Leslie Francis

In sports, the concept of a “level playing field” is much praised but not well understood. One way to construct the idea is in terms of the rules of the game: if the rules are public, consistently enforced, and respected by players, the game is fair. Another approach to construction is in terms of justice: some rules of the game are unfair and thus the field is not level. Interestingly, although the “rules of the game” metaphor is drawn from games to sports, the corresponding idea of a level playing field is not incorporated into the design of games. This chapter explores the relationship between ideas of a level playing field and rules of games. It argues that how games are constructed sheds light on constructivist accounts of level playing fields in sports. Games take many forms and are fluid rather than static; rules develop and change over time. Sports do so as well, responding to pressures for inclusion and fairness. There is no one perfectly level field; there are fields that are more or less level, in different directions and dimensions.

Understanding the intangible harms of privacy violations has proved daunting. Yet it is vitally important to understanding the value of privacy beyond economic harms of privacy loss. This chapter explores how violations of employee privacy affect the dignity of work as a lens for understanding intangible privacy harms. Employee privacy has drawn less attention in recent privacy discussions than informational privacy, even though it is seriously under protected in the U.S. today. Indeed, privacy has largely been linked to employment through the possibility that the information individuals reveal on social media may unwittingly affect their employment prospects and thus cause economic harm. Yet arguments for employee privacy—of information, space, and private lives—also draw on dignity in the sense of protection from vulnerability from loss of important human goods such as the ability to function as a citizen and the need for meaningful work. In this chapter, we explore these dignity-based justifications for employee privacy. We then use this discussion to illuminate when non-consensual uses of information drawn from individuals are particularly troubling with respect to the non-economic harms they may cause.

Surveillance began with counting the numbers of people in the population. At various times in history, numbers have been used to assess the overall strength of the population, to identify the march of dangerous contagion, or to determine needs for food or labor. But even simple counting of population numbers, vital statistics, or reports of disease has been controversial. Information is power and the most rudimentary surveillance can be used both for good and for harm. This chapter sets ethical questions about these basic surveillance methods in historical and epistemological context. It gives examples of uses of data about population numbers, vital statistics, or outbreaks that have been clearly beneficial, as well as examples that have bordered on the genocidal. Counting numbers, as a rudimentary epidemiological method, also presents the opportunity to explore ethical problems raised by epidemiology as a science, such as incomplete data, biased data, or false negatives or positives. Today, with increasing understanding of disease and availability of prevention or treatment, the advantages of outbreak detection may be shared far more widely and more equally. Nonetheless, outbreak detection can generate fear and hostility if patterns of disease track otherwise disfavored groups. COVID-19 has revealed the importance of demographic data about the distribution of disease burdens—data that may either generate mistrust as people see their disadvantage starkly, or that may foster trust if the result is increased attention to disparities in treatment and in health.

Bigotry distractions are strategic invocations of racism, transphobia, or negative stigma toward other marginalized groups to shape political discourse. Although the vast majority of Americans agree on large policy issues ranging from reducing air pollution to prosecuting corporate crime, bigotry distractions divert attention from areas of agreement toward divisive identity issues. This article explores how the nefarious targeting of identity groups through bigotry distractions may be the tallest barrier to health reform, and social change more broadly. The discussion extends the literature on dog whistles, strategic racism, and scapegoating.

J.S. Russell explores sport as a special world of play disengaged from at least some of the moral requirements of ordinary life. This essay explores the opposite question, whether sport can be disengaged from the presence of injustice or cruelty in society more generally. It distinguishes two ways in which the relevance of injustice or cruelty might be framed. One is whether the histories of discrimination faced by particular athletes should be accommodated as the rules of a sport are applied to them. The other is whether sports should be created or shaped to address injustices or cruelty in the larger society, perpetuating, entrenching, or ignoring existing moral failures. Categorizations based on disability and sex or gender identity illustrate.

Identifying cases of contagious disease and following any chains of transmission from them is a mainstay of public health efforts to stop disease spread. This method of surveillance is ineffective, however, if people cannot be found or refuse to reveal contacts. It also declines in efficacy as disease spreads widely in a community or is transmitted in ways such as aerolisization that may make it difficult to recognize that contacts have occurred. This chapter considers the ethics of contact tracing, arguing that the method has far too often been associated with moral condemnation of behaviours such as non-marital sex or with stigmatization of groups. The chapter then explores how contact tracing can be combined with treatment and other support to facilitate warranted trust in the use of this traditional surveillance method.

