes risk culture toremind human to pay attention to the ecological threat and risk. In addition, Bauman and Habermas also have some statements, etc. So my conclusion is, we should consider the autonomy of science development and its inherent relationship with economic interests. In addition, what we concern is the science dual identity of both defendant and expert. Also, the public’s understanding of the uncertainty provides a space for democratization. (shrink)

Societal evaluation of new technologies, specifically nanotechnology and genetically engineered organisms , challenges current practices of governance and science. Employing environmental risk assessment for governance and oversight assumes we have a reasonable ability to understand consequences and predict adverse effects. However, traditional ERA has come under considerable criticism for its many shortcomings and current governance institutions have demonstrated limitations in transparency, public input, and capacity. Problem Formulation and Options Assessment is a methodology founded on three key concepts in (...) class='Hi'>risk assessment and three in governance . Developed through a series of international workshops, the PFOA process emphasizes engagement with stakeholders in iterative stages, from identification of the problem through comparison of multiple technology solutions that could be used in the future with their relative benefits, harms, and risk. It provides “upstream public engagement” in a deliberation informed by science that identifies values for improved decision making. (shrink)

Biomedical research, on the one hand, contributes to important goals from generation of knowledge about the human body to the development and testing of therapeutics of all kinds. On the other hand, it can produce serious and sometimes unforeseeable consequences. In the ethical analysis of these two aspects of biomedical research, two important argumentative strategies play a major role. First, slippery slope arguments are used to warn of potential risks and to highlight knowledge-based limitations. Second, a dual-use problem (...) describes the challenge that already established techniques can be used for both morally wrong and morally right purposes. These two argumentative strategies appear to share several similarities, which will be investigated in this article. For this purpose, the article will first provide clear working definitions for both types of argument. This lays the foundation for the further ethical analysis. In a second step, and in order to investigate the similarities and differences of the argumentative strategies with an example from current ethical debates, CRISPR-Cas9, a currently very promising tool of genome editing, will be examined. The extent to which the possible applications of this genome editing tool can be addressed by slippery slope arguments or the dual use problem will be investigated. For this purpose, selected studies involving the use of CRISPR-Cas9 will be examined. Based on this two-step, analytic and example-based comparison of slippery-slope argumentation and dual-use considerations, the article will detail the ethically relevant difference between the two argumentative strategies and at the same time contribute to the ongoing ethical debate about CRISPR-Cas9. (shrink)

Artificial Intelligence (AI) seems to be impacting all industry sectors, while becoming a motor for innovation. The diffusion of AI from the civilian sector to the defense sector, and AI’s dual-use potential has drawn attention from security and ethics scholars. With the publication of the ethical guideline Trustworthy AI by the European Union (EU), normative questions on the application of AI have been further evaluated. In order to draw conclusions on Trustworthy AI as a point of reference for responsible (...) research and development (R&D), we approach the diffusion of AI across both civilian and military spheres in the EU. We capture the extent of technological diffusion and derive European and German patent citation networks. Both networks indicate a low degree of diffusion of AI between civilian and defense sectors. A qualitative investigation of project descriptions of a research institute’s work in both civilian and military fields shows that military AI applications stress accuracy or robustness, while civilian AI reflects a focus on human-centric values. Our work represents a first approach by linking processes of technology diffusion with normative evaluations of R&D. (shrink)

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight (...) ten AMR priorities and several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)

