Hugh V. McLachlan

In a recent article, Shaw contrasts his own supposed good behaviour, as that of a self-proclaimed “social distance warrior” with the alleged rude behaviour of one of his relatives, Jack, at social events in the former’s house in Scotland in the early stages of the COVID-19 pandemic. He does so to illustrate and support his claims that it was wrong and rude to fail to comply with the governmental advice regarding social distancing because we had a responsibility “to minimize risk” and not wrong nor rude to challenge and cajole those people who failed to do so. This article shows that his claims are contestable. It suggests that his own behaviour was no better than Jack’s.

It is often maintained that, since the buying and selling of organs—particularly the kidneys—of living people supposedly constitutes exploitation of the living vendors while the so-called “altruistic” donation of them does not, the former, unlike the latter, should be a crime. This paper challenges and rejects this view. A novel account of exploitation, influenced by but different from those of Zwolinski and Wertheimer and of Wilkinson, is developed. Exploitation is seen as a sort of injustice. A distinction is made between justice and fairness. To exploit someone is to take advantage of him or her unjustly. Exploitation pertains to the nature of actions, interactions, and transaction rather than to their outcomes or to how they are perceived by exploitees. Desperation on the part of one or other of the parties to a transaction does not preclude the giving of valid consent to the transaction. Disparities of power or wealth between the parties to a transaction do not indicate or entail that the transaction will be exploitative. A disparity in the benefits that arise from a transaction between the parties does not indicate or entail that exploitation has taken place.

Marquis’s account of the ethics of abortion is unsatisfactory but not as Christensen implies baseless. It requires to be amended rather than abandoned. It is true, as Marquis asserts that murder and abortion both might deprive people of something of value to them, in particular, the life of a sort that might have been to them worth living. However, it is mistaken to conclude, as Marquis does, that murder and abortion are thereby morally equivalent. Not all deprivation is wrongful. Not all that is wrongful is wrongful because it deprives someone of something. Contrary to what Christensen asserts, and Marquis seems to accept, it is not solely those discernible people who currently exist who might be deprived by our current actions. It is not only towards and concerning such living discernible people that we can have moral duties. It is not only such living discernible people who can be the beneficiaries of our generosity. Hence, contraception and the emission of greenhouse gases are, like abortion, issues that raise significant moral questions; however, they might each be properly answered. Nonetheless, it does not follow that is morally equivalent to each other far less than they are all morally equivalent to murder. If and when they are morally wrong, they can be different wrongs.

In his paper , Culyer talks about “values” and “value judgments” in relation to equity.1 He says: “The focus is on equity in the allocation of health care resources .... These are value laden questions because any idea of “equity” must embody value judgments about what it is that makes for a good society”. He says too: “Equity in health care policy, as in other arenas of policy, is a question of ethics and therefore of values”.I disagree with this way of talking: it suggests a sort of “postmodernist” moral relativism. It sounds as if there might be, say, socialist beliefs which were vouched for by socialist values while …

Various authors, for instance Elizabeth Anderson, Rosemary Tong, Mary Warnock and Margaret Brazier have argued that commercial surrogate motherhood is exploitative and that it should be prohibited. Their arguments are unconvincing. Exploitation is a more complex notion than it is usually presented as being. Unequal bargaining power can be a cause of exploitation but the exercise of unequal bargaining power is not inevitably or inherently exploitative. Exploitation concerns unfair and/or unjust strategies - rather than the exercise of power as such. Commercial surrogate motherhood is not necessarily exploitative. Furthermore, not all transactions which are exploitative should be made illegal.