In this view from 2007–2009, the ethical challenges facing a potential global effort to control infectious disease are explored; they provide sobering insight into the challenges of later decades. Despite the devastating pandemic of HIV/AIDS that erupted in the early 1980s, despite the failure to eradicate polio and the emergence of resistant forms of tuberculosis that came into focus in the 1990s, and despite newly emerging diseases like Severe Acute Respiratory Syndrome (SARS) in 2003 and the fearsome prospect of human-to-human avian flu, it is nevertheless a time of some excitement over prospects for effective control of much of infectious disease. Funded by national and international governmental and nongovernmental organizations (NGOs), private foundations, and even popular entertainers, large-scale new efforts are under way to address global killers like AIDS, tuberculosis, and malaria, among others. This “marvelous momentum” can be seen as part of a continuing effort from the time of Jenner onward. Extrapolating from this, we explore the notion of a “comprehensive global effort for the eradication, elimination or control of infectious disease”, with particular attention to the ethical issues that arise. This is to “think big” about disease-control efforts that are now often done in piecemeal ways. This chapter identifies five tracks along which such efforts need to be pursued: (1) national and international organizations and the development of collective will; (2) epidemiological and health care infrastructure; (3) scientific development; (4) religious, social, and cultural considerations; (5) legal and social protections for individuals and groups. Each of these poses significant ethical issues which, we argue, should be viewed in a comprehensive way, to ensure that practice, research, and policy in each of these areas understands the person with communicable infectious disease as both victim and (potential) vector.

Privacy is one of our most essential values, but popular understanding of it lags far behind the heat the concept generates. It's easy to understand why. The concept itself has shifted in U.S. law from autonomy, to property, to confidentiality. Further, with a host of cultural differences as to how privacy is understood globally and in different religions, and with nonstop technological advancements, its significance is continually evolving. Leslie P. and John G. Francis draw upon their extensive expertise in law, philosophy, political science, regulatory policy, and bioethics to parse privacy's meaning in the modern age. This book will inform, appease, and alert readers to what is at stake when privacy is breached.

_The Blackwell Guide to Medical Ethics_ is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy.

If the COVID-19 crisis has brought any benefits, one is the increased attention paid to persons with disabilities in the contexts of clinical medicine and public health. There has been a great deal of insightful discussion since the outbreak about controversial disability issues the pandemic has brought to light. For a population often overlooked in both academic circles and the public square, mere visibility is a victory. There are at least two important respects in which the discussion remains underdeveloped, however.First, much of the work being done has focused on disability considerations in policies governing triage and the rationing of critical care resources under crisis conditions. This is undoubtedly an...

It is a welcome development when academic philosophy starts to concern itself with practical issues, in such a way as to influence people's lives. Recently this has happened with one moral issue in particular—but infortunately it is the wrong issue, and people's actions have been influenced in the wrong way. The issue is that of the moral status and treatment of animals. A number of philosophers have argued for what they call ‘animal liberation’, comparing it directly with egalitarian causes such as women's liberation and racial equality and suggesting that, if racism and sexism are rationally indefensible, so is ‘speciesism’. If one ought to give equal consideration to the interests of all human beings, then, so they daim, one must on the same grounds and in the same way recognize that ‘all animals are equal’, be they human or non-human. We believe that this assimilation of ‘animal liberation’ to human liberation movements is mistaken

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for asserting that healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard.

A persistent paradox apparently infects disability civil rights claims. On the one hand, these rights claims are often understood to apply only to those who are sufficiently impaired in body or in mind to qualify for them because of the disadvantage they endure. On the other hand, asserting significant impairments threatens to undermine the plausibility of these claims as civil rights rather than as welfare for those who are dependent and in need of extra help. Behind this paradox lies a type of categorical understanding of disability civil rights: that disability civil rights are only for those who fall into a category of disability and that this category should be defined in a particular way, in terms of disadvantaging disablement. In this article, I dispel this paradox by deploying a critical analysis of Elizabeth Barnes’s account of physical disability in her recent book, The Minority Body. In her book, Barnes makes the important critical point that disability is not “bad” difference. Instead, she argues that physical disability is a physical condition that the disability rights community is working to promote justice for. I argue that this account fails as a project of ameliorative social metaphysics because it fails to understand the role of impairment in the construction of disability antidiscrimination law. I also argue that her account risks privileging physical disability and is thus problematic as a starting place for examining disability justice.

The United States, like other countries facing rising health care costs, is pursuing a commitment to interoperable electronic health records. Electronic records, it is thought, have the potential to reduce the risks of error, improve care coordination, monitor care quality, enable patients to participate more fully in care management, and provide the data needed for research and surveillance. Interoperable electronic health records on a national scale — the ideal of a national health information network — seem likely to magnify these advantages. Thus, the recent economic stimulus package contains considerable funding for the development of “health information technology architecture that will support the nationwide electronic exchange and use of health information in a secure, private, and accurate manner.”