The protection of noncombatants from deadly violence is the centrepiece of any account of ethical and legal constraints on war. It was a major achievement of moral progress from early modern times to World War I. Yet it has been under constant attrition since - perhaps never more so than in our time, with its 'new wars', the spectre of weapons of mass destruction, and the global terrorism alert. Civilian Immunity in War, written in collaboration by eleven authors, provides (...) the first comprehensive analysis of all main aspects of this highly topical subject. It considers the arguments for rejection of civilian immunity and the main theories of the grounds and proper scope of this immunity, both deontological and consequentialist. Separate chapters examine the historical development of the idea of civilian immunity, its standing in current international law, and the problem of "collateral damage": of harming civilians without intent, as a side-effect of attacks on military targets. The volume also addresses a string of specific issues. Civilian immunity has undergone much attrition with the development of air warfare and the tendency of military conflict to degenerate into "total" war. On the other hand, modern military technology with its precision guidance missiles and "smart" bombs opens up the possibility of restricting deadly violence to its proper targets and staying clear of civilian life, limb, and property. Another pressing issue is the fate of women in war in light of mass rapes characteristic of some 'new wars'. (shrink)

This book provides a current review of Medical Research Ethics on a global basis. The book contains chapters that are historically and philosophically reflective and aimed to promote a discussion about controversial and foundational aspects in the field. An elaborate group of chapters concentrates on key areas of medical research where there are core ethical issues that arise both in theory and practice: genetics, neuroscience, surgery, palliative care, diagnostics, risk and prediction, security, pandemic threats, finances, technology, and public (...) policy.This book is suitable for use from the most basic introductory courses to the highest levels of expertise in multidisciplinary contexts. The insights and research by this group of top scholars in the field of bioethics is an indispensable read for medical students in bioethics seminars and courses as well as for philosophy of bioethics classes in departments of philosophy, nursing faculties, law schools where bioethics is linked to medical law, experts in comparative law and public health, international human rights, and is equally useful for policy planning in pharmaceutical companies. (shrink)

The protection of noncombatants from deadly violence is the centrepiece of any account of ethical and legal constraints on war. It was a major achievement of moral progress from early modern times to World War I. Yet it has been under constant attrition since - perhaps never more so than in our time, with its 'new wars', the spectre of weapons of mass destruction, and the global terrorism alert. -/- Civilian Immunity in War, written in collaboration by eleven authors, (...) provides the first comprehensive analysis of all main aspects of this highly topical subject. It considers the arguments for rejection of civilian immunity and the main theories of the grounds and proper scope of this immunity, both deontological (just war theory) and consequentialist. Separate chapters examine the historical development of the idea of civilian immunity, its standing in current international law, and the problem of "collateral damage": of harming civilians without intent, as a side-effect of attacks on military targets. The volume also addresses a string of specific issues. Civilian immunity has undergone much attrition with the development of air warfare and the tendency of military conflict to degenerate into "total" war. On the other hand, modern military technology with its precision guidance missiles and "smart" bombs opens up the possibility of restricting deadly violence to its proper targets and staying clear of civilian life, limb, and property. Another pressing issue is the fate of women in war in light of mass rapes characteristic of some 'new wars'. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish-bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

