James Stacey Taylor

The Affordable Care Act has been touted as a long‐overdue remedy for what is perceived to be the chronic problem of large numbers of Americans living without adequate health insurance. While much of the discussion of the ACA has focused on its legality, it should also be assessed on the basis of its economic implications and its moral acceptability. On its face, the ACA appears to do well on both counts. Given that the uninsured often secure their health care from expensive emergency room treatment (from which they cannot be excluded and whose cost is often borne by third parties), expanding insurance to cover them (and hence to give them access to less expensive treatments) appears to make economic sense. Similarly, it might appear that providing access to insurance for people who otherwise could not afford it, or who would be denied it as a result of having medical conditions that they are not responsible for, would be morally laudable. But these appearances deceive: The ACA is neither economically sound nor morally acceptable. To paraphrase Oscar Wilde, to fail on one of these criteria may be misfortune; to fail on both looks like carelessness.

Schweda and Schicktanz argue that the debate over the ethics of using financial incentives to procure human transplant organs rests on socioempirical premises that need to be critically assessed. They contend that once this is achieved a completely new perspective on the debate should be adopted, with organ donation being viewed primarily as a reciprocal social interaction between donor and recipient. This paper challenges this conclusion, arguing that rather than supporting a new perspective on the debate over the commercial procurement of organs, the observations of Schweda and Schicktanz support the view that human organs should be commercialized

Teck Chuan Voo and Soren Holm argue that “organs should be inheritable if they were to be socially and legally recognised as tradable property.”1 To support this view they first observe that “…legal recognition of objects as property… opens up the possibility of the legal recognition of the survival of the property rights and their inheritability after the death of the source/owner, even if those rights are intimately bound with the person.”1 They also note that if organs are tradable property then they could be sold by their current owners for removal by the buyer after the original owner dies. Having established that a person's property rights in her organs should be respected in this way if organs are tradable property, Voo and Holm hold that “[p]rima facie, organs should be disposable by testation”.1 They believe that this claim is supported by the same consequentialist reasons that support organs being recognised as tradable property: that this increases persons’ freedom and control over their organs, and increases transfers of transplantable organs to persons who need them. But while these reasons support recognising organs as tradable property, they do not support their being …

In recent years a concern with the value of personal autonomy has come to dominate discussions in medical ethics. This emphasis on autonomy has naturally led to discussions of what criteria must be met for a person to be autonomous, or to be autonomous with respect to her decisions, her actions, or those of her desires that motivate her to make or to perform the decisions or the actions that she makes or does. It has also led to discussions of whether autonomy is valuable in itself, instrumentally valuable, or whether its value is a combination of the two: that a person’s autonomy is valuable to her not merely as a means to securing something else that she finds valuable, but is valuable as its possession is part of what makes her life go well.Questions that concern the value of autonomy are necessarily linked to the prior question of the precise nature of autonomy. There are two main approaches to answering this question within the Western philosophical tradition. The first is Kantian ..

Markets have long had a whiff of sulphur about them. Plato condemned innkeepers, whose pursuit of profit he believed led them to take advantage of their customers, Aristotle believed that the pursuit of profit was indicative of moral debasement, and Cicero held that retailers are typically dishonest as this was the only path to gain. And even those who are more favorably disposed towards markets in general are frequently inclined to be suspicious of markets in medical goods and services. For example, Margaret Thatcher supported the legal prohibition of markets in kidneys despite being arguably the most pro-market Prime Minister the United Kingdom saw in the 20th century.

In recent years there has been much philosophical discussion over the question of whether the prohibitions on markets in such items as human body parts and gene sequences, and services such as human reproductive labor and sex, should be lifted. Yet despite the attention paid to this issue there are been surprisingly little discussion of the question of whether markets in certain items that are currently freely traded should be restricted or eliminated. In particular, there has been little discussion of the question of whether markets in items that could be readily used to deceive people should be restricted. I argue in this paper that one of the central moral values of the contemporary West – respect for personal autonomy – requires that such markets be restricted.

