•  1175
    The problem of standard of care in clinical research concerns the level of treatment that investigators must provide to subjects in clinical trials. Commentators often formulate answers to this problem by appealing to two distinct types of obligations: professional obligations and natural duties. In this article, I investigate whether investigators also possess institutional obligations that are directly relevant to the problem of standard of care, that is, those obligations a person has because…Read more
  •  486
    Are Skill-Selective Immigration Policies Just?
    Social Theory and Practice 42 (1): 123-154. 2016.
    Many high-income countries have skill-selective immigration policies, favoring prospective immigrants who are highly skilled. I investigate whether it is permissible for high-income countries to adopt such policies. Adopting what Joseph Carens calls a " realistic approach " to the ethics of immigration, I argue first that it is in principle permissible for high-income countries to take skill as a consideration in favor of selecting one prospective immigrant rather than another. I argue second th…Read more
  •  324
    The field of public policy is dominated by the social sciences. Schools and departments of public policy and public administration are largely populated by economists, political scientists, and sociologists, and the vast majority of work in prestigious public policy journals employs empirical methods. This is unsurprising, in one respect, for collecting data, predicting and identifying the causal impacts of policies, and understanding political institutions and processes are massive, important t…Read more
  •  205
    Immigrant Selection, Health Requirements, and Disability Discrimination
    Journal of Ethics and Social Philosophy 14 (1). 2018.
    Australia, Canada, and New Zealand currently apply health requirements to prospective immigrants, denying residency to those with health conditions that are likely to impose an “excessive demand” on their publicly funded health and social service programs. In this paper, I investigate the charge that such policies are wrongfully discriminatory against persons with disabilities. I first provide a freedom-based account of the wrongness of discrimination according to which discrimination is wrong w…Read more
  •  161
    Social scientists and research ethicists have begun, somewhat belatedly, to confront and address the ethical challenges raised by public policy experiments. In doing so however, they have not fully availed themselves of the large and sophisticated literature on the ethics of clinical research which has developed over the past 40 years. While clinical and public policy research are different, I argue that the clinical research ethics literature yields valuable insights for discussions of the ethi…Read more
  •  102
    Opt-out and Consent
    Journal of Medical Ethics 41 (10): 1-4. 2015.
    A chief objection to opt-out organ donor registration policies is that they do not secure people's actual consent to donation, and so fail to respect their autonomy rights to decide what happens to their organs after they die. However, scholars have recently offered two powerful responses to this objection. First, Michael B Gill argues that opt-out policies do not fail to respect people's autonomy simply because they do not secure people's actual consent to donation. Second, Ben Saunders argues …Read more
  •  100
    Governments often aim to improve children’s wellbeing by targeting the decision-making of their parents. In this paper, I explore this phenomenon, providing an ethical evaluation of the ways in which governments target parental decision-making in the context of anti-poverty policies. I first introduce and motivate the concept of parent-targeted paternalism to categorize such policies. I then investigate whether parent-targeted paternalism is ever pro tanto wrong, arguing that it is when directed…Read more
  •  95
    Review of For the Common Good: Philosophical Foundations of Research Ethics (review)
    Kennedy Institute of Ethics Journal 32 (3): 13-28. 2022.
    The principal goal of Alex John London's For the Common Good is to "articulate a new vision for the philosophical foundations of research ethics" which "moves issues of justice from the periphery of the field to the very center." At the core of this new vision is an understanding of research as a "collaborative social activity between free and equal persons," which aims to develop the knowledge public institutions require to establish and maintain a social order in which people may set and pursu…Read more
  •  93
    Incentive inequalities and freedom of occupational choice
    Economics and Philosophy 32 (1): 21-49. 2016.
    In Rescuing Justice and Equality, G.A. Cohen argues that the incentive inequalities permitted by John Rawls's difference principle are unjust since people cannot justify them to their fellow citizens. I argue that citizens of a Rawlsian society can justify their acceptance of a wide range of incentive inequalities to their fellow citizens. They can do so because they possess the right to freedom of occupational choice, and are permitted – as a matter of justice – to exercise this right by making…Read more
  •  88
    Nudging in Donation Policies: Registration and Decision-Making
    with Katherine Saylor
    In Solveig Lena Hansen & Silke Schicktanz (eds.), Ethical Challenges of Organ Transplantation, Transcript Verlag. pp. 65-80. 2021.
