The first in a series of 4 articles, this article provides an overview of the concepts and methods developed by a team of researchers concerned with preventing harm and promoting ethical discourse in the helping professions. In this article we introduce conceptual, research, analytical, and action frameworks employed to promote the centrality of ethical discourse in mental health practice. We employ recursive processes whereby knowledge gained from case studies refines our emerging conceptual model of applied ethics. Our participatory (...) conceptual framework differs markedly from the restrictive model typically used in applied ethics. Our research relies on lived experiences of ethics, while our analytical framework draws attention to the multiple levels and contexts in which ethical dilemmas take place. Finally, our action framework is designed to collaborate with research participants and practitioners in making use of our data and interpretations. We demonstrate how the various frameworks inform each other in an integrative fashion. The article sets the stage for 2 case studies presented in subsequent articles. (shrink)

There are entitlements, opportunities, and rights presently reserved to married couples by the basic structure of society, its major social institutions. Some claim that this is as it should be. But given the abiding effects of the basic structure on the prospects of individuals living within it, restrictions on liberty built into the basic structure require justification. One might think that we could justify reserving the benefits of marriage to married couples by appealing to harm prevention. In this paper, (...) I argue that the prospects of doing so successfully are dim. (shrink)

Most advocates of biogenetic modification hope to amplify existing human traits in humans in order to increase the value of such traits as intelligence and resistance to disease. These advocates defend such enhancements as beneficial for the affected parties. By contrast, some commentators recommend certain biogenetic modifications to serve social goals. As Ingmar Persson and Julian Savulescu see things, human moral psychology is deficient relative to the most important risks facing humanity as a whole, including the prospect of Ultimate (...) class='Hi'>Harm, the point at which worthwhile life is forever impossible on the planet. These risks can be mitigated, they say, by enhancing moral psychology in novel ways. Persson and Savulescu argue that some parents should modify the underlying biogenetics of their children's moral psychology, if such measures were safe and effective, but they admit these interventions may not decouple humanity from Ultimate Harm. Neither are these modifications the only options, they concede, for addressing risks to humanity. Even with these concessions, saving humanity from itself is a fairly poor reason to modify the moral psychology of children. In most ways, adults would be better candidates, morally speaking, for modifications of psychology. Even then, there is no direct link between morally enhanced human beings and the hoped-for effect of better protection from Ultimate Harm. Asserting a general duty of all to contribute to the avoidance of Ultimate Harm is a better moral strategy than intervening in the moral psychology of some, even though meeting that duty may involve substantial interference with the free exercise of one's interests. (shrink)

European animal disease policy seems to find its justification in a “harm to other” principle. Limiting the freedom of animal keepers—e.g., by culling their animals—is justified by the aim to prevent harm, i.e., the spreading of the disease. The picture, however, is more complicated. Both during the control of outbreaks and in the prevention of notifiable, animal diseases the government is confronted with conflicting claims of stakeholders who anticipate running a risk to be harmed by each other, and (...) who ask for government intervention. In this paper, we first argue that in a policy that aims to prevent animal diseases, the focus shifts from limiting “harm” to weighing conflicting claims with respect to “risks of harm.” Therefore, we claim that the harm principle is no longer a sufficient justification for governmental intervention in animal disease prevention. A policy that has to deal with and distribute conflicting risks of harm needs additional value assumptions that guide this process of assessment and distribution. We show that currently, policies are based on assumptions that are mainly economic considerations. In order to show the limitations of these considerations, we use the interests and position of keepers of backyard animals as an example. Based on the problems they faced during and after the recent outbreaks, we defend the thesis that in order to develop a sustainable animal disease policy other than economic assumptions need to be taken into account. (shrink)

This paper examines the role of clinical practitioners and clinical researchers internationally in establishing the utility of harm-reduction approaches to substance use. It thus illustrates the potential for clinicians to play a pivotal role in health promoting structural interventions based on harm-reduction goals and public health models. Popular media images of drug use as uniformly damaging, and abstinence as the only acceptable goal of treatment, threaten to distort clinical care away from a basis in evidence, which shows that (...) some ways of using drugs are far more harmful than others and that punitive approaches and insistence on total abstinence as the only goal of treatment often increases the harms of drug use rather than reducing drug use. Therefore the leadership and scientific authority of clinicians who understand the health impact of harm-reduction strategies is needed. Through a review of harm-reduction interventions in Canada, the United Kingdom, the United States, Australia, Switzerland, and the Netherlands, we identify three ways that clinicians have helped to achieve a paradigm shift from punitive approaches to harm-reduction principles in clinical care and in drug policy: through clinical research to provide data establishing the effectiveness and feasibility of harm-reduction approaches, by developing innovative clinical programmes that employ harm reduction, and thereby changing the standard of care to include routine use of these evidence-based approaches in their practices. We argue that through promotion of harm-reduction goals and methods, clinicians have unique opportunities to improve the health outcomes of vulnerable populations. (shrink)