We live in the era of Facebook, Fitbit, and Skype. As such, it would be unreasonable to expect that the healthcare industry would not see the same kind of globalization as do our social spheres and consumer activities. Indeed, the explosion of information technology, the ease of transcontinental travel, and the emergence of a more globally aware citizenry allows for scientific collaboration that has had many positive effects on global health. However, the economic and structural disparities between systems of (...) healthcare delivery in the industrialized world and parts of the developing world have created a monster in the form of an international medical tourism industry that endangers the health and safety of citizens of the host country as well as visiting patients. Not only does the practice of medical tourism pose a practical danger to those in direct contact with the industry, but it brings up troubling philosophical problems centering on national responsibility and the commodification of healthcare, among other important issues. In the United States, the driving force behind international medical tourism is the exorbitant cost of healthcare, particularly for the uninsured but also for the underinsured and those who experience catastrophic medical expenses from chronic illness or sudden health crises. Not only have individuals begun to look outside the U.S. for surgical procedures and other expensive therapies, but employers have begun to toy with the idea of outsourcing the medical care of the employees they insure in order to cut costs. In other industrialized nations, the issues that underpin international medical tourism are related to healthcare rationing and reflect different shortcomings in the delivery of healthcare in those nations, such as the United Kingdom and Canada, that have single-payer systems. Yet the regulatory and philosophical implications for both patients and hosts of international healthcare are largely the same. The challenge of regulating international trade in medical care is obvious and becomes particularly acute when there are insurers and employers involved. Complicating matters further, medical care that takes place outside the country of origin of the patient is often brokered by “medical concierge services,” which, though quick to claim indemnity from any harm arising from substandard or inappropriate medical care, cannot be divorced from responsibility for the health outcomes of their clients. Agreements hashed out between concierge services and patients specify that any remedy for harm stemming from their medical care must be pursued within the confines of the law of the host country, but the practical implications of this are troublesome. How can a foreign patient—often without either linguistic or cultural competency in the host country—be expected to navigate the complexity of a foreign legal system, particularly one that may be far less developed than his home country? Furthermore, if insurance companies and employers are involved with such care, who pays for an adverse result or determines responsibility for harm that may befall the patient? Under which countries’ laws? If a patient travels to Singapore for sexual reassignment surgery or a cardiac valve repair, returns to the States and suffers complications, who pays for the restoration of her health? Beyond legal standards and judicial remedies for harm to patients seeking care on the international market, there is the question of what ethical standards and norms apply to such patients. What effect does it have on American patients, for example, to receive care within a system that does not emphasize autonomy and informed consent the way they are used to? Why should foreign physicians care about the cultural mores of their patients’ country of origin? Can they be expected to grasp cultural differences between American, Canadian, and British patients? The medical concierge might respond, “Well, buyer beware!” This is unreasonable: It is nearly impossible for any patient to accurately assess the various options, risks and benefits that go with a particular medical treatment, much less the patient who is attempting to do so on the international market. And the crass invocation of the doctrine of caveat emptor betrays a view of healthcare as a commodity that is naive and inappropriate. Paramount in my mind, however, are the practical implications for the care of the citizens of developing nations that host international patients and the broader philosophical issue of what the goals of the medical profession as a whole and each country’s individual healthcare system should be. While I understand the argument that international medical tourism creates great economic gains for developing nations, which can then be channeled toward the care of their citizenry as a whole, there is much reason to doubt that this “trickle-down” model of economics provides real benefits for underserved, whether in healthcare or other arenas. What is more likely is that, while lucrative international “medi-cities” may keep bright doctors in their home countries, it is also likely to lure them away from the institutions that serve the lion’s share of their countrymen. With the concentration of talented native doctors in private hospitals that serve citizens of the developed world, the population at large is left to obtain care at institutions that suffer “brain drain” from the flight of talented local staff to more prestigious, often “brand name,” institutions that give them more Western-like salaries while allowing them to practice in their countries of origin. The very fact that citizens of the wealthiest nations in the world are forced to go abroad for life-saving care speaks to an abdication of national responsibility on the part of their home countries. The provision of health care is one of the principal responsibilities of any nation and it is unacceptable that a nation with the strength and wealth of the United States would take advantage of the weaker political and economic situations of developing nations in order to shirk its responsibility to its fellow citizens. If we take care of our countrymen and take pride in an equitable system of healthcare delivery, there will be no need to shrug our shoulders and say “Buyer beware” to the patient who heads to the Philippines for heart surgery. (shrink)

This article inquires into what the gospel of peace might mean for Christian theological engagement with international law and sets a provisional agenda for peace ethics in an age of global risks. Two warnings are sounded with respect to the language of ‘peace ethics’ and ‘the rule of law’. Three priorities are identified: thinking with and about the global poor in ways that do not render ‘the other’ somehow different from myself; retrieval of the twin ideas of (...) ‘naturalness’ and distributive justice in natural law reasoning as they bear upon international law and the use of force; how to conceive of international common good by considering ‘peace through law’ as a potentially subversive endeavour when employed in the service of the global poor. (shrink)

