Certifications of immunity are sometimes called “immunity passports” but are better conceptualized as immunity-based licenses. Such policies raise important questions about fairness, stigma, and counterproductive incentives but could also further individual freedom and improve public health. Immunity licenses should not be evaluated against a baseline of normalcy, ie, uninfected free movement. Rather, they should be compared to the alternatives of enforcing strict public health restrictions for many months or permitting activities that could spread infection, both of which exacerbate inequalities and (...) impose serious burdens. This Viewpoint presents a framework for analyzing the ethics of immunity licenses. (shrink)

We explore the ethics of deliberately exposing consenting adults to SARS-CoV-2 to induce immunity to the virus (“DEI” for short). We explain what a responsible DEI program might look like. We explore a consequentialist argument for DEI according to which DEI is a viable harm-reduction strategy. Then we consider a non-consequentialist argument for DEI that draws on the moral significance of consent. Additionally, we consider arguments for the view that DEI is unethical on the grounds that, given that large-scale (...) DEI would be highly likely to result in some severe illnesses and deaths, DEI amounts to a form of killing. Our thesis is that incorporating a DEI program alongside the status-quo “calibrate-the-curve” responses could have significant advantages at the early stages of pandemics. These potential advantages mean that, at a minimum, research into DEI would have been justified early in the COVID-19 pandemic, and that DEI programs should be explored as potential additions to our overall approach to emerging pandemics in the future. (shrink)

Digital COVID certificates are a novel public health policy to tackle the COVID-19 pandemic. These immunity certificates aim to incentivize vaccination and to deny international travel or access to essential spaces to those who are unable to prove that they are not infectious. In this article, we start by describing immunity certificates and highlighting their differences from vaccination certificates. Then, we focus on the ethical, legal, and social issues involved in their use, namely autonomy and consent, data protection, equity, and (...) international mobility from a global fairness perspective. The main conclusion of our analysis is that digital COVID certificates are only acceptable if they meet certain conditions: that they should not process personal data beyond what is strictly necessary for the aimed goals, that equal access to them should be guaranteed, and that they should not restrict people’s autonomy to access places where contagion is unlikely. We conclude that, if such conditions are guaranteed, digital COVID certificates could contribute to mitigating some of the most severe socioeconomic consequences of the pandemic. (shrink)

Abstractabstract:Public health emergencies are fraught by epistemic uncertainty, which raises policy issues of how to handle that uncertainty and devise sustainable public health responses. Among such responses, a herd immunity policy might be an option. Particularly before the development of vaccines, the current COVID-19 pandemic has highlighted the polarized nature of the political debate concerning the ethical feasibility of herd immunity strategies. This article provides a conceptual framework tailored to uncover the ethical rationale behind such strategies. Clarity on this issue (...) is important in order to facilitate the terms of the political debate when tackling future health emergencies. (shrink)

ABSTRACTThis article counters Michael Walzer's argument against tight blockades. It shows that the interdiction of food shipments need not violate the principle of noncombatant immunity. Whether it...

Many areas of business ethics research are “sensitive.” We provide an empirical assessment of the randomized response technique which providesabsoluteanonymity to subjects and “legal immunity” to the researcher. Beyond that, RRT techniques provide complete disclosure to subjects, unconditional privacy is maintained, and there is no deception.

Many areas of business ethics research are “sensitive.” We provide an empirical assessment of the randomized response technique which providesabsoluteanonymity to subjects and “legal immunity” to the researcher. Beyond that, RRT techniques provide complete disclosure to subjects, unconditional privacy is maintained, and there is no deception.

We are moving towards a future where Artificial Intelligence (AI) based agents make many decisions on behalf of humans. From healthcare decision-making to social media censoring, these agents face problems, and make decisions with ethical and societal implications. Ethical behaviour is a critical characteristic that we would like in a human-centric AI. A common observation in human-centric industries, like the service industry and healthcare, is that their professionals tend to break rules, if necessary, for pro-social reasons. This behaviour among humans (...) is defined as pro-social rule breaking. To make AI agents more human-centric, we argue that there is a need for a mechanism that helps AI agents identify when to break rules set by their designers. To understand when AI agents need to break rules, we examine the conditions under which humans break rules for pro-social reasons. In this paper, we present a study that introduces a ‘vaccination strategy dilemma’ to human participants and analyzes their response. In this dilemma, one needs to decide whether they would distribute COVID-19 vaccines only to members of a high-risk group (follow the enforced rule) or, in selected cases, administer the vaccine to a few social influencers (break the rule), which might yield an overall greater benefit to society. The results of the empirical study suggest a relationship between stakeholder utilities and pro-social rule breaking (PSRB), which neither deontological nor utilitarian ethics completely explain. Finally, the paper discusses the design characteristics of an ethical agent capable of PSRB and the future research directions on PSRB in the AI realm. We hope that this will inform the design of future AI agents, and their decision-making behaviour. (shrink)