Various philosophers discuss perlocutionary silencing, but none defend an account of perlocutionary silencing. This gap may exist because perlocutionary success depends on extralinguistic effects, whereas silencing interrupts speech, leaving theorists to rely on extemporary accounts when they discuss perlocutionary silencing. Consequently, scholars assume perlocutionary silencing occurs but neglect to explain how perlocutionary silencing harms speakers as speakers. In relation to that shortcoming, I defend a novel account of perlocutionary silencing. I argue that speakers experience perlocutionary silencing when they are illegitimately (...) deprived of perlocutionary influence on a conversation in which they are active participants, where perlocutionary influence on the conversation relates to speech-related perlocutionary goals meant to influence the conversation or conversational direction. Thus, this account grounds perlocutionary silencing in linguistic phenomena and characterizes perlocutionary silencing in a way that explains why those who experience perlocutionary silencing are harmed as speakers. Moreover, this account explains how perlocutionary silencing harms speakers as conversational participants in a way that cannot be captured by illocutionary or locutionary silencing, for a speaker may be perlocutionarily silenced despite illocutionary success. Consequently, the account explains why “All Lives Matter” silences Black Lives Matter and “Not All Men” silences women sharing experiences of sexual harassment. (shrink)

This paper examines the role of clinical practitioners and clinical researchers internationally in establishing the utility of harm-reduction approaches to substance use. It thus illustrates the potential for clinicians to play a pivotal role in health promoting structural interventions based on harm-reduction goals and public health models. Popular media images of drug use as uniformly damaging, and abstinence as the only acceptable goal of treatment, threaten to distort clinical care away from a basis in evidence, which shows that (...) some ways of using drugs are far more harmful than others and that punitive approaches and insistence on total abstinence as the only goal of treatment often increases the harms of drug use rather than reducing drug use. Therefore the leadership and scientific authority of clinicians who understand the health impact of harm-reduction strategies is needed. Through a review of harm-reduction interventions in Canada, the United Kingdom, the United States, Australia, Switzerland, and the Netherlands, we identify three ways that clinicians have helped to achieve a paradigm shift from punitive approaches to harm-reduction principles in clinical care and in drug policy: through clinical research to provide data establishing the effectiveness and feasibility of harm-reduction approaches, by developing innovative clinical programmes that employ harm reduction, and thereby changing the standard of care to include routine use of these evidence-based approaches in their practices. We argue that through promotion of harm-reduction goals and methods, clinicians have unique opportunities to improve the health outcomes of vulnerable populations. (shrink)

BackgroundThe prevention of HIV remains an ongoing global concern. The safety and welfare of participants in these trials are imperative. Research Ethics Committees (RECs) review all reports of serious adverse events, adverse events and social harms arising in the course of such trials. There is little guidance for RECs on how to respond appropriately to social harm reports.MethodologyThis paper reviews the literature on social harms in HIV prevention trials and offers suggestions for RECs on how to respond appropriately to (...) such reports.ResultsThis review confirms that social harms are reported in clinical trials in South Africa and that specific guidance on managing these is minimal.ConclusionSocial harms in South African HIV prevention trials need to be more systematically researched so that ethical evidence‐based prevention, care and treatment strategies can be developed. This review makes specific suggestions for further research on social harms that can inform further consultations to develop more specific guidance for stakeholders on appropriate responses to such social harms. Such future work may also inform future versions of relevant local and international ethics guidance on HIV prevention trials. (shrink)

Wakefield’s harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction and a value component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mononucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that (...) dysfunctions need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them disorders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction’s harmfulness is best understood in dispositional terms. (shrink)

