•  5
    Some authors argue that it is permissible for clinicians to conscientiously provide abortion services because clinicians are already allowed to conscientiously refuse to provide certain services. Call this the symmetry thesis. We argue that on either of the two main understandings of the aim of the medical profession—what we will call “pathocentric” and “interest‐centric” views—conscientious refusal and conscientious provision are mutually exclusive. On pathocentric views, refusing to provide a …Read more
  •  5
    Reelin’ In The Years: Age and Selective Restriction of Liberty in the COVID-19 Pandemic
    with David Motorniak and Julian Savulescu
    Journal of Bioethical Inquiry 20 (4): 685-693. 2023.
    During the COVID-19 pandemic, focused protection strategies including selective lockdowns of the elderly were proposed as alternatives to general lockdowns. These selective restrictions would consist of isolating only those most at risk of COVID-19 hospitalization and subsequent use of healthcare resources. The proposal seems to have troubling implications, including the permissibility of selective lockdown on the basis of characteristics such as ethnicity, sex, disability, or BMI. Like age, the…Read more
  •  27
    We discuss the relationship between expertise, expert authority, and trust in the case of vaccine research and policy, with a particular focus on COVID-19 vaccines. We argue that expert authority is not merely an epistemic notion, but entails being trusted by the relevant public and is valuable if it is accompanied by expert trustworthiness. Trustworthiness requires, among other things, being transparent, acknowledging uncertainty and expert disagreement (e.g., around vaccines’ effectiveness and…Read more
  •  8
    Freedom, diseases, and public health restrictions
    Bioethics 37 (9): 886-896. 2023.
    The debate around lockdowns as a response to the recent pandemic is typically framed in terms of a tension between freedom and health. However, on some views, protection of health or reduction of virus‐related risks can also contribute to freedom. Therefore, there might be no tension between freedom and health in public health restrictions. I argue that such views fail to appreciate the different understandings of freedom that are involved in the trade‐off between freedom and health. Grasping th…Read more
  •  3
    I argue that appeals to conscience do not constitute reasons for granting healthcare professionals exemptions from providing services they consider immoral (e.g. abortion). My argument is based on a comparison between a type of objection that many people think should be granted, i.e. to abortion, and one that most people think should not be granted, i.e. to antibiotics. I argue that there is no principled reason in favour of conscientious objection qua conscientious that allows to treat these tw…Read more
  •  8
    Conscientious Objection in Healthcare: Neither a Negative Nor a Positive Right
    Journal of Clinical Ethics 31 (2): 146-153. 2020.
    Conscientious objection in healthcare is often granted by many legislations regulating morally controversial medical procedures, such as abortion or medical assistance in dying. However, there is virtually no protection of positive claims of conscience, that is, of requests by healthcare professionals to provide certain services that they conscientiously believe ought to be provided, but that are ruled out by institutional policies. Positive claims of conscience have received comparatively littl…Read more
  •  10
    The Medical Ethics Curriculum in Medical Schools: Present and Future
    with Julian Savulescu and Sharyn Milnes
    Journal of Clinical Ethics 27 (2): 129-145. 2016.
    In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students’ levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three ma…Read more
  •  89
    What in the World Is Collective Responsibility?
    with Neil Levy
    Dialectica 72 (2): 191-217. 2018.
  •  13
    Stop Wishing. Start Doing!: Motivational Enhancement Is Already in Use
    American Journal of Bioethics Neuroscience 6 (1): 29-31. 2015.
  •  86
    Quarantine, isolation and the duty of easy rescue in public health
    with Thomas Douglas, Hannah Maslen, and Julian Savulescu
    Developing World Bioethics 18 (2): 182-189. 2018.
    We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such pub…Read more
  •  37
    Nudging Immunity: The Case for Vaccinating Children in School and Day Care by Default
    with Lucius Caviola, Hannah Maslen, Thomas Douglas, Anne-Marie Nussberger, Nadira Faber, Samantha Vanderslott, Sarah Loving, Mark Harrison, and Julian Savulescu
    HEC Forum 31 (4): 325-344. 2019.
    Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children…Read more
  •  382
    In a paper recently published in this journal, Navin and Largent argue in favour of a type of policy to regulate non-medical exemptions from childhood vaccination which they call ‘Inconvenience’. This policy makes it burdensome for parents to obtain an exemption to child vaccination, for example, by requiring parents to attend immunization education sessions and to complete an application form to receive a waiver. Navin and Largent argue that this policy is preferable to ‘Eliminationism’, i.e. t…Read more
  •  38
  •  41
    Regulating Genome Editing: For an Enlightened Democratic Governance
    Cambridge Quarterly of Healthcare Ethics 28 (1): 76-88. 2019.
    How should we regulate genome editing in the face of persistent substantive disagreement about the moral status of this technology and its applications? In this paper, we aim to contribute to resolving this question. We first present two diametrically opposed possible approaches to the regulation of genome editing. A first approach, which we refer to as “elitist,” is inspired by Joshua Greene’s work in moral psychology. It aims to derive at an abstract theoretical level what preferences people w…Read more
  •  21
  •  16
    The Ethics of Human Enhancement: Understanding the Debate (edited book)
    with Steve Clarke, Julian Savulescu, Tony Coady, and Sagar Sanyal
    Oxford University Press UK. 2016.
    We humans can enhance some of our mental and physical abilities above the normal upper limits for our species with the use of particular drug therapies and medical procedures. We will be able to enhance many more of our abilities in more ways in the near future. Some commentators have welcomed the prospect of wide use of human enhancement technologies, while others have viewed it with alarm, and have made clear that they find human enhancement morally objectionable. The Ethics of Human Enhanceme…Read more
  •  26
    The Ethics of Human Enhancement: Understanding the Debate (edited book)
    with Steve Clarke, Julian Savulescu, C. A. J. Coady, and Sagar Sanyal
    Oxford University Press. 2016.