Vaccination policy is an ethically challenging domain of public policy. It is a matter of collective importance that reaches into the most private sphere of citizens and unavoidably conflicts with individual-based ethics. Policy makers need to walk a tight rope in order to complement utilitarian public health values with individual autonomy rights, protection of privacy, non-discrimination and protection of the worst-off. Whether vaccination is voluntary or compulsory, universal or targeted, every option faces complex ethical hurdles because of the interdependence (...) of humans in infectious disease matters. In this article, we explore the following three policy questions. (i) Ethically, which policy measures should be addressed when vaccination coverage is insufficient in a population? Information campaigns, legal compulsion, or the use of financial incentives can all be effective, but also controversial policy options. (ii) Is it ethical to target vaccination programs at certain risk-groups? If such measures are necessary, we argue that policymakers will often have to decide which is more important to uphold: non-discrimination or the protection of privacy. And (iii), what is the ethical significance of adverse herd immunity effects? Some vaccination programs will improve average population health, but will at the same time increase the risk of severe morbidity and mortality for individuals in the worst-off groups of society. (shrink)

In this paper I examine the claim that businesspersons have what might be called "ethical immunity" with respect to the duty not to deceive. According to this ethical immunity claim, businesspersons are exempt from the ordinary ethical prohibition against deception; and widespread business deception is therefore ethically permissible. I focus on two arguments for the claim. One of the arguments, which has been presented by Albert Carr, relies upon an analogy between business on the one hand, and games in which (...) deception is permitted, on the other. The second argument is based upon the notion that exceptions to ethical duties may sometimes be justified on prudential grounds. In response to the arguments, I try to show that neither one provides strong support for the ethical immunity claim. (shrink)

This paper explores the ethical considerations surrounding human papillomavirus vaccination for adolescents in three special circumstances: a) the preadolescent/adolescent vaccination target population; b) the sexually transmitted nature of the virus; and c) the delay in boys’ vaccination recommendations as compared to initial girls’ recommendations. Examining the gendered components of the HPV vaccine, medical consent, and assent for minors; the changing relationship between medical providers and patients; and the tension between individual and public health, I conclude that, in most cases, parents (...) are ethically required to choose vaccination for their children. (shrink)

The mass childhood immunization programme has traditionally been viewed as a safe and effective preventative measure by health promoters, primary health care professionals and governments. This consensus has meant that immunization has rarely been viewed as ethically problematic. A number of recent changes in the context of the delivery of health care, particularly the emphasis on consumerism and the effect of the marketization of services, makes timely an examination of ethical, social and political issues. This article examines four (...) main grounds for problematizing the mass childhood immunization programme. These are: clinical research evidence about the safety and efficacy of vaccines; the masking of wider social and political determinants of ill health; the contradictory strictures about collective and individual rights in relation to immunization; and the uniqueness of childhood immunization as a physical intrusion into a healthy body. The implications of these ethical issues are discussed in relation to informed consent and the need for a 'greenfield' review that includes the views of dissenting parents, lawyers and moral philosophers, as well as health professionals. Les promoteurs de santé, les soignants et les gouvernements ont tous traditionellement vu le programme d'immunisation globale des enfants comme sain et efficace. Cela voulait dire que l'immunisation a rarement posé un problème éthique. Pourtant, actuellement des changements dans les contextes de la distribution des soins, le consumérisme et de l'effet de la commercialisation des services de santé, exigent une revue des problèmes éthiques, sociaux et politiques. Cet article discute quatre éléments problématiques du programme d'immunisation globale: les données des recherches médicales sur la sûreté et l'efficacité des vaccins; la dissimulation des déterminatifs sociaux et politiques des maladies; les critiques contradictoires des droits individuels et collectifs concernant l'immunisation; et le caractère unique de l'immunisation des enfants comme une intrusion physique dans un corps sain. Les effets de ces questions éthiques sont repris en rapport du consentement informé et de la nécessité d'une revue 'verte' qui comprend les vues des parents dissidents, des juristes, des philsophes et des membres des professions soignantes. Das Massenimpfungsprogramm von Kindern wurde allgemein von Gesundheits behörden, medizinischem Fachpersonal und Regierungen als sichere und wirksame Vorbeugungsmassnahme betrachtet. Diese Uebereinstimmung bedeutete, dass Imp fungen selten ein ethisches Problem darstellten. Eine Anzahl von Aenderungen im Gesundheitswesen - besonders im Hinblickin auf Konsum und Marktwirtschaft im Dienstleistungsbereich - berechtigen jedoch zu einer Untersuchung der ethischen, sozialen und politischen Fragen. Dieser Artikel untersucht vier Hauptgründe, die das Massenimpfungsprogramm für Kinder in Frage stellen: Forschungsergebnisse über die Sicherheit und Wirksamkeit der Impfstoffe; die Verschleierung von andern sozialen und politischen Krankheitsursachen; die widersprüchlichen Anordnungen über kollektive und individuelle Rechte mit Bezug auf die Impfungen; und die aussergewöhnliche Art der Impfung als physische Verletzung eines gesunden Körpers. Die Bedeutung dieser ethischen Fragen werden hier diskutiert im Zusammenhang mit der informierten Vereinstimmung und der Notwendigkeit eines 'grünen' Ueberblickes, der die Ansichten andersdenkender Eltern, Rechtsanwalte, Philosophen und Gesund heitsexperten einschliesst. (shrink)