According to the Harm Principle, roughly, the state may coerce a person only if it can thereby prevent harm to others. Clearly, this principle depends crucially on what we understand by harm. Thus, if any sort of negative effect on a person may count as a harm, the Harm Principle will fail to sufficiently protect individual liberty. Therefore, a more subtle concept of harm is needed. I consider various possible conceptions and argue that none (...) gives rise to a plausible version of the Harm Principle. Whether we focus on welfare, quantities of welfare or qualities of welfare, we do not arrive at a plausible version of this principle. Instead, the concept of harm may be moralized. I consider various ways this may be done as well as possible rationales for the resulting versions of the Harm Principle. Again, no plausible version of the principle turns up. I also consider the prospect of including the Harm Principle in a decision-procedure rather than in a criterion of rightness. Finally, in light of my negative appraisal, I briefly discuss why this principle has seemed so appealing to liberals. (shrink)

Because spaying/neutering animals involves the harming of some animals in order to prevent harm to others, some ethicists, like David Boonin, argue that the philosophy of animal rights is committed to the view that spaying/neutering animals violates the respect principle and that Trap Neuter Release programs are thus impermissible. In response, I demonstrate that the philosophy of animal rights holds that, under certain conditions, it is justified, and sometimes even obligatory, to cause harm to some animals in order (...) to prevent greater harm to others. As I will argue, causing lesser harm to some animals in order to prevent greater harm to others, as TNR programs do, is compatible with the recognition of the inherent value of the ones who are harmed. Indeed, we can, and do, spay/neuter cats while acknowledging that they have value in their own right. (shrink)

Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does not suffice.In this paper, I explore Derek Parfit’s arguments that blur the sharp line between harm to self and others. I analyse cases of treatment refusal by (...) capacitous patients and describe different forms of paternalism arising from a reductionist view of personal identity. I outline an Identity Relative Paternalistic Intervention Principle for determining when we should disallow refusal of treatment where the harm will be accrued by a future self, and consider objections including vagueness and non-identity.Identity relative paternalism does not always justify intervention to prevent harm to future selves. However, there is a stronger ethical case for doing so than is often recognised. (shrink)

Although science and law employ different methods to gather and weigh evidence, their conclusions are remarkably convergent with regard to the effect that workplace stress has on the health of employees. Science, using the language of probability, affirms that certain stressors predict adverse health outcomes such as disabling anxiety and depression, cardiovascular disease, certain types of injury, and a variety of immune system disorders. Law, using the language of reasonable foreseeability, affirms that these adverse outcomes are predictable under certain conditions, (...) typically defined in relation to what a reasonable person should know. Society is arguably in a position to establish standards for the abatement of certain types of workplace stress. As part of this process, we need to conceptualize an ideal form of conduct that exemplifies the standards to which both law and science urge us to aspire. For this purpose, the concept of the neighbor at work is proposed. (shrink)

Effective infectious disease control may require states to restrict the liberty of individuals. Since preventing harm to others is almost universally accepted as a legitimate (prima facie) reason for restricting the liberty of individuals, it seems plausible to employ a mid‐level harm principle in infectious disease control. Moral practices like infectious disease control support – or even require – a certain level of theory‐modesty. However, employing a mid‐level harm principle in infectious disease control faces at least (...) three problems. First, it is unclear what we gain by attaining convergence on a specific formulation of the harm principle. Likely candidates for convergence, a harm principle aimed at preventing harmful conduct, supplemented by considerations of effectiveness and always choosing the least intrusive means still leave ample room for normative disagreement. Second, while mid‐level principles are sometimes put forward in response to the problem of normative theories attaching different weight to moral principles, employing a mid‐level harm principle completely leaves open how to determine what weight to attach to it in application. Third, there appears to be a trade‐off between attaining convergence and finding a formulation of the harm principle that can justify liberty‐restrictions in all situations of contagion, including interventions that are commonly allowed. These are not reasons to abandon mid‐level theorizing altogether. But there is no reason to be too theory‐modest in applied ethics. Morally justifying e.g. if a liberty‐restriction in infectious disease control is proportional to the aim of harm‐prevention, promptly requires moving beyond the mid‐level harm principle. (shrink)

This paper discusses how to deal with research that threatens to cause harm to society—in particular, whether and in what cases bans and moratoria are appropriate. First, it asks what normative resources philosophy of science may draw on to answer such questions. In an effort to presuppose only resources acknowledgeable across different comprehensive worldviews, it is claimed that the aim of credibility provides a good basis for normative reflection. A close analysis reveals an inner tension inherent in the pursuit (...) of credibility, referred to as the paradox of credibility: Although the aim of credibility involves the goal of being trusted, the immediate pursuit of the goal of being trusted as much as possible can run counter to and undermine the pursuit of credibility. From this inner tension, considerations are derived on what it means to uncompromisingly strive for trustworthiness. When applied to the problem of harmful research, it becomes apparent that it is important to distinguish between different types of cases. Some cases allow science to prevent harm while relinquishing credibility in the associated research area. In contrast, other cases demand preserving subject-specific scientific credibility in order to manage potential harm. (shrink)

