Stephen John

The claim that science is value-laden raises concerns that reliance on science, both by individuals or policymakers, might be incompatible with respect for autonomy or democratic principles. This article explores one response to this problem, that, when appealing to non-epistemic values in scientific contexts, scientists ought to use the “democratic” values which their audiences would agree upon. Ultimately, it argues that this “Democratic Alignment Demand” should be rejected. Section 1 articulates why the “Democratic Alignment Demand” may seem appealing. Section 2 suggests a problem with the demand: that it seems implausible in the analogous case of artistic production. Section 3 draws on this analogy to argue that the demand is far weaker than it seems. Section 4 adds a further argument against the demand: that it confuses a sufficient condition for legitimacy with a necessary condition.

How can scientists and science communicators effectively engage the public in times of crisis and in the face of pervasive uncertainty? Drawing on the experiences of the Covid-19 pandemic and the escalating climate crisis, the three essays in this volume examine key dimensions of this challenge. What roles should scientists play in policy-making? How can the spread of fake news in science communication be curtailed? And how can we represent uncertainties in a way that upholds the credibility of scientific knowledge?

Pre-natal-diagnosis technologies allow parents to discover whether their child is likely to suffer from serious disability. One argument for state funding of access to such technologies is that doing so would be “cost-effective”, in the sense that the expected financial costs of such a programme would be outweighed by expected “benefits”, stemming from the births of fewer children with serious disabilities. This argument is extremely controversial. This paper argues that the argument may not be as unacceptable as is often assumed. In doing so, it sets out a more general framework for assessing the relevance of efficiency calculations to policy-making. The final section also investigates the relationship between the paper’s arguments and claims about parental responsibility for child-bearing and rearing, with reference to Scanlon’s work on “substantive responsibility”.

There are many puzzles about whether and how to communicate risk information, particularly in public health and medical settings. This paper does three things. First, it suggests a model for whether and how to communicate risk which balances concerns about autonomy and concerns about beneficence. Second, it argues that in the case of risk communication, there are also difficult questions, stemming from the reference class problem, about what risks to communicate. Third, it uses the Justified Misalignments framework developed in the first part of the paper to address these puzzles.

Sometimes, states face emergencies: situations where many individuals face an imminent threat of serious harm. Some believe that in such cases certain sorts of actions which are normally morally prohibited might be permissible. In this paper, I discuss this view as it applies in both the contexts of war and of public health policy. I suggest that the deontologist can best understand emergencies by analogy with the distinction between act- and rule consequentialism. In real world cases, we must often make decisions in ‘epistemically murky’ situations, such that the application of deontological principles to particular cases is unclear. I suggest that we develop conventions to deal with such cases in a manner which we think is most likely to approximate the demands of abstract deontologicalprinciples across time. I claim that we can best understand ‘supreme emergencies’ as situations which ‘epistemic murkiness’ is resolved. In such cases, there may be a conflict between what would be valid application of abstract deontological principles and the conventions which normally guide us in epistemically murky situations.

There are many analogies between medical and judicial practice. This article explores one such analogy, between “medicalization” and “criminalization.” Specifically, drawing on an analogy between a judge’s speech act of delivering a verdict and a physician’s speech act of giving a diagnosis, it suggests a novel account of the phenomenon of “overdiagnosis.” Using this approach, we can make some headway in understanding debates over the early detection of cancer. The final section outlines the relationship between this approach and familiar debates in philosophy of medicine on the nature of disease and in philosophy of science on the “value-free ideal.”

In this article, we aim to map out the complexities which characterise debates about the ethics of vaccine distribution, particularly those surrounding the distribution of the COVID-19 vaccine. In doing so, we distinguish three general principles which might be used to distribute goods and two ambiguities in how one might wish to spell them out. We then argue that we can understand actual debates around the COVID-19 vaccine – including those over prioritising vaccinating the most vulnerable – as reflecting disagreements over these principles. Finally, we shift our attention away from traditional discussions of distributive justice, highlighting the importance of concerns about risk imposition, special duties, and social roles in explaining debates over the COVID-19 vaccine. We conclude that the normative complexity this article highlights deepens the need for decision-making bodies to be sensitive to public input.

This paper explores some of the ethical issues around offering COVID-19 vaccines to children. My main conclusion is rather paradoxical: the younger we go, the stronger the grounds for justified parental hesitancy and, as such, the stronger the arguments for enforcing vaccination. I suggest that this is not thereductio ad absurdumit appears, but does point to difficult questions about the nature of parental authority in vaccination cases. The first section sketches the disagreement over vaccinating teenagers, arguing that the UK policy was permissible. The second section outlines a problem for this policy, that it faces justified vaccine hesitancy. The third section discusses three strategies for responding to this problem, arguing that there may be no simple way of overcoming parents’ reasons to resist vaccinations.