Any plausible position in the ethics of war and political violence in general will include the requirement of protection of civilians (non-combatants, common citizens) against lethal violence. This requirement is particularly prominent, and particularly strong, in just war theory. Some adherents of the theory see civilian immunity as absolute, not to be overridden in any circumstances whatsoever. Others allow that it may be overridden, but only in extremis. The latter position has been advanced by Michael Walzer under the heading (...) of “supreme emergency.” In this paper, I look into some of the issues of interpretation and application of Walzer’s “supreme emergency” view and some of the criticisms that have been levelled against it. I argue that Walzer’s view is vague and unacceptable as it stands, but that the alternatives proposed by critics such as Brian Orend, C.A.J. Coady, and Stephen Nathanson are also unattractive. I go on to construct a position that is structurally similar to Walzer’s, but more specific and much less permissive, which I term the “moral disaster” view. According to this view, deliberate killing of civilians is almost absolutely wrong. (shrink)

There is widespread concern among public health and emergency response officials that there could be a shortage of health care providers in a public health emergency. At least the following three factors could cause an inadequate supply of physicians, nurses, and other health care providers: the severity of the emergency might greatly increase the demand for health services and outstrip the available supply; health care providers might become unavailable because of their own high rates of illness, as was the case (...) in the SARS epidemic; and many health care providers might not report for duty for personal, family, or professional reasons.One way of addressing the shortage is to encourage health care providers from unaffected areas or parts of the country to volunteer their services. A variety of measures have been enacted to facilitate the use of such volunteers. (shrink)

Healthcare providers have been central actors in containing the COVID-19 pandemic. Although potentially very beneficial, the implementation of large-scale rapid serological tests raises ethical dilemmas and affects HCPs’ capacity to work in optimal conditions. In this regard, we call for attention to address specific and urgent ethical issues distinctively affecting HCPs following the availability and possible mandatory use of rapid serological tests for COVID-19.

A core idea underlying nudging is that it helps individuals to achieve their own goals, yet many nudges actually aim at collective goals or specifically target the benefit of others. An example is nudging healthcare workers to be vaccinated against influenza. I distinguish between self‐regarding nudges, which primarily benefit the nudgee, and other‐regarding nudges, which mainly benefit others, and argue that the default justificatory reason to legitimize self‐regarding nudges, namely the ‘as judged by themselves’ standard, does not apply and that (...) we need to look for other justifications. I examine several possible moral justifications to support strong other‐regarding nudges, namely beneficence, the harm principle and solidarity. (shrink)

In On Immunity: An Inoculation, essayist and author Eula Biss has given academics and clinicians interested in the public’s skepticism of vaccines, and of science skepticism more generally, a fresh look at what drives these phenomena. Despite public health’s continued success in maintaining high rates of coverage for vaccines across the United States, recent measles, mumps, and rubella outbreaks in the U.S. have harmed lives and indicate cracks in the vaccine uptake façade. From a public health perspective, it’s all hands (...) on deck to make sure vaccine coverage stays high. Biss’s outsiders’ view of these issues offers bioethicists, public health practitioners, and physicians much... (shrink)