In this paper, I consider the problem of omission for the counterfactual comparative account of harm. A given event harms a person, on this account, when it makes her worse off than she would have been if it had not occurred. The problem arises because cases in which one person merely fails to benefit another intuitively seem harmless. The account, however, seems to imply that when one person fails to benefit another, the first thereby harms the second, since the (...) second person would have been better off if the first had benefited her. I argue that the cases of failing to benefit at issue are in fact cases of harming. They are cases of preventive harm. I also argue that we can explain away the intuition that no harm occurs in these cases, and that the relevant implication of the counterfactual comparative account is consistent with a variety of plausible views about the moral significance of harm. (shrink)

It is typically wrong to act in a way that foreseeably makes some impending harm worse. Sometimes it is permissible to do so, however, if one also offsets the harm increasing action by doing something that decreases the badness of the same harm by at least as much. This chapter argues that the standard deontological constraint against doing harm is not compatible with the permissibility of harm increases that have been offset. Offsetting neither prevents one's (...) other actions from doing harm nor ensures that the harm those actions do is made permissible by any of the constraint's familiar provisos. To make sense of offsetting, the old constraint against doing harm should be replaced with a new constraint against making unoffset harm increases. The chapter discusses how to formulate the new constraint so that it can handle both the offsetting cases that the old constraint gets wrong as as well as the non-offsetting cases that the old constraint gets right. Adopting this constraint against unoffset harm increases may have important implications both for theoretical questions about the sources of deontological constraints as well as for practical questions, such as whether buying carbon offsets can make emitting carbon dioxide permissible. (shrink)

This first volume in the four-volume series The Moral Limits of the Criminal Law focuses on the "harm principle," the commonsense view that prevention of harm to persons other than the perpetrator is a legitimate purpose of criminal legislation. Feinberg presents a detailed analysis of the concept and definition of harm and applies it to a host of practical and theoretical issues, showing how the harm principle must be interpreted if it is to be a plausible (...) guide to the lawmaker. (shrink)

Standard, familiar models portray harms and benefits as symmetrical. Usually, harm is portrayed as involving a worsening of one's situation, and benefits as involving an improvement. Yet morally, the aversion, prevention, and relief of harms seem, at least presumptively, to matter more than the provision, protection, and maintenance of comparable and often greater benefits. Standard models of harms and benefits have difficulty acknowledging this priority, much less explaining it. They also fail to identify harm accurately and reliably. In (...) this paper, I develop these problems, argue that we should reconsider our commitment to the standard models, and then merely gesture at the direction in which we might locate a superior approach, one that better accounts for the moral significance of harm and its relation to autonomy rights. (shrink)

Team reflexivity has gained increasing research attention as an effective response to the core challenge of constant learning, innovation, and adaptation in teams due to changing circumstances. Under the right conditions, empirical studies have found that team reflexivity can improve team performance, team learning, team innovation, team creativity, and team member well-being. Thus, research shows that team reflexivity is an effective means to improve teamwork and team outcomes. This book addresses the problem that team reflexivity research is focused too narrowly (...) on improving these empirical team outcomes while neglecting the importance of normative principles and values in good teamwork, such as the do no harm principle. Therefore, this book proposes that the team reflexivity concept needs broader reframing and deeper reflection to realize normative principles and values in teams as a precondition for good teamwork, e.g., do no harm. It further presents two team reflexivity tools and applies them in the cases of burnout prevention and speaking up freely in teams to illustrate the point of this book: Do no harm in teams requires team reflexivity, and vice versa, team reflexivity requires do no harm. (shrink)

This symposium contribution offers a reconsideration of a range of “vice crime” legislation from late nineteenth and early twentieth century American law, criminalizing matters such as prostitution, the use of opiates, illegal gambling, and polygamy. According to the standard account, the original justification for these offenses was purely moralistic and paternalistic ; and it was only later, in the late twentieth century, that those who supported such legislative initiatives sought to justify them in terms of their ability to prevent harms. (...) This piece argues that the rationale for these vice crimes laws was much more complicated than has traditionally been thought, encompassing not just moralistic justifications but also a wide range of harm-based rationales—similar to those that underlie modern, technocratic, “preventive justice” legislation involving matters such as anti-social behavior orders, sex offender registration, stop-and-frisk policing, and the fight against terrorism. (shrink)