In a recent paper Carol Hay has argued for the conclusion that “a woman who has been sexually harassed has a moral obligation to confront her harasser.” I will argue in this paper that Hay’s arguments for her conclusion are unsound, for they rest on both a misconstrual of the nature of personal autonomy, and a misunderstanding of its relationship to moral responsibility. However, even though Hay’s own arguments do not support her conclusion that women have a duty to resist sexual harassment this conclusion can draw support from arguments that are independent of hers. Women, then, do indeed have a moral obligation to confront those who sexually harass them.

In ‘Three Arguments Against Prescription Requirements’, Jessica Flanigan argues that ‘prescription drug laws violate patients' rights to self-medication’ and that patients ‘have rights to self-medication for the same reasons they have rights to refuse medical treatment according to the doctrine of informed consent , claiming that the strongest of these reasons is grounded on the value of autonomy. However, close examination of the moral value of autonomy shows that rather than being the strongest justification for the DIC, respect for the value of autonomy is actually the weakest, and it is dependent upon the first two well-being-based justifications for the DIC. Recognising this has important implications for Flanigan's argument against prescription requirements

It is widely accepted that a person can be harmed by events that occur after her death. The most influential account of how persons can suffer such posthumous harm has been provided by George Pitcher and Joel Feinberg. Yet, despite its influence (or perhaps because of it) the Feinberg-Pitcher account of posthumous harm has been subject to several well-known criticisms. Surprisingly, there has been no attempt to defend this account of posthumous harm against these criticisms, either by philosophers who work on the metaphysics of death or by those who draw upon this account of posthumous harm in their work in other philosophical fields. This paper will rectify this omission, by defending this view against the criticisms it has been subject to—a defense that will both be of intrinsic interest to those who work on the metaphysics of death and that will remedy the lacunae in the wide-ranging philosophical literature that draws upon this account of how posthumous harm is possible.

A common argument used to defend markets in ‘contested commodities’ is based on the value of personal autonomy. Autonomy is of great moral value; removing options from a person's choice set would compromise her ability to exercise her autonomy; hence, there should be a prima facie presumption against removing options from persons’ choice sets; thus, the burden of proof lies with those who wish to prohibit markets in certain goods. Christopher Freiman has developed a version of this argument to defend markets in votes. I argue that Freiman's argument fails, and that its failure illustrates the falsity of the widespread claim that the more options a person has available to her the better able she will be to exercise her autonomy. In Part 1, I outline Freiman's argument from ‘the presumption of voter liberty’ for legalising markets in votes. In Part 2, I argue that the option to sell one's vote in a legal market for them would be a ‘constraining option’ – an option which, if chosen, would be likely to lead to a diminution in a person's future ability to exercise her autonomy. In Part 3, I respond to objections to my arguments.

Many still oppose legalizing markets in human organs on the grounds that they are morally repugnant. I will argue in this paper that the repugnance felt by some persons towards sales of human organs is insufficient to justify their prohibition. Yet this rejection of the view that markets in human organs should be prohibited because some persons find them to be morally repugnant does not imply that persons’ feelings of distress at the possibility of organ sales are irrational. Eduardo Rivera-Lopez argues that such instinctive distress is an appropriate response to the perception that certain kinds of arguments that are offered in favor of legalizing organ sales are “in an important sense, illegitimate.” Having argued that repugnance should not ground the prohibition of markets in human organs, I will also argue that the moral distress that some feel towards certain arguments that favor such markets is not rationally defensible, either

In 1998, The Lancet published a research paper by Andrew Wakefield that provided support to the formerly-discredited theory that the Measles, Mumps, Rubella (MMR) vaccine could cause colitis and autism spectrum disorders (Wakefield et al. 1998). Although this paper was fully retracted in 2010 after being exposed as fraudulent, it served as a catalyst for concerns about the safety of vaccination, both the MMR vaccine in particular and vaccination in general. While the scientific consensus concerning both the MMR vaccine and others that are routinely provided to persons in developed Western countries is that the benefits of receiving them far outweigh the risks, there is still serious concern on the part of some parents about the safety of vaccinating their children. Moreover, in addition to concerns about the safety of vaccination some parents are concerned about the effects that receiving certain vaccinations will have upon their childrens’ volitional actions. For example, the possibil