Aksel Sterri

The global allocation of vaccines during the COVID-19 pandemic is widely perceived as unfair. Priority was given to countries that paid the most with little or no concern for who needed the vaccines the most. No satisfactory institutions have been established to allocate vaccines in a future pandemic. In this paper, we join reformers in proposing a new scheme for vaccine distribution: a global auction for vaccines where profits are distributed fairly to participating countries. Our proposal improves upon previous suggestions morally by taking countries’ differing valuations of money and vaccines seriously. Since an auction is in the interest of both vaccine manufacturers and high-income countries, it is also politically feasible. A global redistributive auction for vaccines thus promises to be a robust and morally desirable way to allocate vaccines.

I boken _Aktiv dødshjelp - etikk ved livets slutt_ (2019) tar vi til orde for at vi bør legalisere dødshjelp i Norge. Personer som lider uutholdelig, ikke har utsikter til bedring og har tatt et kompetent, konsistent og ikke presset valg om å avslutte livet, bør bli tilbudt hjelp til å en trygg, skånsom og verdig måte. I artikkelen "Bør dødshjelp legaliseres i Norge?" kritiserer Morten Magelssen argumentasjonen i vår bok. Han er ikke den første til å kritisere oss. Vi har tidligere svart på Lars Johan Materstvedts (2022) kritikk av boken (Sterri og Moen 2023). I denne artikkelen svarer vi på Magelssens kritikk. Magelssen skriver at han har to formål med artikkelen. I tillegg til å ville vise hvor vår argumentasjon kommer til kort, vil han også demonstrere hvordan en ny fremgangsmåte for å diskutere dødshjelp. Vi vil begynne med å diskutere Magelssens metode.

Should health authorities exclude vaccines with a small risk of severe side effects during a deadly pandemic, even if this is expected to lead to more harm due to delayed vaccination and prolonged social distancing measures? This question was at the centre of controversy amid the COVID-19 pandemic, where countries excluded vaccines with harmful side effects for some or all groups. Through this case study, I test the normative force and empirical applicability of principles for vaccine allocation and argue for the superiority of a Principle of Sufficient Benefit, according to which health authorities should only offer vaccines that sufficiently improve the recipient’s prospects. I present multiple challenges to the principle: that it is self-defeating, leads to unfair and societally worse outcomes, and prevents people from doing their duties. Given the force of these objections, I conclude that the most satisfactory justification for excluding riskier vaccines fails. In the final section, I argue that compensating people for receiving vaccines with higher risks is a way of retaining the force of the Principle of Sufficient Benefit while accounting for the possibly unfair and harmful consequences that result from putting the recipients first.

The global allocation of vaccines during the COVID-19 pandemic is widely perceived as unfair. Priority was given to countries that paid the most with little or no concern for who needed the vaccines the most. No satisfactory institutions have been established to allocate vaccines in a future pandemic. In this paper, we join reformers in proposing a new scheme for vaccine distribution: a global auction for vaccines where profits are distributed fairly to participating countries. Our proposal improves upon previous suggestions morally by taking countries’ differing valuations of money and vaccines seriously. Since an auction is in the interest of both vaccine manufacturers and high-income countries, it is also politically feasible. A global redistributive auction for vaccines thus promises to be a robust and morally desirable way to allocate vaccines.

Organ shortage is a major survival issue for millions of people worldwide. Globally 1.2 million people die each year from kidney failure. In this paper, we critically examine and find lacking extant proposals for increasing organ supply, such as opting in and opt out for deceased donor organs, and parochial altruism and paired kidney exchange for live organs. We defend two ethical solutions to the problem of organ shortage. One is to make deceased donor organs automatically available for transplant without requiring consent from the donor or their relatives. The other is for society to buy nonvital organs in a strictly regulated market and provide them to people in need for free.