When should we make use of the criminal law? Suppose that a responsible legislature seeks to enact a morally justifiable range of criminal prohibitions. What criteria should it apply when deciding whether to proscribe conduct? Crimes, Harms, and Wrongs is a philosophical analysis of the nature, significance, and ethical limits of criminalisation. The authors explore the scope and moral boundaries of harm-based prohibitions, proscriptions of offensive behaviour, and 'paternalistic' prohibitions aimed at preventing self-harm. Their aim is to (...) develop guiding principles for these various grounds of state prohibition, including an analysis of the constraints and mediating factors that weigh for and against criminalisation. Both authors have written extensively in the field. In Crimes, Harms, and Wrongs they have reworked a number of well-known essays and added several important new essays to produce an integrated, accessible, philosophically-sophisticated account that will be of great interest to legal academics, philosophers, and advanced students alike"--Provided by publisher. (shrink)

Preventive use of force may be defined as the initiation of military action in anticipation of harmful actions that are neither presently occurring nor imminent. This essay explores the permissibility of preventive war from a cosmopolitan normative perspective, one that recognizes the basic human rights of all persons, not just citizens of a particular country or countries. It argues that preventive war can only be justified if it is undertaken within an appropriate rule-governed, institutional framework that is designed to help (...) protect vulnerable countries against unjustified interventions while also avoiding unacceptable risks of the costs of inaction. The key to ensuring the fairness of rules governing the preventive use of force is accountability.This essay proposes a scheme that would make those promoting and those rejecting the preventive use of force more accountable. The proposal contains the following crucial features:States proposing preventive war are required to enter into a contract with a diverse body of states as a condition for authorization of their actions;Prior to taking preventive action, states must make an evidence-based case to the UN Security Council, and agree in advance to submit themselves to an evaluation by an impartial body after the preventive action occurred;Both proponents of action and those opposing it will be held accountable ex post for the accuracy of their prior statements and the proportionality of their actions;Sanctions will be imposed against intervening states or states that opposed preventive action, respectively, depending on the findings of the ex post evaluation.If preventive action were blocked in the Security Council, states seeking to engage in preventive action could then present their case in a different body–a coalition of democratic states–with its own ex post and ex ante accountability procedures. (shrink)

This book arises from a three-year study of Preventive Justice directed by Professor Andrew Ashworth and Professor Lucia Zedner at the University of Oxford. The study seeks to develop an account of the principles and values that should guide and limit the state's use of preventive techniques that involve coercion against the individual. States today are increasingly using criminal law or criminal law-like tools to try to prevent or reduce the risk of anticipated future harm. Such measures include criminalizing (...) conduct at an early stage in order to allow authorities to intervene; incapacitating suspected future wrongdoers; and imposing extended sentences or indefinate on past wrongdoers on the basis of their predicted future conduct - all in the name of public protection and security. The chief justification for the state's use of coercion is protecting the public from harm. Although the rationales and justifications of state punishment have been explored extensively, the scope, limits and principles of preventive justice have attracted little doctrinal or conceptual analysis. This book re-assesses the foundations for the range of coercive measures that states now take in the name of prevention and public protection, focussing particularly on coercive measures involving deprivation of liberty. It examines whether these measures are justified, whether they distort the proper boundaries between criminal and civil law, or whether they signal a larger change in the architecture of security. In so doing, it sets out to establish a framework for what we call 'Preventive Justice'. (shrink)

John Stuart Mill's harm principle holds that an individual's freedom can only be restricted to prevent harm to others. However, there is an important ambiguity between a strong version, which limits legitimate interference to self-defense and therefore prohibits society from protecting third parties (those who are not its members), and a narrow version, which grants any society universal jurisdiction to prevent nonconsensual harms, no matter who is harmed. Mill sometimes appeals to the strong harm principle to preclude (...) interference, but elsewhere endorses measures (including humanitarian foreign intervention and animal cruelty laws) to protect third parties, suggesting that he subscribes only to the weak harm principle. This ambiguity regarding who it is that society has standing to protect has important implications for the scope of individual freedom. (shrink)

