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1206The Paradox of Conscientious Objection and the Anemic Concept of 'Conscience': Downplaying the Role of Moral Integrity in Health CareKennedy Institute of Ethics Journal 24 (2): 159-185. 2014.Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity a…Read more
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1066After-birth abortion: why should the baby live?Journal of Medical Ethics 39 (5): 261-263. 2013.Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion is, including cases where the…Read more
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1041Why and How to Compensate Living Organ Donors: Ethical Implications of the New Australian SchemeBioethics 29 (4): 283-290. 2014.The Australian Federal Government has announced a two-year trial scheme to compensate living organ donors. The compensation will be the equivalent of six weeks paid leave at the rate of the national minimum wage. In this article I analyse the ethics of compensating living organ donors taking the Australian scheme as a reference point. Considering the long waiting lists for organ transplantations and the related costs on the healthcare system of treating patients waiting for an organ, the 1.3 mil…Read more
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955Abortion and the Argument from Potential: What We Owe to the Ones Who Might ExistJournal of Medicine and Philosophy 37 (1): 49-59. 2012.Next SectionI challenge the idea that the argument from potential (AFP) represents a valid moral objection to abortion. I consider the form of AFP that was defended by Hare, which holds that abortion is against the interests of the potential person who is prevented from existing. My reply is that AFP, though not unsound by itself, does not apply to the issue of abortion. The reason is that AFP only works in the cases of so-called same number and same people choices, but it falsely presupposes th…Read more
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941Don't mind the gap: intuitions, emotions, and reasons in the enhancement debateHastings Center Report 45 (5): 39-47. 2015.Reliance on intuitive and emotive responses is widespread across many areas of bioethics, and the current debate on biotechnological human enhancement is particularly interesting in this respect. A strand of “bioconservatives” that has explicitly drawn connections to the modern conservative tradition, dating back to Edmund Burke, appeals explicitly to the alleged wisdom of our intuitions and emotions to ground opposition to some biotechnologies or their uses. So-called bioliberals, those who in …Read more
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716EuthanasiaInternational Journal of Applied Philosophy 27 (1): 35-46. 2013.The current impasse in the old debate about the morality of euthanasia is mainly due to the fact that the actual source of conflict has not been properly identified—or so I shall argue. I will first analyse the two different issues involved in the debate, which are sometimes confusingly mixed up, namely: (a) what is euthanasia?, and (b) why is euthanasia morally problematic? Considering documents by physicians, philosophers and the Roman Catholic Church, I will show that (a) ‘euthanasia’ is defi…Read more
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493Impartiality and infectious disease: Prioritizing individuals versus the collective in antibiotic prescriptionAJOB Empirical Bioethics 10 (1): 63-69. 2019.Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human health care. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should…Read more
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397Liberty, Fairness and the ‘Contribution Model’ for Non-medical Vaccine Exemption Policies: A Reply to Navin and LargentPublic Health Ethics 10 (3). 2017.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
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362The Ethics of Human EnhancementPhilosophy Compass 10 (4): 233-243. 2015.Ethical debate surrounding human enhancement, especially by biotechnological means, has burgeoned since the turn of the century. Issues discussed include whether specific types of enhancement are permissible or even obligatory, whether they are likely to produce a net good for individuals and for society, and whether there is something intrinsically wrong in playing God with human nature. We characterize the main camps on the issue, identifying three main positions: permissive, restrictive and c…Read more
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224Conscientious Objection to VaccinationBioethics 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
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146Vaccination, Risks, and Freedom: The Seat Belt AnalogyPublic Health Ethics. forthcoming.We argue that, from the point of view public health ethics, vaccination is significantly analogous to seat belt use in motor vehicles and that coercive vaccination policies are ethically justified for the same reasons why coercive seat belt laws are ethically justified. We start by taking seriously the small risk of vaccines’ side effects and the fact that such risks might need to be coercively imposed on individuals. If millions of individuals are vaccinated, even a very small risk of serious s…Read more
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132The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescueMedicine, Health Care and Philosophy 21 (4): 547-560. 2018.We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence…Read more
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123The Artificial Moral Advisor. The “Ideal Observer” Meets Artificial IntelligencePhilosophy and Technology 31 (2): 169-188. 2018.We describe a form of moral artificial intelligence that could be used to improve human moral decision-making. We call it the “artificial moral advisor”. The AMA would implement a quasi-relativistic version of the “ideal observer” famously described by Roderick Firth. We describe similarities and differences between the AMA and Firth’s ideal observer. Like Firth’s ideal observer, the AMA is disinterested, dispassionate, and consistent in its judgments. Unlike Firth’s observer, the AMA is non-abs…Read more
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106The Ethics of VaccinationSpringer Verlag. 2019.This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd imm…Read more