The concept of noncombatant immunity prohibits the intentional targeting of noncombatants. The availability of nonlethal weapons (NLW) may weaken this prohibition, especially since using NLWs against noncombatants may, in some cases, actually save the noncombatants' lives. Given the advancement of NLWs, I argue that their probable appearance on the battlefield demands close scrutiny due to the moral problems associated with their use. In this paper, I examine four distinct cases and determine whether the use of NLWs is morally permissible. While (...) it seems that the reduced harm caused by NLWs makes their use more acceptable, adhering to noncombatant immunity requires more than not killing noncombatants. It also requires that military forces treat noncombatants a certain way. In the cases I present, to use NLWs against noncombatants treats them as combatants and coerces them to do something against their will. While a consequentialist foundation for noncombatant immunity may permit this action, a rights-based concept of noncombatant immunity does not. I contend that only a rights-based concept of noncombatant immunity is viable, and that the availability of NLWs should not significantly alter the prohibitions prescribed by noncombatant immunity. (shrink)

In their recent article, Brown et al analyse several ethical aspects around immunity passports and put forward some recommendations for implementing them. Although they offer a comprehensive perspective, they overlook two essential aspects. First, while the authors consider the possibility that immunological passports may appear to discriminate against those who do not possess them, the opposite viewpoint of immune people is underdeveloped. We argue that if a person has been tested positive for and recovered from COVID-19, becoming immune to it, (...) she cannot be considered a hazard to public health and, therefore, the curtailment of her fundamental rights is not legitimate. Second, they omit that vaccine distribution will create similar problems related to immunity-based licenses. Vaccine certificates will de facto generate a sort of immunity passport. In the next phases of the pandemic, different immunity statuses will be at stake, because the need to identify who can spread COVID-19 is unavoidable. If a person does not pose a threat to public health because she cannot spread the infection, then her right to freedom of movement should be respected, regardless of how she acquired that immunity. (shrink)

Civilian Immunity is the legal and moral protection that civilians enjoy against the effects of hostilities under the laws of armed conflict and according to the ethics of killing in war. Immunity specifies different permissibility conditions for directly targeting civilians on the one hand, and for harming civilians incidentally on the other hand. Immunity is standardly defended by appeal to the Doctrine of Double Effect. We show that Immunity's prohibitive stance towards targeting civilians directly, and its more permissive stance (...) towards harming them incidentally, can be defended without appealing to the DDE if agents suffer from overconfidence. Overconfidence is a cognitive bias that affects agents who are required to make decisions in the presence of significant uncertainty. (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)

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)

The public health benefits of herd immunity are often used as the justification for coercive vaccine policies. Yet, ‘herd immunity’ as a term has multiple referents, which can result in ambiguity, including regarding its role in ethical arguments. The term ‘herd immunity’ can refer to (1) the herd immunity threshold, at which models predict the decline of an epidemic; (2) the percentage of a population with immunity, whether it exceeds a given threshold or not; and/or (3) the indirect benefit afforded (...) by collective immunity to those who are less immune. Moreover, the accumulation of immune individuals in a population can lead to two different outcomes: elimination (for measles, smallpox, etc) or endemic equilibrium (for COVID-19, influenza, etc). We argue that the strength of a moral obligation for individuals to contribute to herd immunity through vaccination, and by extension the acceptability of coercion, will depend on how ‘herd immunity’ is interpreted as well as facts about a given disease or vaccine. Among other things, not all uses of ‘herd immunity’ are equally valid for all pathogens. The optimal conditions for herd immunity threshold effects, as illustrated by measles, notably do not apply to the many pathogens for which reinfections are ubiquitous (due to waning immunity and/or antigenic variation). For such pathogens, including SARS-CoV-2, mass vaccination can only be expected to delay rather than prevent new infections, in which case the obligation to contribute to herd immunity is much weaker, and coercive policies less justifiable. (shrink)

Government policies and practices can exert significant influence on ethical behavior in a society. Many governments still rely ona long-standing prerogative of sovereigns, the defense of sovereign immunity, to avoid public inquiry about acts that are clearly immoral. However, the basic theory and frequent practice of invoking sovereign immunity cannot be ethically justified. Moreover, such practices model conduct based on power rather than reason, fairness, or justice, and invite both nations and individuals to view politics and business as a power (...) game to be played and won, rather than as a process of buiIding communities that emphasize reciprocity and commitment to moral principles. (shrink)