In recent years, there has been an intense public debate about whether and, if so, to what extent investments in nuclear energy should be part of strategies to mitigate climate change. Here, we address this question from an ethical perspective, evaluating different strategies of energy system development in terms of three ethical criteria, which will differentially appeal to proponents of different normative ethical frameworks. Starting from a standard analysis of climate change as arising from an intergenerational collective action problem, (...) we evaluate whether contributions from nuclear energy will, on expectation, increase the likelihood of successfully phasing out fossil fuels in time to avert dangerous global warming. For many socio-economic and geographic contexts, our review of the energy system modeling literature suggests the answer to this question is “yes.” We conclude that, from the point of view of climate change mitigation, investments in nuclear energy as part of a broader energy portfolio will be ethically required to minimize the risks of decarbonization failure, and thus the tail risks of catastrophic global warming. Finally, using a sensitivity analysis, we consider which other aspects of nuclear energy deployment, apart from climate change, have the potential to overturn the ultimate ethical verdict on investments in nuclear energy. Out of several potential considerations, we suggest that its potential interplay — whether beneficial or adverse — with the proliferation of nuclear weapons is the most plausible candidate. (shrink)

Rapid technological change is resulting in the development of ever increasingly capable autonomous weapon systems. As they become more sophisticated, the calls for developing restrictions on their use, up to and including their complete prohibition, are growing. Not unlike the call for restrictions on the sale and use of drones, most proposed restrictions are well-intentioned but are often ill-informed, with a high likelihood of degrading national security and putting additional lives at risk. Employed by experienced operators well-versed in the (...) laws of armed conflict, autonomous weapons can advance the objectives of those who would prohibit their use. This essay takes an operational perspective to examine the role that autonomous weapon systems can play while complying with the laws of armed conflict. With responsible design and incorporation of applicable control measures, autonomous weapons will be able not just to comply but also to enhance the ethical use of force. This essay contends that efforts by the international community to use international legal means and/or institutions to over-regulate or even ban lethal autonomous weapons are counterproductive. It considers and describes the end-game results of the use of autonomous weapons in enhancing the application of both international law and human ethical values. (shrink)

The use of genetically modified plants in agriculture (GM crops) is controversially discussed in academic publications. Important issues are whether the release of GM crops is beneficial or harmful for the environment and therefore acceptable, and whether the modification of plants is ethically permissible per se . This study provides a comprehensive overview of the moral reasoning on the use of GM crops expressed in academic publications from 1975 to 2008. Environmental ethical aspects in the publications were investigated. Overall, 113 (...) articles from 15 ecology, environmental ethics, and multidisciplinary science journals were systematically reviewed. Three types of moral concerns were used to structure the normative statements, moral notions, and moral issues found in the articles: concerns addressing consequences of the use of GM crops, concerns addressing the act (the technique itself), and concerns addressing the virtues of an actor. Articles addressing consequences (84%) dealt with general ecological and risk concerns or discussed specific ecological issues about the use of GM crops. Articles addressing the act (57%) dealt with the value of naturalness, the value of biotic entities, and conceptual reductionism, whereas articles addressing the actor (43%) dealt with virtues related to the handling of risks and the application of GM crops. The results of this study may help to structure the academic debate and contribute to a better understanding of moral concerns that are associated with the key aspects of the ethical theories of consequentialism, deontology, and virtue ethics. (shrink)