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105What in the World Is Moral Disgust?Australasian Journal of Philosophy 94 (2): 227-242. 2016.I argue that much philosophical discussion of moral disgust suffers from two ambiguities: first, it is not clear whether arguments for the moral authority of disgust apply to disgust as a consequence of moral evaluations or instead to disgust as a moralizing emotion; second, it is not clear whether the word ‘moral’ is used in a normative or in a descriptive sense. This lack of clarity generates confusion between ‘fittingness’ and ‘appropriateness’ of disgust. I formulate three conditions that ar…Read more
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90Quarantine, isolation and the duty of easy rescue in public healthDeveloping 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
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70Objection to Conscience: An Argument Against Conscience Exemptions in HealthcareBioethics 31 (4): 400-408. 2017.I argue that appeals to conscience do not constitute reasons for granting healthcare professionals exemptions from providing services they consider immoral. 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 two cases differen…Read more
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60Influenza Vaccination Strategies Should Target ChildrenPublic Health Ethics 11 (2): 221-234. 2018.Strategies to increase influenza vaccination rates have typically targeted healthcare professionals and individuals in various high-risk groups such as the elderly. We argue that they should focus on increasing vaccination rates in children. Because children suffer higher influenza incidence rates than any other demographic group, and are major drivers of seasonal influenza epidemics, we argue that influenza vaccination strategies that serve to increase uptake rates in children are likely to be …Read more
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59Taxing Meat: Taking Responsibility for One’s Contribution to Antibiotic ResistanceJournal of Agricultural and Environmental Ethics 30 (2): 179-198. 2017.Antibiotic use in animal farming is one of the main drivers of antibiotic resistance both in animals and in humans. In this paper we propose that one feasible and fair way to address this problem is to tax animal products obtained with the use of antibiotics. We argue that such tax is supported both by deontological arguments, which are based on the duty individuals have to compensate society for the antibiotic resistance to which they are contributing through consumption of animal products obta…Read more
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58An Argument for Compulsory Vaccination: The Taxation AnalogyJournal of Applied Philosophy 37 (3): 446-466. 2019.I argue that there are significant moral reasons in addition to harm prevention for making vaccination against certain common infectious diseases compulsory. My argument is based on an analogy between vaccine refusal and tax evasion. First, I discuss some of the arguments for compulsory vaccination that are based on considerations of the risk of harm that the non‐vaccinated would pose on others; I will suggest that the strength of such arguments is contingent upon circumstances and that in order…Read more
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52Antimicrobial resistance and antimicrobial stewardship programmes: benefiting the patient or the population?Journal of Medical Ethics 43 (10): 653-654. 2017.Antimicrobial resistance kills people. According to a recent estimate, ‘7 00 000 people die of resistant infections every year’, and ‘by 2050 10 million lives a year are at risk due to drug resistant infections, as are 100 trillion USD of economic output’.1 Today, ‘bacteria are resistant to nearly all antibiotics that were earlier active against them’.2 For all these reasons, antimicrobial resistance is considered a ‘slowly emerging disaster’3 and a ‘global health security issue’.4 The prospect …Read more
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49Demandingness and Public Health EthicsMoral Philosophy and Politics 6 (1): 65-87. 2019.Public health policies often require individuals to make personal sacrifices for the sake of protecting other individuals or the community at large. Such requirements can be more or less demanding for individuals. This paper examines the implications of demandingness for public health ethics and policy. It focuses on three possible public health policies that pose requirements that are differently demanding: vaccination policies, policy to contain antimicrobial resistance, and quarantine and iso…Read more
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47Regulating Genome Editing: For an Enlightened Democratic GovernanceCambridge 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
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47Queue questions: Ethics of COVID‐19 vaccine prioritizationBioethics 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
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46Nudging Immunity: The Case for Vaccinating Children in School and Day Care by DefaultHEC 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
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46Enhancing EqualityJournal of Medicine and Philosophy 44 (3): 335-354. 2019.The range of opportunities people enjoy in life largely depends on social, biological, and genetic factors for which individuals are not responsible. Philosophical debates about equality of opportunities have focussed mainly on addressing social determinants of inequalities. However, the introduction of human bioenhancement should make us reconsider what our commitment to equality entails. We propose a way of improving morally relevant equality that is centred on what we consider a fair distribu…Read more
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44Payment in challenge studies: ethics, attitudes and a new payment for risk modelJournal of Medical Ethics 46 (12): 815-826. 2020.Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coer…Read more
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44Normality, therapy, and enhancement - What should bioconservatives say about the medicalization of love?Cambridge Quarterly of Healthcare Ethics 24 (3): 347-354. 2015.According to human enhancement advocates, it is morally permissible (and sometimes obligatory) to use biomedical means to modulate or select certain biological traits in order to increase people’s welfare, even when there is no pathology to be treated or prevented. Some authors have recently proposed to extend the use of biomedical means to modulate lust, attraction, and attachment. I focus on some conceptual implications of this proposal, particularly with regard to bioconservatives’ understand…Read more
Areas of Interest
Applied Ethics |
Normative Ethics |