In response to adverse events in retroviral gene therapy clinical trials conducted in France to correct for X-linked severe combined immune deficiency disorder (X-SCID), an advisory committee of the Food and Drug Administration convened in October 2002, February 2003, and March 2005, to deliberate and provide recommendations for similarly sponsored research in the United States. A similar National Institutes of Health committee met in February 2003. In this article, I review the transcripts and/or minutes of these meetings to evaluate the (...) extent to which the ethical dimension of the research was engaged even as the molecular and clinical evidence was reviewed. I then provide representative ethical arguments to demonstrate the sort of ethical reasoning that should be included as part of the agenda of such committee meetings. (shrink)

When a novel scientific theory conflicts with otherwise plausible moral assumptions, we do not treat that as evidence against the theory. We may scrutinize the empirical data more keenly and take extra care over its interpretation, but science is in some core sense immune to moral refutation. Can the same be said of philosophical theories (or the non-ethical, ‘metaphysical’ ones at least)? If a position in the philosophy of mind, for example, is discovered to have eye-widening moral import, does that (...) count against it at all? Actual responses by philosophers to the question of whether unanticipated moral consequences of metaphysical theories have evidential force are scattered, implicit, divergent, under-argued, and sometimes even self-undermining. The present discussion is, most immediately, an attempt to sort out the confusion. Beyond that, it exploits the new perspective this question gives us on a familiar topic: the relation of philosophy to science. (shrink)

The principle of noncombatant immunity prohibits warring parties from intentionally targeting noncombatants. I explicate the moral version of this view and its criticisms by reductive individualists; they argue that certain civilians on the unjust side are morally liable to be lethally targeted to forestall substantial contributions to that war. I then argue that reductivists are mistaken in thinking that causally contributing to an unjust war is a necessary condition for moral liability. Certain noncontributing civilians—notably, war-profiteers—can be morally liable to be (...) lethally targeted. Thus, the principle of noncombatant immunity is mistaken as a moral (though not necessarily as a legal) doctrine, not just because some civilians contribute substantially, but because some unjustly enriched civilians culpably fail to discharge their restitutionary duties to those whose victimization made the unjust enrichment possible. Consequently, the moral criterion for lethal liability in war is even broader than reductive individualists have argued. (shrink)

Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...) at school or day-care by default, without requiring parental authorization, but with parents retaining the right to opt their children out of vaccination. We show that such a policy is likely to be effective, at least in cases in which non-vaccination is due to practical obstacles, rather than to strong beliefs about vaccines, ethically acceptable and less controversial than some alternatives because it is not coercive and affects individual autonomy only in a morally unproblematic way, and likely to receive support from the UK public, on the basis of original empirical research we have conducted on the lay public. (shrink)

This paper introduces three new concepts: epistemic health, epistemic immunity, and epistemic inoculation. Epistemic health is a measure of how well an entity (e.g. person, community, nation) is functioning with regard to various epistemic goods or ideals. It is constituted by many different factors (e.g. possessing true beliefs, being disposed to make reliable inferences), is improved or degraded by many different things (e.g. research funding, social trust), and many different kinds of inquiry are relevant to its study. Epistemic immunity is (...) the robustness with which an entity is resistant to performing certain kinds of epistemic activity, such as questioning certain ideas, believing certain sources, or making certain inferences. Epistemic inoculation occurs when social, political or cultural processes cause an entity to become immune to engaging in certain epistemic activities. After outlining each of these concepts, we close by considering some of the risks associated with attempts to improve others’ epistemic health. (shrink)

Vaccine mandates can take many forms, and different kinds of mandates can implicate an array of values in diverse ways. It follows that good ethics arguments about particular vaccine mandates will attend to the details of individual policies. Furthermore, attention to particular mandate policies—and to attributes of the communities they aim to govern—can also illuminate which ethics arguments may be more salient in particular contexts. If ethicists want their arguments to make a difference in policy, they should attend (...) to these kinds of empirical considerations. This paper focuses on the most common and contentious vaccine mandate reform in the contemporary United States: the elimination of nonmedical exemptions (NMEs) to school and daycare vaccine mandates. It highlights, in particular, debates about California's Senate Bill 277 (SB277), which was the first successful recent effort to eliminate NMEs in that country. We use media, secondary sources, and original interviews with policymakers and activists to identify and evaluate three ethics arguments offered by critics of SB277: parental freedom, informed consent, and children's rights to care and education. We then turn to one ethics argument often offered by advocates of SB277: harm prevention. We note, however, that three arguments for mandates that are common in the immunization ethics literature—fairness/free-riding, children's rights to vaccination, and utilitarianism—did not play a role in debates about SB277. (shrink)