    An international team of ethicists refresh the debate about human enhancement by examining whether resistance to the use of technology to enhance our mental and physical capabilities can be supported by articulated philosophical reasoning, or explained away, e.g. in terms of psychological influences on moral reasoning.
  •  222
    Conscientious Objection to Vaccination
    Bioethics 31 (3): 155-161. 2016.
    Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases ; second, if so, to what constraints or requirements should conscientious objection to vaccination be subject. To address these questions, we consider an analogy between CO …Read more
  •  1
    Challenging human enhancement
    In Steve Clarke, Julian Savulescu, C. A. J. Coady, Alberto Giubilini & Sagar Sanyal (eds.), The Ethics of Human Enhancement: Understanding the Debate, Oxford University Press. 2016.
  •  14
    Although the COVID-19 pandemic is a serious public health and economic emergency, and although effective vaccines are the best weapon we have against it, there are groups and individuals who oppose certain kinds of vaccines because of personal moral or religious reasons. The most widely discussed case has been that of certain religious groups that oppose research on COVID-19 vaccines that use cell lines linked to abortions and that object to receiving those vaccine because of their moral opposit…Read more
  •  22
    Vaccine mandates for healthcare workers beyond COVID-19
    with Julian Savulescu, Jonathan Pugh, and Dominic Wilkinson
    Journal of Medical Ethics 49 (3): 211-220. 2023.
    We provide ethical criteria to establish when vaccine mandates for healthcare workers are ethically justifiable. The relevant criteria are the utility of the vaccine for healthcare workers, the utility for patients (both in terms of prevention of transmission of infection and reduction in staff shortage), and the existence of less restrictive alternatives that can achieve comparable benefits. Healthcare workers have professional obligations to promote the interests of patients that entail exposu…Read more
  •  21
    Which Vaccine? The Cost of Religious Freedom in Vaccination Policy
    with Julian Savulescu and Dominic Wilkinson
    Journal of Bioethical Inquiry 18 (4): 609-619. 2021.
    We discuss whether and under what conditions people should be allowed to choose which COVID-19 vaccine to receive on the basis of personal ethical views. The problem arises primarily with regard to some religious groups’ concerns about the connection between certain COVID-19 vaccines and abortion. Vaccines currently approved in Western countries make use of foetal cell lines obtained from aborted foetuses either at the testing stage or at the development stage. The Catholic Church’s position is …Read more
  •  22
    A focused protection vaccination strategy: why we should not target children with COVID-19 vaccination policies
    with Sunetra Gupta and Carl Heneghan
    Journal of Medical Ethics 47 (8): 565-566. 2021.
    Cameron et al ’s1 ethical considerations about the ‘Dualism of Values’ in pandemic response emphasise the need to strike a fair balance between the interests of the less vulnerable to COVID-19 and the interests of the more vulnerable. Those considerations are at the basis of ethical defences of focused protection strategies.2 One example is the proposal put forward in the Great Barrington Declaration. It presented focused protection strategies as more ethical alternatives to lockdowns which woul…Read more
  •  7
    Genetic Immunisation
    In David Edmonds (ed.), Future Morality, Oxford University Press. 2021.
    [book blurb:] The world is changing so fast that it's hard to know how to think about what we ought to do. We barely have time to reflect on how scientific advances will affect our lives before they're upon us. New kinds of dilemma are springing up. Can robots be held responsible for their actions? Will artificial intelligence be able to predict criminal activity? Is the future gender-fluid? Should we strive to become post-human? Should we use drugs to improve our intimate relationships — or to …Read more
  •  19
    Seven COVID-19 vaccines are now being distributed and administered around the world (figure correct at the time of submission), with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among heal…Read more
  •  43
    Queue questions: Ethics of COVID‐19 vaccine prioritization
    with Julian Savulescu and Dominic Wilkinson
    Bioethics 35 (4): 348-355. 2021.
    The rapid development of vaccines against COVID‐19 represents a huge achievement, and offers hope of ending the global pandemic. At least three COVID‐19 vaccines have been approved or are about to be approved for distribution in many countries. However, with very limited initial availability, only a minority of the population will be able to receive vaccines this winter. Urgent decisions will have to be made about who should receive priority for access. Current policy in the UK appears to take t…Read more
  •  14
    We argue that we should provide extra payment not only for extra time worked but also for the extra risks healthcare workers (and those working in healthcare settings) incur while caring for COVID‐19 patients—and more generally when caring for patients poses them at significantly higher risks than normal. We argue that the extra payment is warranted regardless of whether healthcare workers have a professional obligation to provide such risky healthcare. Payment for risk would meet four essential…Read more
  •  8
    Conscientious Objection, Conflicts of Interests, and Choosing the Right Analogies. A Reply to Pruski
    with Julian Savulescu
    Journal of Bioethical Inquiry 18 (1): 181-185. 2021.
    In this response paper, we respond to the criticisms that Michal Pruski raised against our article “Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.” We defend our original position against conscientious objection in healthcare by suggesting that the analogies Pruski uses to criticize our paper miss the relevant point and that some of the analogies he uses and the implications he draws are misplaced.
  •  9
    Fair go: pay research participants properly or not at all
    with Olivia Grimwade, Julian Savulescu, Justin Oakley, and Anne-Marie Nussberger
    Journal of Medical Ethics 46 (12): 837-839. 2020.
    We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Resear…Read more