The nature and significance of equity and equality in relation to health and healthcare policy is discussed in the light of a recent article by Culyer. Culyer makes the following claims: the importance of equity in relation to the provision of health care derives from the human need for health in order to flourish; and for the sake of equity, equality of health among the members of particular political jurisdictions should be the aim of health policy. Both these claims are challenged in this paper.The argument put forward is that it is only when needs arise and are met in particular contexts that need and equity are fused. The state and its agents and agencies should distribute what it distributes impartially, whatever it distributes. Whether or not equity applies to the distribution of healthcare services depends on how they are provided and not on their nature as “primary goods”. Contrary to what Culyer suggests, a policy of trying to produce the outcome of health equality would be inequitable. It would not be impartial and it would fail to treat persons as persons ought to be treated

In his discussion of ethics and abortion, Prof. Richard Dawkins makes the provocative claim that: ‘The Great Beethoven Fallacy is a typ ical example of the kind of logical mess we get into when our minds are befuddled by religiously inspired absolutism.’ (Dawkins, p. 339) This supposed fallacy is presented as if it exemplified not only a particular view of abortion held, for instance, by certain fundamentalist Christians but as if it revealed some flaw that is characteristic of the thinking of theists. I shall examine his claim

In a recent article in Health Care Analysis (Vol. 8, No. 1),Campbell misrepresents our specific arguments about commercialsurrogate motherhood (C.S.M.) and our general philosophical andpolitical views by saying or suggesting that we are `Millsian'liberals and consequentialists. He gives too the false impressionthat we do not oppose, in principle, slavery and child purchase.Here our position on C.S.M. is re-expressed and elaborated uponin order to eliminate possible confusion. Our general ethical andphilosophical framework is also outlined and shown to be otherthan Campbell says that it is. In particular, a moral philosophythat it is based on neither consequentialism nor Kantianism ispresented. C.S.M., it is argued, is not child purchase. It is like it insome respects and unlike it in others. It is unlike it in therespects which, relative to the present discussion, matter

Wardrope argues against my proposed non-consequentialist policy for the distribution of scarce influenza vaccine in the face of a pandemic. According to him, even if one accepts what he calls my deontological ethical theory, it does not follow that we are required to agree with my proposed randomised allocation of doses of vaccine by means of a lottery. He argues in particular that I fail to consider fully the prophylactic role of vaccination whereby it serves to protect from infection more people than are vaccinated. He concludes that: ‘The benefits and burdens of vaccination are provided impartially and far more effectively by targeted vaccination than impartial lotteries.’ He has shown convincingly that this conclusion can be established in the case of his particular envisaged scenario. However, Wardrope gives no reason to suppose that, in the circumstances that we actually face, targeted vaccination would constitute impartial treatment of citizens in the UK. I readily agree with Wardrope that if it should treat its citizens justly and impartially, it does not necessarily follow that the state should distribute vaccinations of the basis of a lottery. That will be a reasonable thing to do only if certain assumptions are made. These assumptions will not always be reasonable. However, they are reasonable ones to make in the actual circumstances that currently apply

The current UK policy for the distribution of scarce vaccination in an influenza pandemic is ethically dubious. It is based on the planned outcome of the maximum health benefit in terms of the saving of lives and the reduction of illness. To that end, the population is classified in terms of particular priority groups. An alternative policy with a non-consequentialist rationale is proposed in the present work. The state should give the vaccination, in the first instance, to those who are at risk of catching the pandemic flu in the line of their duties of public employment. Thereafter, if there is not sufficient vaccine to give all citizens equally an effective dose, the state should give all citizens an equal chance of receiving an effective dose. This would be the just thing to do because the state has a duty to treat each and all of its citizens impartially and they have a corresponding right to such impartial treatment. Although this article specifically refers to the UK, it is considered that the suggested alternative policy would be applicable generally. The duty to act justly is not merely a local one

In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try to prevent each and everyone from dying. In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations

Coggon’s remarks on a previous paper on active and passive euthanasia elicit a clarification and an elaboration of the argument in support of the claim that there is a moral difference between killing and letting die. The relevant moral duties are different in nature, strength and content. Moreover, not all people who are involved in the relevant situations have the same moral duties. The particular case that is presented in support of the claim that to kill is not the same as to let die is based upon a rejection of consequentialism