A. M. Viens

Critical literatures, and public discourses, on public health policies and practices often present fixated concerns with paternalism. In this paper, rather than focus on the question of whether and why intended instances of paternalistic policy might be justified, we look to the wider, real-world socio-political contexts against which normative evaluations of public health must take place. We explain how evaluative critiques of public health policy and practice must be sensitive to the nuance and complexity of policy contexts. This includes sensitivity to the ‘imperfect’ reach and application of policy, leading to collateral effects including collateral paternalism. We argue that theoretical critiques must temper their demandingness to real-world applicability, allowing for the detail of social and policy contexts, including harm reduction: apparent knock-down objections of paternalism cannot hold if they are limited to an abstract or artificially-isolated evaluation of the reach of a public health intervention.

To address the complex challenge of global antimicrobial resistance (AMR), a pandemic treaty should include mechanisms that 1) equitably address the access gap for antimicrobials, diagnostic technologies, and alternative therapies; 2) equitably conserve antimicrobials to sustain effectiveness and access across time and space; 3) equitably finance the investment, discovery, development, and distribution of new technologies; and 4) equitably finance and establish greater upstream and midstream infection prevention measures globally. Biodiversity, climate, and nuclear governance offer lessons for addressing these challenges.

Emergencies are extreme events which threaten to cause massive disruption to society and negatively affect the physical and psychological well-being of its members. They raise important practical and theoretical questions about how we should treat each other in times of 'crisis'. The articles selected for this volume focus on the nature and significance of emergencies, demonstrate the normative implications of emergencies and provide multi-disciplinary perspectives on the ethics of emergency response.

Our initial response to COVID-19 has been plagued by a series of failures—many of which have extended inequity within and across populations, especially in low- and middle-income countries. The global health governance of pandemic preparedness and response needs to move further away from the advocacy of a one-size-fits-all approach that tends to prioritize the interests of high-income countries towards a context-sensitive approach that gives equity a central role in guiding our pandemic preparedness and response strategies.

The author comments on several articles on addiction. Recent developments in neuroscience suggest that addicted individuals have substantial impairments in the cognitive control of voluntary behavior. The author differs on the observations that addicts either act on desires that are not conducive to rational action. The author also states that addiction seems to be a prime manifestation of akrasia, in which one fails to be motivated to act in accordance with what one judges ought to be done. Accession Number: 24077920; Authors: Viens, A. M. 1; Email Address: [email protected]; Affiliations: 1: University of Oxford, Hertford College, Oxford, United Kingdom; Subject: EDITORIALS; Subject: ADDICTIONS; Subject: COGNITION; Subject: DECISION making; Subject: AKRASIA; Subject: NEUROSCIENCES; Number of Pages: 3p

There is an underdeveloped potential for using neuroscience as a particular input in the process of law-making. This paper examines one such instance in the area of public health law. Neuroscience could play an important role in elucidating and strengthening the relevance of the conditions underlying and re-enforcing our ability to cooperate in balancing the benefits and burdens necessary to achieve particular goods; for instance, the protection of public health in an outbreak of pandemic influenza. In particular, I shall focus on how a better understanding of the neurobiological basis of reciprocity could be used to help increase support and compliance with public heath laws—especially those involving restrictive measures (such as quarantine and isolation).

In this paper, we provide a state-of-the-art overview of the ethical challenges that arise in the context of antimicrobial resistance, which includes an introduction to the contributions to the symposium in this issue. We begin by discussing why AMR is a distinct ethical issue, and should not be viewed purely as a technical or medical problem. In the second section, we expand on some of these arguments and argue that AMR presents us with a broad range of ethical problems that must be addressed as part of a successful policy response to emerging drug resistance. In the third section, we discuss how some of these ethical challenges should be addressed, and we argue that this requires contributions from citizens, ethicists, policy makers, practitioners and industry. We conclude with an overview of steps that should be taken in moving forward and addressing the ethical problems of AMR

The aim of establishing a consistent and unified approach in law concerning the ethics of commercializing human embryos and their derivative parts, products, or related technologies remains incomplete within the European Union. In an attempt to elucidate these problems and implications, I examine three separate moral considerations (i.e., exploitation, commodification, and objectification) that could be used to ground the putative wrongness associated with commercializing stem cells—in particular patenting these materials. It is argued that the moral justification for legal prohibitions on such biological materials for commercial purposes is faced by a number of problematic issues.

While Powers and Faden do not consider possible anti-paternalism objections to their view, there are two variants of this objection that a social justice perspective is susceptible to. It is worth exploring which responses to such objections may be less promising than others. It is argued that for most public health measures targeting the disadvantaged, theorists and practitioners taking a social justice perspective should bite the paternalist bullet. Insofar as the government has the ability to reduce mortality and morbidity within the population in a way that is fair and in everyone’s interests, then the use of paternalistic means or resultant paternalistic effects should be thought to be the lesser evil

The right to bodily integrity is a controversial issue within moral, political and legal discourse. This first collection of scholarly research articles provides a comprehensive overview of the debates around the ethical and legal aspects of the right to bodily integrity and its implications in theory and practice. The selected essays examine topics such as pregnancy and reproduction, altering children's bodies, transplantation, controversial modifications and surgeries, and experimentation and dead bodies.

In this paper, we explore the role of reciprocity in the employment of restrictive measures in contexts of contagion. Reciprocity should be understood as a substantive value that governs the use, level and extent of restrictive measures. We also argue that independent of the role reciprocity plays in the legitimisation the use of restrictive measures, reciprocity can also motivate support and compliance with legitimate restrictive measures. The importance of reciprocity has implications for how restrictive measures should be undertaken when preparing and evaluating public health responses to contagion.

Descartes is typically interpreted as asserting two related theses: 1) that the will is absolutely free in the sense that no bodily state can compel it or restrain its activity; and 2) that error is always avoidable, no matter what the condition of the body. On the basis of Descartes’s discussions of insanity and dreaming, I argue that both of these interpretive claims are false. In other words, Descartes acknowledged that a diseased or otherwise out of sorts body can compel the will to affirm obscure and confused perceptions. After marshalling textual evidence for this conclusion, I go on to show how Descartes’s acknowledgment of physically induced impaired judgment can be squared with his unqualified assertions of free will, his commitment to the non-deceptiveness of God, and his epistemology.

The goal of improving public health involves the use of different tools, with the law being one way to influence the activities of institutions and individuals. Of the regulatory mechanisms afforded by law to achieve this end, criminal law remains a perennial mechanism to delimit the scope of individual and group conduct. However, criminal law may promote or hinder public health goals, and its use raises a number of complex questions that merit exploration. This examination of the interface between criminal law and public health brings together international experts from a variety of disciplines, including law, criminology, public health, philosophy and health policy, in order to examine the theoretical and practical implications of using criminal law to improve public health.