This paper discusses the inefficacy problem that arises in contexts of “collective harm.‘ These are contexts in which by acting in a certain sort of way, people collectively cause harm, or fail to prevent it, but no individual act of the relevant sort seems to itself make a difference. The inefficacy problem is that if acting in the relevant way won’t make a difference, it’s unclear why it would be wrong. Each individual can argue, “things will be just (...) as bad whether or not I act in this way, so there’s no point in doing otherwise.‘ The goal of this paper is to give an overview of some of the main responses available to the problem and to highlight central issues that arise for each type of response. In the final section, I explain what I take to be the most promising strategy and discuss the form that this strategy should take. (shrink)

In The Ends of Harm, Victor Tadros claims that the general justifying aim of the criminal law should be general deterrence. He also takes seriously that we cannot use people as a means, and thus he argues that we may only punish people in the name of general deterrence who have a ‘duty’ to suffer. Tadros claims that this duty arises as follows: An offender initially has a duty not to harm the victim. If the offender violates that (...) duty, the offender still has a duty to stop the harm from occurring. And if the harm does occur, then the offender has a duty to rectify that harm. This duty to rectify, argues Tadros, requires the defendant not only to compensate the victim but also to protect the victim to the extent that he would have been able to have been harmed to prevent the threat from occurring. Tadros further advances intricate arguments for why the state may therefore punish the offender to protect other potential victims to the extent of the offender’s duty to rectify. This symposium contribution seeks to explore three problems with Tadros’ analysis, ultimately arguing that Tadros’ theory fails on its own terms. First, attempts present a substantial problem for Tadros’ regime because attempts do not give rise to duties to prevent harm because there is no harm to be prevented. Tadros’ attempt to account for attempts, as completed offenses of diversions of security resources, ultimately leads to punishments that bear little resemblance to the crime attempted. Such a wildly counterintuitive result creates problems for a regime premised on general deterrence, which must be understood and respected. Second, Tadros’ regime will often exempt the rich from suffering criminal punishment. Tadros claims that duties to prevent harms from occurring are only enforceable when compensation will be inadequate. However, affluent offenders may be able to fully compensate. Moreover, since the scope of the duty to suffer will be determined by what remains of the duty after the victim is compensated, affluent offenders will be able to compensate more and thereby suffer less. Again, the actual sentences will thereby bear little resemblance to the rationale for criminalization, thus threatening the deterrent message of the law. Moreover, a system that exacerbates distributive inequalities will not achieve public respect. Third, Tadros cannot justify taking the duty that the defendant owes to the victim and forcing the victim to transfer this asset to the state. In his quest to articulate a theory that does not impermissibly use defendants, he ultimately endorses a theory that impermissibly uses their victims. He thus fails to achieve the very goal he sets for himself, which is to achieve general deterrence without impermissibly using anyone. (shrink)

This paper challenges one line of argument which has been advanced to justify imposing risks of collateral harm on prospective beneficiaries of armed humanitarian interventions. This argument - the ‘Beneficiary Principle’ - holds that non-liable individuals’ immunity to being harmed as a side effect of just armed humanitarian interventions may be diminished by their prospects of benefiting from the intervention. Against this, I defend the view that beneficiary status does not morally distinguish beneficiaries from other non-liable individuals in such (...) a way as to permit exposing them to greater risks of being harmed. The argument proceeds in four steps. I first show that the BP can neither be grounded in liability-based nor in lesser-evil justifications for harming. I then argue that a standalone justification for unintended harming based on beneficiary status would face at least two critical challenges. The first concerns the BP’s applicability to collectives; the second questions the normative weight we can plausibly ascribe to beneficiary status when beneficiaries are such by virtue of being victims of wrongful threats of harm. I argue that standing to benefit is morally irrelevant when the benefit consists in the mitigation or prevention of wrongful harms, and consequently suggest that the BP may only serve as a distributive principle in allocating risks of harm if it is disambiguated in a number of critical aspects and applied in a more narrowlydefined set of circumstances. (shrink)

Children are presumptively regarded as incompetent to make their own medical decisions, and the responsibility for making such decisions typically falls to parents. Parental authority is not unlimited, however, and ethical guidelines identifying appropriate bounds on this authority are needed. One proposal currently gaining support is the Harm Threshold (HT), which asserts that the state may only legitimately intervene in parental decision-making when serious and preventable harm to children is likely. This paper considers two questions: in virtue of (...) what underlying principle or property does the HT gain its purported justification?; and does this underlying principle or property ground the HT as its proponents conceive of it? I identify two separate grounds represented in the literature: (i) J.S. Mill’s Harm Principle; and (ii) the liberty interests of parents. I find that the HT is not sufficiently grounded in either of these, revealing a substantial conceptual difficulty for its advocates. (shrink)