With regard to the handling of dual use research, the dominant approach in Germany aimed at mitigating dual use risks emphasizes the freedom of research and the strengthening of academic self-regulation. This article presents this approach as one example for a framework for handling security-relevant research, underlines the need for awareness-raising about risks of security-relevant research, and, more generally, highlights some of the dilemmas researchers and legislators face when dealing with security-relevant research. The article furthermore presents the key (...) questions developed by the German Joint Committee on the Handling of Security-Relevant Research to provide guidance for researchers and institutions when they address possible research of concern. It applies these key questions in a case study of a well-publicized experiment in which artificial intelligence and drug discovery technologies were used to determine their dual use potential in identifying highly toxic chemical substances. Moreover, it discusses the utility of the framework applied in Germany and concludes that this approach is practicable. Given the strong emphasis on the researchers’ own responsibility, however, awareness of dual use risks and risk mitigation strategies should be further enhanced and an academic culture of responsible handling of security-relevant research should be promoted. (shrink)

This chapter considers the key values underlying and explaining important features of international law as a system of law. It uses that value analysis as a way of interpreting international law and of asking whether, within those values, international law can be made to serve certain 'global cosmopolitan' re-distributive aims. The chapter argues that the constraints of international law mean that it is not an appropriate medium for global re-distributive goals commonly associated with (...) theories of societal justice. Because those features and constraints are based in values that international law distinctly serves, those constraints cannot simply be ignored, overridden, or changed judicially. (shrink)

We attempt to justify the use of synthetic biology in response to the climate crisis, based on the premise that it is impossible to avert runaway climate change without sequestering sufficient greenhouse gases (GHG), which could only become possible through Negative Emissions Technologies (NETs). Then, moving from a consequentialist standpoint, we acquiesce to how the consequences of using NETs through synthetic biology are preferable to the catastrophic consequences of runaway climate change. In conclusion, we show how our analysis (...) of synthetic biology resonates with a zoecentric view of climate science and ethics. (shrink)

There are limits to what can be achieved using the means and medium of international law. This article explores those limits by providing an innovative theory of the nature of international law and how we should understand its limits in terms of value theory. A "four functions" theory is proposed, and these functions are used to interpret areas of international law in terms of their distinctive and valuable contribution to a specific area of human relations. On the (...) basis of this analysis of international law and international legal interpretation, the paper argues that the cosmopolitan aims of a number of moral cosmopolitan scholars fail to taken into account the value limits of international law. This is presented as a value problem, not a problem of feasibility or practicality. (shrink)

Criticisms of patent laws for technological innovations in the United States reveal a multifaceted milieu of problems centered around the protection of short-term economic gain and individual property rights. In this article, we consider this a conflict between current patent laws and the innovation capabilities of organizations. We propose a solution that enables the company to assure its long-term survival in the face of these restrictions. This presumes that the firm will at least maintain its innovation capacities while preserving the (...) company's ethical values and those of its social environment. We offer a theoretical model that is designed to help managers and policymakers reorient their governance strategies for managing the innovation process, using the “ethics of responsibility,” which establishes the link to individual moral values at the beginning of a governance process as well as the consequences of a decision. Our integrated causal model of ethical innovation for patents is presented and implications for global organizations and possible solutions for patent law process failure are offered. (shrink)

Recent technological advancements have deeply transformed society and the way people interact with each other. Instantaneous communication platforms have allowed connections with other people, forming global communities, and creating unprecedented opportunities in many sectors, making access to online resources more ubiquitous by reducing limitations imposed by geographical distance and temporal constrains. These technological developments bear ethically relevant consequences with their deployment, and legislations often lag behind such advancements. Because the appearance and deployment of these technologies happen much faster than (...) legislative procedures, the way these technologies affect social interactions have profound ethical effects before any legislative regulation can be built, in order to prevent and mitigate those effects. Ethics in Online AI-Based Systems: Risks and Opportunities in Current Technological Trends features a series of reflections from experts in different fields on potential ethically relevant outcomes that upcoming technological advances could bring about in our society. Creating a space to explore the ethical relevance that technologies currently still under development could have constitutes an opportunity to better understand how these technologies could or should not be used in the future in order to maximize their ethically beneficial outcomes, while avoiding potential detrimental effects. Stimulating reflection and considerations with respect to the design, deployment and use of technology will help guide current and future technological advancements from an ethically informed position in order to ensure that, tomorrow, such advancements could contribute towards solving current global and social challenges that we, as a society, have today. This will not only be useful for researchers and professional engineers, but also for educators, policy makers, and ethicists. (shrink)

