•  170
    A principal rationale for public policy is to address market failures. Pareto efficiency is therefore a highly common and relatively non-controversial evaluative criterion for many policy analyses and is discussed at length in policy analysis texts. This makes sense, for Pareto improvements involve making at least one person better off without making anyone worse off. Who could object to that? But does efficiency deserve the prominence it enjoys in public policy? Is one policy option better than…Read more
  •  4
    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
  •  2
    3. Nudging in Donation Policies
    with Katherine Saylor
    In Solveig Lena Hansen & Silke Schicktanz (eds.), Ethical Challenges of Organ Transplantation, Transcript Verlag. pp. 65-80. 2021.
  •  139
    Fair Subject Selection in Clinical and Social Scientific Research
    In Ana S. Iltis & Douglas MacKay (eds.), The Oxford Handbook of Research Ethics, Oxford University Press. 2020.
    This chapter provides a critical overview and interpretation of fair subject selection in clinical and social scientific research. It first provides an analytical framework for thinking about the problem of fair subject selection. It then argues that fair subject selection is best understood as a set of four subprinciples, each with normative force and each with distinct and often conflicting implications for the selection of participants: fair inclusion, fair burden sharing, fair opportunity, a…Read more
  •  682
    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
  •  184
    Policy analyses begin with a systematic overview of the policy problem they address. This includes a comprehensive discussion of the nature and context of the problem, and the institutional and behavioral factors responsible for its emergence. Problem statements must also explain why the status quo is bad or undesirable, why it is something that governments, rather than private actors, should address, and establish that the relevant government institutions have the legitimacy to intervene. In th…Read more
  •  243
    Designing a Just Soda Tax
    with Alexandria Huber-Disla
    Economics and Philosophy 1-21. 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
  •  204
    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
  •  4
  •  295
    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
  •  201
    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
  •  300
    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
  •  48
    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
  •  20
    Paying for Fairness? Incentives and Fair Subject Selection
    American Journal of Bioethics 21 (3): 35-37. 2021.
    In their Target Article, “Promoting Ethical Payment in Human Infection Challenge Studies,” Lynch et al. propose a framework for ethical payment to research participants and apply it to the c...
  •  11
    Reconsidering scarce drug rationing: implications for clinical research
    with Zev M. Nakamura, Arlene M. Davis, Elizabeth R. Brassfield, Benny L. Joyner Jr, and Donald L. Rosenstein
    Journal of Medical Ethics 47 (12). 2021.
    Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case …Read more
  •  198
    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
  •  249
    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
  •  18
    Selecting participants fairly for controlled human infection studies
    with Nancy S. Jecker, Punnee Pitisuttithum, and Katherine W. Saylor
    Bioethics 34 (8): 771-784. 2020.
    Controlled human infection (CHI) studies involve the deliberate exposure of healthy research participants to infectious agents to study early disease processes and evaluate interventions under controlled conditions with high efficiency. Although CHI studies expose participants to the risk of infection, they are designed to offer investigators unique advantages for studying the pathogenesis of infectious diseases and testing potential vaccines or treatments in humans. One of the central challenge…Read more
  •  124
    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
  •  75
    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
  •  1343
    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
  •  54
    Geographic Location and Moral Arbitrariness in the Allocation of Donated Livers
    with Samuel Fitz
    Journal of Law, Medicine and Ethics 47 (2): 308-319. 2019.
    The federal system for allocating donated livers in the United States is often criticized for allowing geographic disparities in access to livers. Critics argue that such disparities are unfair on the grounds that where one lives is morally arbitrary and so should not influence one's access to donated livers. They argue instead that livers should be allocated in accordance with the equal opportunity principle, according to which US residents who are equally sick should have the same opportunity …Read more
  •  117
    Basic Income, Cash Transfers, and Welfare State Paternalism
    Journal of Political Philosophy 27 (4): 422-447. 2019.
    Journal of Political Philosophy, EarlyView.
  •  16
    Health Research Priority Setting: A Duty to Maximize Social Value?
    American Journal of Bioethics 18 (11): 25-26. 2018.
  •  337
    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
  •  124
    Rawlsian Justice and the Social Determinants of Health
    with Jayna Fishman
    Journal of Applied Philosophy 36 (4): 608-625. 2018.
    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
  •  111
    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
  •  11
    In a carefully argued article, Haley K. Sullivan and Benjamin E. Berkman address the important question of whether investigators have a duty to report incidental findings to research participants in low‐resource settings. They suggest that the duty to rescue offers the most plausible justification for the duty to return incidental findings, and they explore the implications of this duty for the context of research in low‐resource settings. While I think they make valuable headway on an important…Read more
  •  12
    Weighing obligations to home care workers and Medicaid recipients
    with Paul C. Treacy
    Nursing Ethics 26 (2): 418-424. 2019.
  •  64
    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