•  1270
    In a recent paper published in this journal, Giubilini, Douglas and Savulescu argue that we have given insufficient weight to the moral importance of fairness in our account of the best policies for non-medical exemptions to childhood immunization requirements. They advocate for a type of policy they call Contribution, according to which parents must contribute to important public health goods before their children can receive NMEs to immunization requirements. In this response, we argue that Gi…Read more
  •  965
    Resisting Moral Permissiveness about Vaccine Refusal
    Public Affairs Quarterly 27 (1): 69-85. 2013.
    I argue that a parental prerogative to sometimes prioritize the interests of one’s children over the interests of others is insufficient to make the parental refusal of routine childhood vaccines morally permissible. This is because the moral permissibility of vaccine refusal follows from such a parental prerogative only if the only (weighty) moral reason in favor of vaccination is that vaccination is a means for promoting the interests of others. However, there are two additional weighty moral …Read more
  •  925
    Latent in John Rawls’s discussion of envy, resentment and voluntary social segregation is a plausible (partial) explanation of two striking features of contemporary American life: (1) widespread complacency about inequality and (2) decreased political participation, especially by the least advantaged members of society.
  •  903
    Recent increases in the rates of parental refusal of routine childhood vaccination have eroded many countries’ “herd immunity” to communicable diseases. Some parents who refuse routine childhood vaccines do so because they deny the mainstream medical consensus that vaccines are safe and effective. I argue that one reason these vaccine denialists disagree with vaccine proponents about the reasons in favor of vaccination is because they also disagree about the sorts of practices that are conducive…Read more
  •  900
    The Ethics of Vaccination Nudges in Pediatric Practice
    HEC Forum 29 (1): 43-57. 2017.
    Techniques from behavioral economics—nudges—may help physicians increase pediatric vaccine compliance, but critics have objected that nudges can undermine autonomy. Since autonomy is a centrally important value in healthcare decision-making contexts, it counts against pediatric vaccination nudges if they undermine parental autonomy. Advocates for healthcare nudges have resisted the charge that nudges undermine autonomy, and the recent bioethics literature illustrates the current intractability o…Read more
  •  449
    Leaders of the world’s largest food sovereignty movement, La Vía Campesina, have argued that gender justice is a core component of food justice. On their view, food justice requires an end to violence against women and a guarantee of women’s equal social and political status. However, some have wondered what gender justice has to do with food. In particular, they have worried that La Vía Campesina’s embrace of radical gender egalitarianism cannot be grounded in food-related concerns. My goal in …Read more
  •  289
    Scaling‐Up Alternative Food Networks
    Journal of Social Philosophy 46 (4): 434-448. 2015.
    Alternative Food Networks (AFNs), which include local food and Fair Trade, work to mitigate some of the many shortcomings of mainstream food systems. If AFNs have the potential to make the world’s food systems more just and sustainable (and otherwise virtuous) then we may have good reasons to scale them up. Unfortunately, it may not be possible to increase the market share of AFNs while preserving their current forms. Among other reasons, this is because there are limits to both the productive c…Read more
  •  287
    How Demanding is the Duty of Assistance?
    In Win-Chiat Lee & Helen Stacy (eds.), Economic Justice, Springer. pp. 205-220. 2013.
    Among Anglo-American philosophers, contemporary debates about global economic justice have often focused upon John Rawls’s Law of Peoples. While critics and advocates of this work disagree about its merits, there is wide agreement that, if today’s wealthiest societies acted in accordance with Rawls’s Duty of Assistance, there would be far less global poverty. I am skeptical of this claim. On my view, the Duty of Assistance is unlikely to require the kinds and amounts of assistance that would be …Read more
  •  280
    Luck and Oppression
    Ethical Theory and Moral Practice 14 (5): 533-547. 2011.
    Oppression can be unjust from a luck egalitarian point of view even when it is the consequence of choices for which it is reasonable to hold persons responsible. This is for two reasons. First, people who have not been oppressed are unlikely to anticipate the ways in which their choices may lead them into oppressive conditions. Facts about systematic phenomena (like oppression) are often beyond the epistemic reach of persons who are not currently subject to such conditions, even when they posses…Read more
  •  276
    Local Food and International Ethics
    Journal of Agricultural and Environmental Ethics 27 (3): 349-368. 2014.