The COVID-19 pandemic has led a number of countries to introduce restrictive ‘lockdown’ policies on their citizens in order to control infection spread. Immunity passports have been proposed as a way of easing the harms of such policies, and could be used in conjunction with other strategies for infection control. These passports would permit those who test positive for COVID-19 antibodies to return to some of their normal behaviours, such as travelling more freely and returning to work. The introduction of (...) immunity passports raises a number of practical and ethical challenges. In this paper, we seek to review the challenges relating to various practical considerations, fairness issues, the risk to social cooperation and the impact on people’s civil liberties. We make tentative recommendations for the ethical introduction of immunity passports. (shrink)

Issues of immunity from attack and the assignment of responsibility for civilian deaths are central to the modern war convention. Koontz addresses several difficulties with Walzer's treatment of noncombatant immunity in Just and Unjust Wars.

This article underlines and draws attention to critical insights that Esposito makes regarding the prospects of rethinking community in a globalized world. Alongside Agamben and Nancy, Esposito challenges the property prejudice found in mainstream models of community. In identity politics, collective identity is converted into a form of communal property. Borders, sovereign territories, and exclusive rights are fiercely defended in the name of communal property. Esposito responds to this problem by developing what I call a “deontological communal contract” where being (...) and ethics are prioritized over having and economics. I examine this new perspective on community in relation to mainstream models found in contemporary and classical social theory. (shrink)

Imagine a future in which a country’s government is thinking about whether to pursue human enhancement. There are several ways that humans might be enhanced, among them physical aids, pharmaceutical interventions, and genetic modification. In this imagined scenario...

The issue of what is proper to nature, or life itself, is central to critical accounts of biomedicine and its complex interrelations with social, political and economic forces. These engagements, namely biopolitical accounts of medical practices and ethical-political critiques of biomedical discourse, grapple with the indistinction between the political and biological that biomedicine enacts. Making a significant contribution to both literatures, Ed Cohen’s A Body Worth Defending argues that the emergence of the concept of biological immunity signals the entry of (...) politics into life itself and, as such, constitutes a concrete example of biopolitics. This article examines Cohen’s account of how the political becomes biological, and the view of life it assumes. Seeking to open up the question of biology, it draws on the work of Georges Canguilhem, and New Materialist accounts of matter–meaning entanglement, to offer a reading of knowledge and life, or politics and biology, as ontologically entangled. (shrink)

A core idea underlying nudging is that it helps individuals to achieve their own goals, yet many nudges actually aim at collective goals or specifically target the benefit of others. An example is nudging healthcare workers to be vaccinated against influenza. I distinguish between self‐regarding nudges, which primarily benefit the nudgee, and other‐regarding nudges, which mainly benefit others, and argue that the default justificatory reason to legitimize self‐regarding nudges, namely the ‘as judged by themselves’ standard, does not apply and that (...) we need to look for other justifications. I examine several possible moral justifications to support strong other‐regarding nudges, namely beneficence, the harm principle and solidarity. (shrink)

The current SARS-CoV-2 pandemic has killed thousands across the world. SARS-CoV-2 is the latest but surely not the last such global pandemic we will face. The biomedical response to such pandemics includes treatment, vaccination, and so on. In this paper, though, we argue that it is time to consider an additional strategy: the somatic enhancement of human immunity. We argue for this approach and consider bioethics objections we believe can be overcome.