Continuing rapid developments in the life sciences offer the promise of providing tools to meet global challenges in health, agriculture, the environment, and economic development; some of the benefits are already being realized. However, such advances also bring with them new social, ethical, legal, and security challenges. Governance questions form an increasingly important part of the discussions about these advances--whether the particular issue under debate is the development of ethical principles for human genome editing, how to establish regulatory systems (...) for the safe conduct of field trials of gene drive-modified organisms, or many others. However there are continuing concerns that the knowledge, tools, and techniques resulting from life sciences research could also enable the development of bioweapons or facilitate bioterrorism. Between June 10 and 13, 2018, more than 70 participants from 30 different countries and 5 international organizations took part in an international workshop, The Governance of Dual Use Research in the Life Sciences: Advancing Global Consensus on Research Oversight, in Zagreb, Croatia. Hosted by the Croatian Academy of Sciences and Arts, the workshop was a collaboration among the InterAcademy Partnership, the Croatian Academy, the Croatian Society for Biosafety and Biosecurity, and the U.S. National Academies of Sciences, Engineering, and Medicine. This publication summarizes the presentations and discussions from the workshop."--Publisher's description. (shrink)

Using food regime analysis, this paper critically analyzes how corporate actors amass, secure and apply power in the global agrifood system through International Investment Agreements (IIAs). IIAs are a key enabler of increasing corporate power in the agrifood system. We focus on three sets of investment provisions in IIAs: (a) the stringent enforceability mechanism of the investor-state dispute settlement (ISDS) system, (b) the expansion of the concept of expropriation, and (c) limitations or prohibitions on host countries to (...) impose performance requirements on foreign investors. We argue that these provisions compromise fairness in the international economic system. Attracted by promises of technology transfer, economic growth and employment, host states often prioritize policies that favor foreign investors even if such policies compromise domestic policy space. We provide analysis and examples of escalating corporate power at different stages of the industrial and transgenic model of agriculture. (shrink)

Risk is the most often cited reason for ethical concern about any medical science or technology, particularly those new technologies that are not yet well understood, or create unfamiliar conditions. In fact, while risk and risk-benefit analyses are but one aspect of ethical oversight, ethical review and risk assessment are sometimes taken to mean the same thing. This is not surprising, since both the Common Rule and Food and Drug Administration foreground procedures for minimizing risk (...) for human subjects and require local IRBs to engage in some sort of risk-benefit analysis in decisions to approve or deny proposed research. Existing ethical review and oversight practices are based on the presumption that risk can be clearly identified within the planned activities of the protocol, that metrics can reasonably accurately predict potential hazards, and that mitigation measures can be taken to deal with unintended, harmful, or catastrophic events. (shrink)

Societal decisions regarding the possible granting of permission for industrial and power plants, waste disposals, traffic routes and other facilities implementing modern science and technology (here simply called technology-decisions) often provoke debates regarding the risks involved. A main theme in these debates concerns the magnitudes of these risks and whether or not they are worth taking to reach some aim. This is also a main theme in traditional risk-analysis and critical discussions of risk-management. However, sometimes the fact (...) that some people do not want to be exposed to the risks in question has been suggested as an independent argument, i.e. regardless of the magnitudes of these risks. A well known phenomenon in this respect on the local and national level is what has been labelled "not in my backyard" (NIMBY), but the argument also has been used on an international level. In accordance, the view that unwanted risks are less acceptable than wanted or indifferent ones (regardless of their magnitudes) has been proposed as being highly relevant for technology-decisions. The paper explores to what extent there are good reasons for accepting such a proposal. The main part of the paper is devoted to an examination of the extent to which the view that unwanted risks are less acceptable than wanted ones can be supported by, on the one hand, welfare-based ethical theories underlying standard models for risk-analysis, such as utilitarianism, and, on the other, a moral requirement to respect the autonomy of individual persons. Also, the very concept of an unwanted risk is explored and some peculiarities are noted. It is argued that no categorical impermissibility of exposing people to unwanted risks can be supported. However, there are still good reasons for policy-makers to consider the degree to which risks are unwanted as a factor in technology-decisions that is relevant independently of the welfare-gains at stake. In particular, policy-makers should avoid paternalism in risk-management, i.e.. (shrink)