    Many advocate practices of ‘local food’ or ‘locavorism’ as a partial solution to the injustices and unsustainability of contemporary food systems. I think that there is much to be said in favor of local food movements, but these virtues are insufficient to immunize locavorism from criticism. In particular, three duties of international ethics—beneficence, repair and fairness—may provide reasons for constraining the developed world’s permissible pursuit of local food. A complete account of why (a…Read more
  •  274
    Fair Equality of Opportunity in Global Justice
    Social Philosophy Today 24 39-52. 2008.
    Many political philosophers argue that a principle of ‘fair equality of opportunity’ ought to extend beyond national borders. I agree that there is a place for FEO in a theory of global justice. However, I think that the idea of cross-border FEO is indeterminate between three different principles. Part of my work in this paper is methodological: I identify three different principles of cross-border fair equality of opportunity and I distinguish them from each other. The other part of my work in …Read more
  •  144
    Reasons to Accept Vaccine Refusers in Primary Care
    with Jason Adam Wasserman and Douglas Opel
    Pediatrics 6 (146). 2020.
    Vaccine refusal forces us to confront tensions between many values, including scientific expertise, parental rights, children’s best interests, social responsibility, public trust, and community health. Recent outbreaks of vaccine-preventable and emerging infectious diseases have amplified these issues. The prospect of a coronavirus disease 2019 vaccine signals even more friction on the horizon. In this contentious sociopolitical landscape, it is therefore more important than ever for clinicians…Read more
  •  139
    Parents in the US and other societies are increasingly refusing to vaccinate their children, even though popular anti-vaccine myths – e.g. ‘vaccines cause autism’ – have been debunked. This book explains the epistemic and moral failures that lead some parents to refuse to vaccinate their children. First, some parents have good reasons not to defer to the expertise of physicians, and to rely instead upon their own judgments about how to care for their children. Unfortunately, epistemic self-relia…Read more
  •  136
    HPV and the Ethics of CDC’s Vaccination Requirements for Immigrants
    Kennedy Institute of Ethics Journal 25 (2): 111-132. 2015.
    Joseph Carens’ groundbreaking article on immigration ethics begins with the observation that “[b]orders have guards and the guards have guns”. I begin my article with a similar observation: border guards have syringes. Aliens who do not want to be turned away by a border guard’s gun must often agree to be injected with vaccines. While Carens challenges the popular consensus that states have an expansive moral right to forcibly restrict migration, my focus is narrower. I will evaluate the claim t…Read more
  •  103
    Vaccine mandates, value pluralism, and policy diversity
    with Katie Attwell
    Bioethics 33 (9): 1042-1049. 2019.
    Political communities across the world have recently sought to tackle rising rates of vaccine hesitancy and refusal, by implementing coercive immunization programs, or by making existing immunization programs more coercive. Many academics and advocates of public health have applauded these policy developments, and they have invoked ethical reasons for implementing or strengthening vaccine mandates. Others have criticized these policies on ethical grounds, for undermining liberty, and as symptoms…Read more
  •  73
    In The Idea of Human Rights (hereafter IHR), Charles Beitz advocates a different approach to questions about the nature and aims of human rights. He advances a ‘practical conception’, which turns to the role that human rights play in contemporary political discourse to arrive at answers about the structure and function of human rights. As Beitz says, ‘we take the functional role of human rights in international discourse and practice as basic: it constrains our conception of a human right from t…Read more
  •  66
    Rescuing Justice and Equality (review)
    Journal of Moral Philosophy 7 (3): 411-413. 2010.
    G. A. Cohen wanted to rescue justice and equality from John Rawls and his followers. In this, his final book, Cohen presents a clear, focused, and all-together powerful attack on the Rawlsian approach to political philosophy and distributive justice.
  •  34
    Cooptation or solidarity: food sovereignty in the developed world
    with J. M. Dieterle
    Agriculture and Human Values 35 (2): 319-329. 2018.
    This paper builds on previous research about the potential downsides of food sovereignty activism in relatively wealthy societies by developing a three-part taxonomy of harms that may arise in such contexts. These are direct opposition, false equivalence, and diluted goals and methods. While this paper provides reasons to resist complacency about wealthy-world food sovereignty, we are optimistic about the potential for food sovereignty in wealthy societies, and we conclude by describing how weal…Read more
  •  31
    Globalization and Global Justice: Shrinking Distance, Expanding Obligations (review)
    Philosophical Review 123 (2): 244-247. 2014.
