Ben Saunders

The novel coronavirus (SARS-CoV-2) pandemic has refocused attention on the issue of mandatory vaccination. Some have suggested that vaccines ought to be mandatory, while others propose more moderate alternatives, such as incentives. This piece surveys a range of possible interventions, ranging from mandates through to education. All may have their place, depending on circumstances. However, it is worth clarifying the options available to policymakers, since there is sometimes confusion over whether a particular policy constitutes a mandate or not. Further, I illustrate a different kind of alternative to mandatory vaccination. Rather than seeking less coercive alternatives to a mandate, we might instead employ an alternative mandate, which requires people to do something less than get vaccinated. For instance, we might merely require people to attend an appointment at a vaccine clinic. Whether this mandatory attendance policy is justified will depend on specific circumstances, but it represents another way to promote vaccination, without mandating it. In some cases, this may represent an appropriate balance between promoting public health goals and respecting individual liberty.

Two recent critics of Mill's qualitative hedonism, Michael Hauskeller and Kristin Schaupp, argue that Mill's distinction between higher and lower pleasures was largely unsuccessful. They allege that Mill failed to demonstrate that some pleasures are lexically preferred to others, and indeed that this can be shown false by the fact that most people would not renounce supposedly lower pleasures, such as chocolate or sex, even for greater amounts of higher pleasures, such as reading or opera. I respond that many of these criticisms rest on uncharitable assumptions or interpretations of Mill's position. We need not suppose that Mill was even trying to do the things he supposedly failed to do. However, considering these objections may lead us to a more plausible interpretation of Mill's views, according to which the quality of pleasures, along with their quantity, contributes towards happiness. There is no need to suppose that ‘higher pleasures’ must be lexically preferred to lower ones, or even to be dogmatic about which pleasures are higher.

The spread of vaccine misinformation may contribute to vaccine refusal/hesitancy and consequent harms. Nonetheless, censorship is often rejected on the grounds of free expression. This article examines John Stuart Mill’s influential defence of free expression but finds that his arguments for freedom apply only to normal, reasonably favourable circumstances. In other cases, it may be permissible to restrict freedom, including freedom of speech. Thus, while Mill would ordinarily defend the right to express false views, such as that vaccines cause autism, he might have accepted restrictions on anti-vaccine misinformation during the present pandemic. This illustrates that even the staunchest defenders of free speech can permit temporary restrictions in exceptional circumstances.

In the event of a pandemic, demand for vaccines may exceed supply. One proposal for allocating vaccines is to use a lottery, to give all citizens an equal chance, either of getting the vaccine or of surviving. However, insistence on strict equality can result in seriously suboptimal outcomes. I argue that the requirement to treat all citizens impartially need not be interpreted to require equal chances, particularly where citizens are differently situated. Assuming that we want to save lives, we should also seek to use vaccine efficiently, so far as this is compatible with equality. Thus, in allocating vaccine, we may want to be sensitive to different levels of need and/or effects on vaccine production. While such policies may result in unequal chances, they may even improve everyone’s chances. In such cases, the resultant inequality is not a violation of impartiality, but a consequence of considering each person’s claim seriously.

Endörfer has recently argued that proponents of the harm principle are wrong to exempt market harms as potential justifications for state interference. I argue that – contrary to suggestions in Endörfer’s article – John Stuart Mill did not exempt market harms from his harm principle. On Mill’s view, the state can (as a matter of principle) legitimately interfere with free markets to prevent market harms where they occur but, on the whole, it is better policy not to interfere. Mill’s general preference for free trade rests on utilitarian considerations and not on his harm principle, which does not exclude market harms.

It is widely assumed that the strongest case for permitting non‐medical sex selection is where parents aim at family balance. This piece criticizes one representative attempt to justify sex selection for family balance. Kluge (2007) assumes that some couples may seek sex selection because they hold discriminatory values, but this need not impugn those who merely have preferences, without evaluative commitments, for a particular sex. This is disputed by those who see any sex selection as inherently sexist because it upholds stereotypes about the sexes. This article takes an alternative approach. I argue that, even if we accept that preference‐based selection is unobjectionable, a policy permitting selection for family balancing does a poor job of distinguishing between value‐based and preference‐based selection. If we wish to permit only preference‐based sex selection we should seek to identify parents’ motives. If we wish to justify a family balancing policy, other arguments are needed.