The chapter focuses on cases of assisted suicide and voluntary euthanasia in relation to the rarely discussed notion of indirect paternalism. Indirect paternalism involves not just a paternalistic intervener and a person whose welfare is supposed to be protected, but also another party, whom I call “assistant.” Indirect paternalism interferes with an assistant in order to prevent harm to another person. I will introduce a strategy that paternalists can pursue to justify indirect paternalism. It specifically targets an element of (...) assistance cases, namely the fact that people do not necessarily have a justified claim or entitlement to demand such assistance. To prevent people from providing assistance seems normatively different from preventing a person to do something to herself by her own means. I critically discuss arguments from the goals of medicine and from the conscientious objection. These aspects are not deemed decisive when considering the case of indirect paternalistic intervention. Finally, I argue against the rationale of indirect paternalism by showing that there are at least two situations where it does not succeed. One such situation that undermines the justification of indirect paternalism is present when the offered service is itself harmless, another pertinent situation consists of a person necessarily requiring assistance to be really free. At least in some cases, these very conditions are given when contemplating assistance to die. (shrink)

The harm principle, understood as the normative requirement that conduct should be criminalized only if it is harmful, has difficulty in dealing with those core cases of criminal wrongdoing that can occur without causing any direct harm. Advocates of the harm principle typically find it implausible to hold that these core cases should not be crimes and so usually seek out some indirect harm that can justify criminalizing the seemingly harmless conduct. But this strategy justifies criminalization (...) of a wide range of conduct on the basis of the fear, worry, and anxiety it generates among those who are not the direct victims of the conduct, and thereby undermines the limiting role of the harm principle by permitting the very move it was meant to prevent: the criminalization of harmless conduct on the ground of others’ feelings about it. The best way to avoid this dilemma is to recognize that people have rights, operating independently of the harm principle, to be treated in certain ways just because they are persons. The existence of such rights provides a ground for both criminalizing conduct and limiting the scope of criminalization because these rights point both to conduct that people must be permitted to engage in and conduct that might well be criminalized. A complete account of criminal law will therefore require the harm principle to work together with an independent account of rights. (shrink)

When life-saving medical resources are scarce and not everyone can be saved, is the only relevant goal saving the most lives? Or can other factors be considered, at least as tiebreakers, such as how early in life the people we don't save will die or how much future life they are likely to lose? This commentary defends a multiprinciple allocation approach that considers objectives in addition to saving more lives, including preventing early death and preventing harm in (...) the form of lost future life. Particularly compared to an arbitrary, coin-flip tiebreaker, this multiprinciple approach more effectively prevents harm, prioritizes the worst-off, mitigates socioeconomic and racial health disparities, and tracks public values regarding allocation under scarcity—and is legally sound. -/- . (shrink)

Mill’s harm principle is commonly supposed to rest on a distinction between self-regarding conduct, which is not liable to interference, and other-regarding conduct, which is. As critics have noted, this distinction is difficult to draw. Furthermore, some of Mill’s own applications of the principle, such as his forbidding of slavery contracts, do not appear to fit with it. This article proposes that the self-regarding/other-regarding distinction is not in fact fundamental to Mill’s harm principle. The sphere of protected liberty (...) includes not only self-regarding conduct, but also actions that affect only consenting others. On the other hand, the occasional permissibility of interfering with self-regarding conduct can plausibly be explained by reference to the agent’s consent. Thus, the more important distinction appears to be that between consensual and non-consensual harm, rather than that between the self-regarding and non-self-regarding action. That is, interference can be justified in order to prevent non-consensual harms, but not to prevent consensual harms. It is argued that the harm principle, thus reformulated, both captures Mill’s intentions and is a substantively plausible position. (shrink)

Ethical and legal traditions recognize prenatal duties to avoid harm to offspring. However, applying the harm principle to pregnancy requires a careful balancing of a baby's welfare with a pregnant woman's interest in liberty and bodily integrity. In the case of maternal PKU the mother can prevent harm to her baby by returning to the admittedly unpleasant diet that prevented her from being retarded. Informing, counseling, and access to medical care should be the primary policy. Seizures and (...) forced treatment cannot be justified in this case, and only rarely in other situations. (shrink)