    In Globalization and Global Justice, Nicole Hassoun advocates a political philosophy that is deeply-informed by empirical work and a utopianism that is constrained by considerations of real-world feasibility. As Hassoun acknowledges, these features are unusual for philosophical work, and she is right to think that the global justice literature needs to be more focused on practical questions and better-informed by facts about international political economy (15-7). However, it is also a mark of g…Read more
  •  28
    Sincerity, accuracy and selective conscientious objection
    Journal of Military Ethics 12 (2). 2013.
    Conscientious objectors to military service are either general objectors or selective objectors. The former object to all wars; the latter object to only some wars. There is widespread popular and political support in western liberal democracies for exemptions for general objectors, but currently there is little support for exemptions for selective objectors. Many who advocate exemptions for selective objectors attempt to build upon the strength of support that is enjoyed by exemptions for gener…Read more
  •  24
    Considering Whether the Dismissal of Vaccine-Refusing Families Is Fair to Other Clinicians
    with Michael J. Deem and John D. Lantos
    JAMA Pediatrics 172 (6): 515-516. 2018.
    A recent American Academy of Pediatrics (AAP) clinical report states that it is an acceptable option for pediatric care clinicians to dismiss families who refuse vaccines. This is a clear shift in guidance from the AAP, which previously advised clinicians to “endeavor not to discharge” patients solely because of parental vaccine refusal. While this new policy might be interpreted as encouraging or recommending dismissal of vaccine-refusing families, it instead expresses tolerance for diverse pro…Read more
  •  21
    Reasons to Amplify the Role of Parental Permission in Pediatric Treatment
    American Journal of Bioethics 17 (11): 6-14. 2017.
    Two new documents from the Committee on Bioethics of the American Academy of Pediatrics expand the terrain for parental decision making, suggesting that pediatricians may override only those parental requests that cross a harm threshold. These new documents introduce a broader set of considerations in favor of parental authority in pediatric care than previous AAP documents have embraced. While we find this to be a positive move, we argue that the 2016 AAP positions actually understate the impor…Read more
  •  20
    Context In response to outbreaks of vaccine‐preventable disease and increasing rates of vaccine refusal, some political communities have recently implemented coercive childhood immunization programs, or they have made existing childhood immunization programs more coercive. Many other political communities possess coercive vaccination policies, and others are considering developing them. Scholars and policymakers generally refer to coercive immunization policies as “vaccine mandates.” However, m…Read more
  •  18
    Children’s preferences about medical treatment—like the preferences of other patients—hold moral weight in decision-making that is independent of considerations of autonomy or best interests. In light of this understanding of the moral value of patient preferences, the American Academy of Pediatrics could strengthen the ethical foundation for its formal guidance on pediatric assent.
  •  17
    We agree with Emily Walsh (2020) that the current preferences of patients with dementia should sometimes supersede those patients’ advance directives. We also agree that consensus clinical ethics guidance does a poor job of explaining the moral value of such patients’ preferences. Furthermore, Walsh correctly notes that clinicians are often averse to treating patients with dementia over their objections, and that this aversion reflects clinical wisdom that can inform revisions to clinical ethics…Read more
  •  13
    When a patient lacks decision-making capacity, then according to standard clinical ethics practice in the United States, the health care team should seek guidance from a surrogate decision-maker, either previously selected by the patient or appointed by the courts. If there are no surrogates willing or able to exercise substituted judgment, then the team is to choose interventions that promote a patient’s best interests. We argue that, even when there is input from a surrogate, patient preferenc…Read more
  •  12
    George Kateb, Human Dignity (review)
    Journal of Moral Philosophy 10 (2): 251-253. 2013.
    Many want to justify the continued existence of the human species or the absolutism of human rights. In his recent book, George Kateb argues that moral values (which, in his view, focus primarily upon suffering) are insufficient for these tasks. Morality condemns humanity for its history of needless death and destruction; morality tolerates violations of human rights. Kateb claims that human dignity (which he characterizes as an existential value) must do some of the heavy lifting required to de…Read more
  •  12
    Pox Parties for Grannies? Chickenpox, Exogenous Boosting, and Harmful Injustices
    with Heidi Malm
    American Journal of Bioethics 20 (9): 45-57. 2020.
    Some societies tolerate or encourage high levels of chickenpox infection among children to reduce rates of shingles among older adults. This tradeoff is unethical. The varicella zoster virus (VZV) causes both chickenpox and shingles. After people recover from chickenpox, VZV remains in their nerve cells. If their immune systems become unable to suppress the virus, they develop shingles. According to the Exogenous Boosting Hypothesis (EBH), a person’s ability to keep VZV suppressed can be ‘booste…Read more