For the purpose of this analysis, risk assessment becomes the primary term and risk management the secondary term. The concept of risk management as a primary term is based upon a false ontology. Risk management implies that risk is already there, not created by the decision, but lies already inherent in the situation that the decision sets into motion. The risk that already exists in the objective situation simply needs to be “managed”. By (...) considering risk assessment as the primary term, the ethics of responsibility for risking the lives of others, the environment and future generations in the first place comes into the forefront. The issue of risk heeding is especially important as it highlights the need to pay attention to warnings of danger and to take action to redress problems before disasters occur. In this paper, the decision making that led to the choice of technology utilized and the implementation of such technology in the case of the space shuttle Challenger disaster will be used as a model to illustrate the need to take ethical factors into account when making decisions regarding the safety of technological systems and the heeding of danger warnings. While twenty-five years separates the decision to launch the Challenger and the Fukushima Daiichi nuclear plant disaster, the lessons of the Challenger disaster are still to be learned. (shrink)

Digital transformation and “artificial intelligence (AI)”—which can more adequately be called “data-based systems (DS)”—comprise ethical opportunities and risks. Therefore, it is necessary to identify precisely ethical opportunities and risks in order to be able to benefit sustainably from the opportunities and to master the risks. The UN General Assembly has recently adopted a resolution aiming for ‘safe, secure and trustworthy artificial intelligence systems’. It is now urgent to implement and build on the UN General Assembly Resolution. Allowing humans and the (...) planet to flourish sustainably in peace and guaranteeing globally that human dignity is respected not only offline but also online, in the digital sphere, and in the domain of DS, requires two policy measures: (1) human rights-based data-based systems (HRBDS): HRBDS means that human rights serve as the basis of digital transformation and DS. (2) International Data-Based Systems Agency (IDA): IDA should be established at the UN as a platform for cooperation in the field of digital transformation and DS, fostering human rights, security, and peaceful uses of DS, as well as a global supervisory institution and regulatory authority in digital transformation and DS. The establishment of IDA is realistic because humanity has already shown in its past that we are able to not always “blindly” pursue the technically possible but also to limit ourselves to what is technically feasible when humanity and the planet are at stake. For instance, humans researched the field of nuclear technology, developed the atomic bomb, and detonated it several times. Nonetheless, the same humans limited research and development in the field of nuclear technology to prevent even worse consequences by establishing the International Atomic Energy Agency (IAEA) at the UN. (shrink)

Risk analysis and regulatory systems are usually evaluated according to utilitarian frameworks, as they are viewed to operate “objectively” by considering the health, environmental, and economic impacts of technological applications. Yet, the estimation of impacts during risk analysis and the decisions in regulatory review are affected by value choices of actors and stakeholders; attention to principles such as autonomy, justice, and integrity; and power relationships. In this article, case studies of biotechnology are used to illustrate how (...) non-utilitarian principles are prominent in risk analysis and regulatory review and to argue that these relationships should be carefully considered as we consider nanotechnology oversight systems for its products. We argue that there are not distinct separations between “science-based” review systems, in which evaluations of the consequences of technological products are primarily considered, and principles of integrity, justice, non-maleficence, and autonomy. It should further be expected that, given research into fair treatment during decision-making processes, attention to ethics will affect how citizens assess emerging technologies. Finally, a more holistic approach for evaluating oversight systems for the products of nanotechnology is suggested, one which does not draw a sharp distinction between risk analysis, regulation, and respect for non-utilitarian values. (shrink)