In this article, I argue we have collective duties to people who suffer from kidney failure and these duties are best fulfilled through a government-monopsony market in kidneys. A government-monopsony market is a model where the government is the sole buyer, and kidneys are distributed according to need, not ability to pay. The framework of collective duties enables us to respond to several of the most pressing ethical and practical objections to kidney markets, including Cécile Fabre's objection that it is unjust to be paid to do one's duty, Simon Rippon's objections that it is harmful to be pressured to sell a kidney and that a market is unfair, Richard Titmuss's crowding out objection, and Ronald Dworkin's objection that body parts should not be among the goods we owe each other.

Worldwide 1.2 million people are dying from kidney failure each year, and in the USA alone, approximately 100 000 people are currently on the waiting list for a kidney transplant. One possible solution to the kidney shortage is for governments to pay donors for one of their healthy kidneys and distribute these kidneys according to need. There are, however, compelling objections to this government-monopsony model. To avoid these objections, I propose a small adjustment to the model. I suggest we reward kidney sellers with both money and a ceremony that celebrates their noble act. They should, in other words, receive a prize rather than a price.

Do we have stronger duties to assist in emergencies than in nonemergencies? According to Peter Singer and Peter Unger, we do not. Emergency situations, they suggest, merely serve to make more salient the very extensive duties to assist that we always have. This view, while theoretically simple, appears to imply that we must radically revise common-sense emergency norms. Resisting that implication, theorists like Frances Kamm, Jeremy Waldron, and Larry Temkin suggest that emergencies are indeed normatively exceptional. While their approach is more in line with common-sense, however, it is theoretically less simple, and it is has proven difficult to justify the exception. In this paper we propose a model of emergencies that we call the Informal-Insurance Model, and explain how this can be used to combine theoretical simplicity with common-sense emergency norms.

In this chapter, we ask three questions about pedophilia: Is it immoral to be a pedophile? Is it immoral for pedophiles to seek out sexual contact with children? Is it immoral for pedophiles to satisfy their sexual preferences by using computer-generated graphics, sex dolls, and/or sex robots that mimic children? We argue that it is not immoral to be a pedophile, it is immoral for pedophiles to seek out sexual contact with children because of the expected harm to children, and it is morally permissible for pedophiles to satisfy their sexual preferences in ways that do not involve any real children.

When widespread use of sex‐selective abortion and sex selection through assisted reproduction lead to severe harms to third parties and perpetuate discrimination, should these practices be banned? In this paper I focus on India and show why a common argument for a ban on sex selection fails even in these circumstances. I set aside a common objection to the argument, namely that women have a right to procreative autonomy that trumps the state's interest in protecting other parties from harm, and argue against the ban on consequentialist grounds. I perform a pairwise comparative analysis of sex selection and its plausible alternatives and argue that that the ban fails to improve the state of affairs relative to a scenario without a ban. The ban makes the situation worse, especially for mothers and their daughters. India should therefore repeal its ban on sex selection.

English summary: Provocative Public Philosophy In 2017, I argued that people with Down syndrome cannot live full lives. This sparked a heated debated in the Norwegian public sphere. This gave rise to a debate over what academics should and should not say in public. A certain form of public philosophy, what I will call provocative public philosophy, was criticized for being harmful, imperialistic, for eroding trust in philosophers, and for creating too much noise. In this article I will, in light of the Down syndrome debate, defend provocative public philosophy against these allegations. Norsk sammendrag: En uttalelse om at personer med Downs syndrom ikke kan leve fullverdige liv, satte i gang en stor og opphetet debatt i den norske offentligheten i 2017. Denne ga opphav til en mer overordnet debatt om hva akademikere bør og ikke bør si i offentligheten. En viss form for offentlig filosofi, det jeg vil kalle provokativ offentlig filosofi, er blitt utpekt som synder. I denne artikkelen vil jeg, med utgangspunkt i debatten om fullverdige liv, forsvare provokativ offentlig filosofi mot både epistemiske og etiske innvendinger.