    In this chapter, we provide an overview of the ethical considerations relevant to the use of nudges in organ donation policy. We do not defend a position on the permissibility of nudging in this context, but instead aim to clearly outline the strongest arguments on the different sides of this issue that have been presented in the English-language scholarly bioethics literature. We also highlight the questions that are in need of further investigation. In part 1, we briefly discuss nudging before…Read more
  •  65
    Public Policy Experiments without Equipoise: When is Randomization Fair?
    with Emma Cohn
    Ethics and Human Research 45 (1): 15-28. 2023.
    Government agencies and nonprofit organizations have increasingly turned to randomized controlled trials (RCTs) to evaluate public policy interventions. Random assignment is widely understood to be fair when there is equipoise; however, some scholars and practitioners argue that random assignment is also permissible when an intervention is reasonably expected to be superior to other trial arms. For example, some argue that random assignment to such an intervention is fair when the intervention i…Read more
  •  50
    Government Policy Experiments and the Ethics of Randomization
    Philosophy and Public Affairs 48 (4): 319-352. 2020.
    Governments are increasingly using randomized controlled trials (RCTs) to evaluate policy interventions. RCTs are often understood to provide the highest quality evidence regarding the causal efficacy of an intervention. While randomization plays an essential epistemic role in the context of policy RCTs however, it also plays an important distributive role. By randomly assigning participants to either the intervention or control arm of an RCT, people are subject to different policies and so, oft…Read more
  •  47
    Rawlsian Justice and the Social Determinants of Health
    with Jayna Fishman
    Journal of Applied Philosophy 36 (4): 608-625. 2019.
    In this article, we suggest that the evidence regarding the social determinants of health calls for a deep re‐thinking of our understanding of distributive justice. Focusing on John Rawls's theory of distributive justice in particular, we argue that a full reckoning with the social determinants of health requires a re‐working of Rawls's principles of justice. We argue first that the social bases of health – a Rawlsian conception of the social determinants of health – should be considered a socia…Read more
  •  46
    The Ethics of Organ Donor Registration Policies: Nudges and Respect for Autonomy
    with Alexandra Robinson
    American Journal of Bioethics 16 (11): 3-12. 2016.
    Governments must determine the legal procedures by which their residents are registered, or can register, as organ donors. Provided that governments recognize that people have a right to determine what happens to their organs after they die, there are four feasible options to choose from: opt-in, opt-out, mandated active choice, and voluntary active choice. We investigate the ethics of these policies' use of nudges to affect organ donor registration rates. We argue that the use of nudges in this…Read more
  •  42
    Designing a Just Soda Tax
    with Alexandria Huber-Disla
    Economics and Philosophy. forthcoming.
    Soda taxes are controversial. While proponents point to their potential health benefits and the public projects that could be funded with their revenue, critics argue that they are paternalistic and regressive. In this paper, we explore the prospects for designing a just soda tax, one that appropriately balances the often-competing ethical considerations of promoting social welfare, respecting people’s autonomy, and ensuring distributive fairness. We argue that policymakers have several paths fo…Read more
  •  39
    Experienced Utility or Decision Utility for QALY Calculation? Both
    with Paige A. Clayton
    Public Health Ethics 11 (1): 82-89. 2018.
    Policy-makers must allocate scarce resources to support constituents’ health needs. This requires policy-makers to be able to evaluate health states and allocate resources according to some principle of allocation. The most prominent approach to evaluating health states is to appeal to the strength of people’s preferences to avoid occupying them, which we refer to as decision utility metrics. Another approach, experienced utility metrics, evaluates health states based on their hedonic quality. I…Read more
  •  38
    Ending SNAP-Subsidized Purchases of Sugar-Sweetened Beverages: The Need for a Pilot Project
    with Nicole M. V. Ross
    Public Health Ethics 10 (1). 2017.
    Recent efforts by legislative officials and public health advocates to reform the US food stamp program, or Supplemental Nutrition Assistance Program, have focused on restricting the types of foods eligible for purchase with SNAP benefits, specifically sugar-sweetened beverages. We argue that it is, in principle, permissible for the US government to enact a SNAP-specific SSB ban prohibiting the purchase of SSBs with SNAP benefits. While the government has a duty to ensure that citizens meet thei…Read more
  •  34
    Basic Income, Cash Transfers, and Welfare State Paternalism
    Journal of Political Philosophy 27 (4): 422-447. 2019.
