Michael Hayes

Many philosophers find welfare perfectionism implausible because it is arguably underinclusive, as it fails to count as good certain acts, events, and things that intuitively improve one's quality of life. Likewise, philosophers intuit that the experience of pleasure directly contributes to well-being. The problem for welfare perfectionism is straightforward: neither desire-satisfaction nor the experience of pleasure seem to perfect one's nature. This leaves two options for the welfare perfectionist. He can “bite the bullet” and argue that these intuitions are mistaken and that pleasure and desire-satisfaction don't impact well-being. Alternatively, he can explain how such intuitive goods can directly contribute to well-being, despite initial appearances. I advance the latter approach. I argue that at least for some perfectionists, desire-satisfaction and pleasure both directly contribute to well-being. One cannot argue that welfare perfectionism necessarily neglects the intuitive importance of desire-satisfaction and pleasure.

The U.S. Food and Drug Administration's drug advisory committees provide expert assessments of the safety and efficacy of new therapies considered for approval. A committee hears from a variety of speakers, from six groups, including voting members of the committee, FDA staff members, employees of the pharmaceutical company seeking approval of a therapy, patient and consumer representatives, expert speakers invited by the company, and public participants. The committees convene at the request of the FDA when the risks and harms of novel products are not immediately clear, and their final decisions carry significant weight, as most therapies that receive advisory committee approval are subsequently approved by the FDA. In recent years, across a series of diverse publications, the financial conflicts of interest of each category of participants in the meetings have been investigated. Here, we summarize these findings and their ethical implications, focusing on the FDA Oncologic Drugs Advisory Committee, and we suggest ways to move toward more transparent and impartial advisory committee meetings.