Douglas Diekema influentially argues that interference with parental decisions is not in fact guided by the child’s best interests, but rather by a more permissive standard, which he calls the harm principle. This article first seeks to clarify this alternative position and defend it against certain existing criticisms, before offering a new criticism and alternative. This ‘harm principle’ has been criticized for (i) lack of adequate moral grounding, and (ii) being as indeterminate as the best interest standard that it seeks to replace. I argue that these are not serious problems. I take Diekema’s negative point to be right—our actual standard for intervention is not literally the best interests of the child—but I disagree with his proposed replacement. First, Diekema’s proposed harm threshold should be more carefully distinguished from Mill’s harm principle. Second, there is no reason to assume that the standard for permissible intervention coincides with the threshold for harm (or serious harm). Thus, I propose that the best alternative to the best interests standard is not a harm principle, but rather a sufficiency threshold between adequate (or ‘good enough’) and inadequate (or ‘substandard’) parenting.

Donald Trump promised to build a wall along the US–Mexico border and to make Mexico pay for it, but this seems to violate the principle of ‘no taxation without representation’ on which the United States was founded. Some democratic theorists propose even more radical principles of inclusion, such as that all those affected by or subject to a decision should have a say in it. But even a more moderate principle, requiring that those who pay must be represented, is sufficient to show that Trump's proposed border wall lacks democratic legitimacy.Export citation.

Arash Abizadeh has recently argued that political communities have no right to close their borders unilaterally, since by doing so they subject outsiders to coercion which lacks democratic justification. His conclusion is that any legitimate regime of border controls must be justified to outsiders. David Miller has sought to defend closed borders by distinguishing between coercion and prevention and arguing that the latter does not require democratic justification. This paper explores a different route, arguing firstly that the requirements of democracy do not provide us with practical guidance unless we also consider other values, such as rights, and secondly that being subject to coercion does not entitle one to democratic justification. These arguments suggest that Abizadeh is wrong to hold closed borders in need of democratic justification.

abstract This paper examines the problem of selecting a number of candidates to receive a good (admission) from a pool in which there are more qualified applicants than places. I observe that it is rarely possible to order all candidates according to some relevant criterion, such as academic merit, since these standards are inevitably somewhat vague. This means that we are often faced with the task of making selections between near‐enough equal candidates. I survey one particular line of response, which says that we should allow our choice of borderline candidates to be guided by non‐relevant criteria such as gender‐balancing. I argue that this would not, as commonly objected, be a case of sex discrimination if it is to be applied either in favour of men or women. Nonetheless, I argue that such policies are problematic because they violate the demand for publicity, which is required for legitimacy and to assure everyone that discrimination has not in fact taken place. Instead, I suggest that, if we are concerned to avoid discrimination, there may be a case for using lotteries as tie‐breakers, not on grounds of fairness but to prevent taint of bias.

In a recent article, Fiona Woollard draws attention to a number of problems, both theoretical and pragmatic, with current discourse around infant feeding. References both to the ‘benefits of breastfeeding’ and ‘harms of formula’ are problematic, since there is no obvious baseline of comparison against which to make these evaluations. Further, she highlights the pragmatic consequences of these linguistic choices. Saying that formula feeding harms babies, for instance, is likely to exacerbate feelings of guilt and shame felt by many mothers who use formula, for various reasons. Since I agree with much that Woollard says, this response is mostly sympathetic, but I wish to draw attention to one point that is largely missing from her analysis. The pragmatic effect of an utterance depends significantly on who is speaking, to whom, and in what context. Thus, we might differentiate between what it is appropriate to say in a professional context, such as an academic journal, from what one might say in a policy document or to a new mother. While we should always be careful about the language that we use, we need not assume that the same language is appropriate in all contexts nor that equal care is always required.