A number of philosophers have become interested in the ways that individuals are subject to harm as the performers of illocutionary acts. This paper offers an account of the underlying structure of such harms: I argue that speakers are the subjects of illocutionary harm when there is interference in the entitlement structure of their linguistic activities. This interference comes in two forms: denial and incapacitation. In cases of denial, a speaker is prevented from achieving the outcomes to which (...) they are entitled by their speech. In cases of incapacitation, a speaker’s standing to expect certain outcomes is itself undermined. I also discuss how individual speakers are subject to interference along two dimensions: as exercisers of certain non-linguistic capacities, and as producers of meaningful speech. (shrink)

Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS. While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, (...) and models. In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers. (shrink)

J s mill's principle of liberty is often thought to say that the only good reason for interfering with a person's conduct is that it is harmful to others. An alternative interpretation is defended: that the only good reason for interfering is to prevent harm to others. Harm-Prevention is the aim, But the latter principle allows that conduct affected not be harmful; interference must be calculated to prevent harm to others, Perhaps indirectly. This accords with mill's official (...) statement of his principle, Accommodates his own otherwise troublesome examples of cooperation and good samaritan requirements, And fits as well with the texts. (shrink)

Most people believe that some optimific acts are wrong. Since we are not permitted to perform wrong acts, we are not permitted to carry out optimific wrongs. Does the moral relevance of the distinction between action and omission nonetheless permit us to allow others to carry them out? I show that there exists a plausible argument supporting the conclusion that it does. To resist my argument, we would have to endorse a principle according to which, for any wrong action, there (...) is some reason to prevent that action over and above those reasons associated with preventing harm to its victim. I argue that it would be a mistake to value the prevention of wrong acts in the way required to resist my argument. (shrink)

The adoption and reporting of CSR policies have important ethical and managerial implications that need scrutiny. This study answers the call of CSR scholars for further studies in controversial sectors by focusing on the voluntary reporting practices of companies that market products or services that generate addiction among consumers. It contributes to the debate on organizational legitimacy and corporate reporting by empirically analyzing whether and how corporations in the tobacco, alcohol and gambling industries disclose their CSR actions and what reactions (...) such disclosures generate in stakeholders. Drawing on legitimacy theory and organizational façades, we apply a consequent mixed-methods design (initiation approach) built on (i) a content analysis of reports prepared by a large set of companies listed on the European, British, US, Canadian, Australian and New Zealand stock exchanges and (ii) an experiment on how different actions taken by the companies (preventive vs. remedial) elicit different perceptions of company hypocrisy and action effectiveness. While previous analyses have focused on “sin” or “harm” industries, this is one of the first to assess how companies account for “addiction”, which is more difficult for them to report and legitimate due to long-term negative consequences. This study contributes to the literature on the instrumental use of CSR reporting by empirically investigating how addiction companies shape their organizational façades and manage organizational legitimacy through disclosure. Moreover, the experimental evidence advances the knowledge of how cognitive mechanisms influence stakeholders in terms of legitimacy assessment and the perceived hypocrisy/effectiveness of CSR disclosure. (shrink)

Jerome Wakefield has argued that a disorder is a harmful dysfunction. This paper develops how Wakefield should construe harmful in his harmful dysfunction analysis. Recently, Neil Feit has argued that classic puzzles involved in analyzing harm render Wakefield’s HDA better off without harm as a necessary condition. Whether or not one conceives of harm as comparative or non-comparative, the concern is that the HDA forces people to classify as mere dysfunction what they know to be a disorder. (...) For instance, one can conceive of cases where simultaneous disorders prevent each other from being, in any traditional sense, actually harmful; in such cases, according to the HDA, neither would be a disorder. I argue that the sense of harm that Wakefield should employ in the HDA is dispositional, similar to the sense of harm used when describing a vile of poison: “Be careful! That’s poison. It’s harmful.” I call this harm in the damage sense. Using this sense of harm enables the HDA to avoid Feit’s arguments, and thus it should be preferred to other senses when analyzing harmful dysfunction. (shrink)

Discussion of epistemic responsibility typically focuses on belief formation and actions leading to it. Similarly, accounts of collective epistemic responsibility have addressed the issue of collective belief formation and associated actions. However, there has been little discussion of collective responsibility for preventing epistemic harms, particularly those preventable only by the collective action of an unorganized group. We propose an account of collective epistemic responsibility which fills this gap. Building on Hindriks' (2019) account of collective moral responsibility, we introduce the (...) Epistemic Duty to Join Forces. Our theory provides an account of the responsibilities of scientists to prevent epistemic harms during inquiry. (shrink)