Screening for asymptomatic disease is a routine aspect of contemporary public health practice. However, it is also controversial, because it leads to overdiagnosis and overtreatment, with many arguing that programmes are “ineffective,” i.e., the “costs” outweigh the “benefits.” This paper explores a more fundamental objection to screening programmes: that, even if they are effective, they are ethically impermissible because they breach the principle of non-maleficence. In so doing, it suggests a new approach to the ethics of risk, justifying a concern with how policies affect individuals’ absolute ex-ante prospects. Part 1 sets up the tension between screening and non-maleficence. Part 2 introduces and motivates a novel interpretation of the non-maleficence principle, “ex-ante Do No Harm,” which resolves this tension. Part 3 defends and clarifies this principle by discussing its relationship to the ex-ante Pareto principle. Part 4 discusses the worry that risk estimates are too “subjective.”

During the COVID-19 pandemic, there was disagreement over whether the science supported facemask mandates. This paper interrogates debates over this question, paying particular attention to an ambiguity between two scientific virtues: epistemic caution and epistemic responsiveness. I suggest that there is an argument from each virtue to reasons to trust scientists’ claims in policy debate. However, as the case of facemask debates illustrates, it is not clear that scientists can possess both virtues simultaneously: the two virtues are in tension. After showing how this general framework can help us better understand debate, I turn to consider some possible ways of resolving this tension, arguing that none of them is entirely satisfactory.

Objectivity is a key concept both in how we talk about science in everyday life and in the philosophy of science. This Element explores various ways in which recent philosophers of science have thought about the nature, value and achievability of objectivity. The first section explains the general trend in recent philosophy of science away from a notion of objectivity as a 'view from nowhere' to a focus on the relationship between objectivity and trust. Section 2 discusses the relationship between objectivity and recent arguments attacking the viability or desirability of 'value free' science. Section 3 outlines Longino's influential 'social' account of objectivity, suggesting some worries about drawing too strong a link between epistemic and ethical virtues. Section 4 turns to the value of objectivity, exploring concerns that notions of objectivity are politically problematic, and cautiously advocating in response a view of objectivity in terms of invariance.

Lockdown measures in response to the COVID-19 pandemic involve placing huge burdens on some members of society for the sake of benefiting other members of society. How should we decide when these policies are permissible? Many writers propose we should address this question using cost-benefit analysis, a broadly consequentialist approach. We argue for an alternative non-consequentialist approach, grounded in contractualist moral theorising. The first section sets up key issues in the ethics of lockdown, and sketches the apparent appeal of addressing these problems in a CBA frame. The second section argues that CBA fundamentally distorts the normative landscape in two ways: first, in principle, it allows very many morally trivial preferences—say, for a coffee—might outweigh morally weighty life-and-death concerns; second, it is insensitive to the core moral distinction between victims and vectors of disease. The third section sketches our non-consequentialist alternative, grounded in Thomas Scanlon’s contractualist moral theory. On this account, the ethics of self-defence implies a strong default presumption in favour of a highly restrictive, universal lockdown policy: we then ask whether there are alternatives to such a policy which are justifiable to all affected parties, paying particular attention to the complaints of those most burdened by policy. In the fourth section, we defend our contractualist approach against the charge that it is impractical or counterintuitive, noting that actual CBAs face similar, or worse, challenges.

This paper argues for a novel account of deceitful scientific communication, as “wishful speaking”. This concept is of relevance both to philosophy of science and to discussions of the ethics of lying and misleading. Section 1 outlines a case-study of “ghost-managed” research. Section 2 introduces the concept of “wishful speaking” and shows how it relates to other forms of misleading communication. Sections 3–5 consider some complications raised by the example of pharmaceutical research; concerning the ethics of silence; how research strategies—as well as the communication of results—may be misleading; and questions of multiple authorship. The conclusion suggests some more general conclusions.

In many countries and regions across the world, the initial response to the massive health risks posed by COVID-19 has been the institution of lockdown measures. Although they vary from place to place, these measures all involve trade-offs between ethical goods and imperatives, imposing significant restrictions on central human capabilities—including citizens’ ability to work, socialize, exercise democratic rights, and access education—in the name of protecting population health. As such, it seems imperative for philosophers to ask whether lockdown measures are ethical.This is a difficult question. We are deeply uncertain about the possible effects of COVID-19 and of lockdown policies, raising questions about...

In this paper, I set out two ethical complications for Rid and Wendler’s proposal that a “Patient Preference Predictor” (PPP) should be used to aid decision making about incapacitated patients’ care. Both of these worries concern how a PPP might categorize patients. In the first section of the paper, I set out some general considerations about the “ethics of apt categorization” within stratified medicine and show how these challenge certain PPPs. In the second section, I argue for a more specific—but more contentious—claim that proper respect for the autonomy of incapacitated patients might require us to act on reasons which they could endorse and show how this claim places important limits on the categories employed by an ethically acceptable PPP. The conclusion shows how these concerns about apt categorization relate to more familiar worries about Rid and Wendler’s proposals