The Ethics of War and Peace is a lively introduction to one of the oldest but still most relevant ethical debates. Focusing on the philosophical questions surrounding the ethics of modern war, Helen Frowe presents contemporary just war theory in a stimulating and accessible way. This 2nd edition includes new material on weapons and technology, and humanitarian intervention, in addition to: theories of self-defence and national defence jus ad bellum, jus in bello and jus post bellum the moral (...) status of combatants the principle of non-combatant immunity and the nature of terrorism and the moral status of terrorists. Each chapter uses examples and concludes with a summary, discussion questions and suggestions for further reading to aid student engagement, learning and revision. The glossary has been expanded to cover the full range of relevant terminology. This is the ideal textbook for students of philosophy and politics approaching this important area for the first time. (shrink)

Background Ethical reasoning and sensitivity are always important in public health, but it is especially important in the sensitive and complex area of public health emergency preparedness. Here, we explored the ethical challenges, and dilemmas encountered by frontline health workers amid the coronavirus disease-19 (COVID-19) pandemic in Ethiopia. Methods A nationwide survey was conducted amongst the frontline health workers from nineteen public hospitals. Health workers were invited to respond to a self-administered questionnaire. Data were weighted and analyzed using descriptive statistics. (...) Results Of the 285 frontline health workers to whom questionnaires were distributed, 217 of them gave their responses (response rate 76.1%). Respondents frequently reported encountering rationing dilemmas on health commodities directly used for the prevention and treatment of COVID-19. Most (83.9%) of the health workers agreed that they encountered ethical challenges very frequently or frequently. Almost all [215(99.1%)] claimed that the limitation of resources was directly used for the treatment and prevention of COVID-19. The frequency of difficulty in the provision of essential clinical services varied between 77% and 98.7% for different services. More than half of the study participants reported that they had encountered difficulty in the provision of clinical care on a daily or weekly basis. Regarding rationing strategies, isolating COVID-19 treatment units and limiting admission were the most frequent rationing strategies used by two-thirds of health workers on a daily or weekly basis. Conclusion Front-line health workers encountered numerous ethically challenging situations during COVID-19. More than half of health workers reported that they encountered ethical challenges in rationing the resources and delivery of different clinical services such as family planning services, maternal and childcare, immunization, and chronic care. With limited resources such as ventilators and hospital beds, healthcare providers have been faced with the difficult task of deciding who gets access to these resources and who doesn't. Overall, the COVID-19 pandemic has presented numerous ethical challenges for healthcare providers, highlighting the importance of ethical considerations in healthcare delivery. By being aware of these dilemmas and having policies in place to address them, healthcare providers can ensure that they are providing the best possible care to their patients while upholding ethical standards. (shrink)

The principle of noncombatant immunity prohibits warring parties from intentionally targeting noncombatants. I explicate the moral version of this view and its criticisms by reductive individualists; they argue that certain civilians on the unjust side are morally liable to be lethally targeted to forestall substantial contributions to that war. I then argue that reductivists are mistaken in thinking that causally contributing to an unjust war is a necessary condition for moral liability. Certain noncontributing civilians—notably, war-profiteers—can be morally liable to be (...) lethally targeted. Thus, the principle of noncombatant immunity is mistaken as a moral (though not necessarily as a legal) doctrine, not just because some civilians contribute substantially, but because some unjustly enriched civilians culpably fail to discharge their restitutionary duties to those whose victimization made the unjust enrichment possible. Consequently, the moral criterion for lethal liability in war is even broader than reductive individualists have argued. (shrink)

Despite the availability of safe vaccines against SARS-CoV-2, some people will remain vulnerable because they will not be vaccinated. Who are these non-vaccinated people? We can distinguish two groups: (i) persons who cannot be vaccinated for clinical reasons and who, despite having been vaccinated, have not achieved immunity; (ii) persons who voluntarily refuse to get vaccinated. These groups have in common an immune system that will make them vulnerable to COVID-19. The reasons for their vulnerability and the ethical judgment they (...) deserve are different; the solutions offered to them are also different. In the case of those who voluntarily avoid vaccination, States are not compromised to introduce new protective policies. In the case of people who remain involuntarily vulnerable, instead, the response should be articulated on the same rules and principles that inform the social model of disability because they will live with an organic disability. (shrink)

This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd immunity’, ‘public goods’, and ‘vaccine refusal’; and explains why (...) failure to vaccinate raises certain ethical issues. The second chapter analyses, from a philosophical perspective, the relationship between individual, collective, and institutional responsibilities with regard to the realisation of herd immunity. The third chapter is about the principle of least restrictive alternative in public health ethics and its implications for vaccination policies. Finally, the fourth chapter presents an ethical argument for unqualified compulsory vaccination, i.e. for compulsory vaccination that does not allow for any conscientious objection. The book will appeal to philosophers interested in public health ethics and the general public interested in the philosophical underpinning of different arguments about our moral obligations with regard to vaccination. (shrink)