Interference is paternalistic when it restricts an individual’s freedom for their own good. Anti-paternalists, such as John Stuart Mill, object to this for various reasons, including that the individual is usually a better judge of her own interests than the would-be paternalist. However, Wilkinson argues that a Parfitian reductivist approach to personal identity opens the door to what he calls ‘identity-relative paternalism’ where someone’s present action is restricted for the sake of a different future self.1 This is an interesting argument, but it is not clear whether it involves permissible paternalism. At the risk of stating the obvious, permissible paternalism must be both permissible and paternalistic. Wilkinson’s identity-relative paternalism could be either, but not obviously both. If the present and future selves are different individuals, then interference is potentially permissible but no longer paternalistic. Alternatively, they are identical, in which case the interference is genuine paternalism, but cannot be justified by appeal to their distinctness. Wilkinson may escape this dilemma by invoking Parfit, who challenges the common notion that identity is all or nothing.2 According to Parfit’s revisionary view, the present and future self may share some connections but not others. However, once we have identified these similarities and differences, there is no further question whether or not they …

Mill appears to subscribe to the hedonist view that happiness consists in pleasure and the absence of pain, yet he departs from the Benthamite tradition by suggesting that some pleasures are more valuable than others. I suggest that the value of a pleasure depends on its contribution to happiness. Other things equal, more pleasure is more conducive to happiness than less, but some pleasures are also more valuable than others, quantity being equal. These more valuable pleasures are those that Mill describes as higher in quality. Happiness, then, is a function of quality and quantity of pleasures (with quantity itself being a function of intensity and duration). Quality is distinct from quantity and might be traded off against it, since a great quantity of lower quality pleasure can produce more happiness than a smaller quantity of higher quality pleasure, but it is not a good independent of pleasure.

A number of authors criticise opt-out (or ‘deemed consent’) systems for failing to secure valid consent to organ donation. Further, several suggest that mandated choice offers a more ethical alternative. This article responds to criticisms that opt-out does not secure informed consent. If we assume current (low) levels of public awareness, then the explicit consent secured under mandated choice will not be informed either. Conversely, a mandated choice policy might be justifiable if accompanied by a significant public education campaign. However, if this entitles us to assume that members of the public are informed, then an opt-out system would also be justified in the same circumstances. The alleged advantages of mandated choice seem to rest on an unfair comparison, between mandated choice with a public education campaign and an opt-out system without one. While it may be that some countries with opt-out systems should do more to inform their publics, I see no reason to assume that this cannot be done. Indeed, advocates of mandated choice seem committed to thinking it possible to raise awareness. If opt-out systems adopt the same methods, such as writing to every individual, this should also address concerns about whether consent is informed.

Abstractabstract: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.

There has been much discussion of the justifiability of strikes by healthcare workers, but comparatively little discussion of the political processes through which strikes occur. This article focuses on the Trade Union Act 2016, which currently governs strike ballots in the UK. This legislation has important implications for healthcare workers being balloted on strikes (or other forms of industrial action). The article first explains the legal requirements for a strike mandate and illustrates how votes in strike ballots can be counterproductive, bringing about outcomes opposite of what the voter wanted. Second, it argues that the turnout threshold responsible for these surprising results is undemocratic, since it means that outcomes need not reflect the wishes of those balloted. Third, it suggests that this has consequences for how balloted workers ought to vote, if they want the process to be more democratic. In particular, I propose that those who are neutral or indifferent have reason to cast spoiled ballots, in order to negate the turnout threshold. Further, those who oppose a strike also have reasons—if they value democratic decision-making—to vote, even though this may be less effective than abstaining. As I write, in August 2023, junior doctors in the UK are once again being balloted over strike action.1 While the global picture is more varied, strikes by medical professionals have historically been rare in the UK. When British doctors went on strike in 2012, over changes to pensions, it was the first time since 1975.2 Since then, however, industrial action has become more common. Some attribute this to an erosion of patient-centred professional values, which has made workers more prepared to strike in response to deteriorating pay and conditions.3 4 Whether or not this is the explanation, the increased prevalence of strikes has caused some concern. It is often …