Background In this study, we examined the ethical implications of Egypt’s new clinical trial law, employing the ethical framework proposed by Emanuel et al. and comparing it to various national and supranational laws. This analysis is crucial as Egypt, considered a high-growth pharmaceutical market, has become an attractive location for clinical trials, offering insights into the ethical implementation of bioethical regulations in a large population country with a robust healthcare infrastructure and predominantly treatment-naïve patients. Methods We conducted a comparative (...) analysis of Egyptian law with regulations from Sweden and France, including the EU Clinical Trials Regulation, considering ethical human subject research criteria, and used a directed approach to qualitative content analysis to examine the laws and regulations. This study involved extensive peer scrutiny, frequent debriefing sessions, and collaboration with legal experts with relevant international legal expertise to ensure rigorous analysis and interpretation of the laws. Results On the rating of the seven different principles (social and scientific values, scientific validity, fair selection of participants, risk-benefit ratio, independent review, informed consent and respect for participants) Egypt, France, and EU regulations had comparable scores. Specific principles (Social Value, Scientific Value, and Fair selection of participants) were challenging to directly identify due to certain regulations embodying 'implicit' principles more than explicitly stated ones. Conclusion The analysis underscores Egypt's alignment with internationally recognized ethical principles, as outlined by Emanuel et al., through its comparison with French, Swedish, and EU regulations, emphasizing the critical need for Egypt to continuously refine its ethical regulations to safeguard participant protection and research integrity. Key issues identified include the necessity to clarify and standardize the concept of social value in research, alongside concerns regarding the expertise and impartiality of ethical review boards, pointing towards a broader agenda for enhancing research ethics in Egypt and beyond. (shrink)

ABSTRACT In this paper we explore how a public national media outlet, the British BBC, represents an international legal case which has a highly political nature. The case is US versus Huawei/meng Wanzhou, which took place between 2018 and 2021. Accusations were that the Chinese technology company committed fraud, leading the global HSBC bank to breach US sanctions against Iran. The charges were made by the US using what is called an ‘extraterritorial law’, which, while rejected as law (...) by governments around the world, is policed by US economic powers and control over international finance. Using Critical Discourse Analysis we show that, while the BBC presents much detail of legal process, the actual nature of the law the US uses to bring criminal charges against international companies and banks, is neither considered nor questioned. Our interest is how such a law, which has a huge influence over global trade and politics, is presented to the public in this particular case. We contribute to the position that the nature of laws, how they are used and known, must always be understood within the prevailing discourses of the moment. (shrink)

This survey was conducted in 2017 to investigate factors influencing social risk perception of biotechnologists and plant breeders in training toward GM food based on a conceptual model. A random sample of 210 biotechnologists and plant breeders in training was studied. Confirmatory factor analysis and the reliability tests have been used to verify the uni-dimensionality of the measurement scale, SEM also was carried out to determine the most parsimonious models with the best fit for social risk perception (...) of GM foods and path analysis was conducted to understand the exogenous variables introduced in the research model. The findings revealed that the engineers in training had moderate social risk perception regarding GM foods. Moreover, the results of structural equation modeling showed the capability of the model in predicting the social risk perceptions of engineers in training. The psychological attributes of risks, social benefit perception, attitude toward using technology, level of religiosity, and moral and ethical beliefs emerged as the most powerful predictors of the social risk perception. The social benefit perception and attitude toward using technology also mediated the effects of psychological attributes of risks, level of religiosity, and moral and ethical beliefs. The social benefit perception also had an indirect influence on the engineers in training’s social risk perception of GM foods. Finally, we recommend the application of the model developed by this study for better understanding of social risk perception of stakeholders to have a more informed view of the development and promotion of GM foods. (shrink)