    Journal of Political Philosophy, EarlyView.
  •  34
    Incentive Inequalities and Talents: A Reply to Shiffrin
    Philosophia 41 (2): 521-526. 2013.
    In a recent article, Seana Valentine Shiffrin offers a distinctive egalitarian critique of the types of incentive inequalities that are permitted by John Rawls's difference principle. She argues that citizens of a well-ordered society, who publicly accept Rawls's two principles of justice and their justifications, may not demand incentives to employ their talents in productive ways since such demands are inconsistent with a major justification for the difference principle: the moral arbitrarines…Read more
  •  31
    In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For all arms of a p…Read more
  •  31
    Government Policy Experiments and Informed Consent
    with Averi Chakrabarti
    Public Health Ethics 12 (2): 188-201. 2019.
    Governments are increasingly making use of field experiments to evaluate policy interventions in the spheres of education, public health and welfare. However, the research ethics literature is largely focused on the clinical context, leaving investigators, institutional review boards and government agencies with few resources to draw on to address the ethical questions they face regarding such experiments. In this article, we aim to help address this problem, investigating the conditions under w…Read more
  •  29
    Patients with Passports: Medical Tourism, Law, and Ethics by I Glenn Cohen
    Kennedy Institute of Ethics Journal 26 (3): 1-10. 2016.
    I. Glenn Cohen’s Patients with Passports: Medical Tourism, Law, and Ethics offers a thorough examination of the growing practice of medical tourism, the legal regulations governing it, and the many ethical issues it raises for policy-makers, health care providers, and prospective medical tourists. Demonstrating mastery of the relevant literatures in the social sciences, law, ethics, and political philosophy, Cohen provides a comprehensive overview of the current practice of medical tourism, and …Read more
  •  28
    Calculating qalys: Liberalism and the value of health states
    Economics and Philosophy 33 (2): 259-285. 2017.
    The value of health states is often understood to depend on their impact on the goodness of people's lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification requirement – the requirement that public officials choose laws and policies that are justifiable to their citizens – should evaluate health states. Since the public justificatio…Read more
  •  28
    The Oxford Handbook of Research Ethics (edited book)
    Oxford University Press. 2020.
    This handbook is currently in development, with individual articles publishing online in advance of print publication. At this time, we cannot add information about unpublished articles in this handbook, however the table of contents will continue to grow as additional articles pass through the review process and are added to the site. Please note that the online publication date for this handbook is the date that the first article in the title was published online. For more information, please …Read more
  •  27
    The Duty to Rescue and Investigators' Obligations
    with Tina Rulli
    Kennedy Institute of Ethics Journal 27 (1): 71-105. 2017.
    The duty to rescue is a highly plausible and powerful ethical principle. It requires agents to assist others in extreme need in cases where doing so does not conflict with some weighty moral aim; requires little personal sacrifice; and is likely to significantly benefit the recipients.1 As a general obligation, it binds all persons simply qua persons, and it is owed to all persons simply qua persons. Clinical investigators working in low-income countries frequently encounter sick or destitute pe…Read more
  •  26
    Fair subject selection in clinical research: formal equality of opportunity
    Journal of Medical Ethics 42 (10): 672-677. 2016.
    In this paper, I explore the ethics of subject selection in the context of biomedical research. I reject a key principle of what I shall refer to as the standard view. According to this principle, investigators should select participants so as to minimise aggregate risk to participants and maximise aggregate benefits to participants and society. On this view, investigators should exclude prospective participants who are more susceptible to risk than other prospective participants. I argue instea…Read more
  •  19
    Federalism and Responsibility for Health Care
    with Marion Danis
    Public Affairs Quarterly 30 (1): 1-29. 2016.
    Political philosophers often formulate the problem of distributive justice as the problem of how the government ought to distribute different types of goods—for example, income or health care—to its citizens. They therefore presuppose that the government is a unitary agent that governs its citizens directly. However, although a number of governments are unitary in this way, many are federations, exhibiting a division of sovereignty between two or more levels of government having independent grou…Read more
  •  15
    Four Faces of Fair Subject Selection
    with Katherine Witte Saylor
    American Journal of Bioethics 20 (2): 5-19. 2020.
    Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sh…Read more