Kennedy Institute of Ethics Journal最新文献

We reply to van Basshuysen and White's criticism of our paper. We argue that they have misconstrued what our original claims were. Nevertheless, we maintain that their arguments against the position they incorrectly attribute to us fail.

Legal standards of disclosure in a variety of jurisdictions require physicians to inform patients about the likely consequences of treatment, as a condition for obtaining the patient's consent. Such a duty to inform is special insofar as extensive disclosure of risks and potential benefits is not usually a condition for obtaining consent in non-medical transactions.What could morally justify the physician's special legal duty to inform? I argue that existing justifications have tried but failed to ground such special duties directly in basic and general rights, such as autonomy rights. As an alternative to such direct justifications, I develop an indirect justification of physicians' special duties from an argument in Kant's political philosophy. Kant argues that pre-legal rights to freedom are the source of a duty to form a state. The state has the authority to conclusively determine what counts as "consent" in various kinds of transactions. The Kantian account can subsequently indirectly justify at least one legal standard imposing a duty to inform, the reasonable person standard, but rules out one interpretation of a competitor, the subjective standard.

This article examines injectable Opioid Agonist Treatment (iOAT), in which patients suffering from long-term, treatment refractory opioid use disorder (OUD) are prescribed injectable diacetylmorphine, the active ingredient of heroin. While iOAT is part of the continuum of care for OUD in some European countries and in some parts of Canada, it is not an available treatment in the United States. We suggest that one reason for this situation is the belief that a genuine treatment for substance use disorder cannot prescribe the same substance as that used. We examine possible rationales for this belief by considering four combinations of views on the constitutive causal basis of substance use disorders and the definition of effective treatment. We show that all but one combination counts iOAT as a genuine treatment and that there are good reasons to reject the one that does not. Specifically, we claim that medical interventions, such as iOAT, that significantly reduce the severity of a disorder deserve to be categorized as effective treatments and regarded as such in practice.

It is often held that people have a moral right to believe and say whatever they want. For instance, one might claim that they have a right to believe racist things as long as they keep those thoughts to themselves. Or, one might claim that they have a right to pursue any scholarly question they want as long as they do so with a civil tone. This paper rejects those claims and argues that no one has such unlimited moral rights. Part 1 explores the value of the freedoms of thought and expression. Part 2 argues against the unlimited moral right to free expression, focusing in particular on the special obligations and moral constraints that obtain for academics. Part 3 argues against the unlimited moral right to free thought.

Sometimes, people who are otherwise eligible to donate blood are unduly deferred from donating. "Unduly" indicates a gap where a deferral policy misstates what exposes potential donors to risk and so defers more donors than is justified. A number of bioethicists and public health officials have criticized specific deferral policies in order to reformulate or eliminate them. Policy change is undoubtedly the right goal because the policy is what prevents otherwise eligible donors from donating needed blood. But this policy-level focus passes over a largely undiscussed question: if policy change takes time and there is a need for blood now, then what should unduly deferred donors do in the meanwhile? Blood banks and federal agencies recommend that deferred donors donate their time or money until they become eligible, but blood is a non-fungible good: donated cash or volunteered time cannot replace a transfusion. Further, this request ignores the fact that otherwise eligible donors could safely donate their blood in addition to their time and money. If a donor justifiably believes that her blood does not pose a risk to a recipient, but knows that honestly answering a donor questionnaire would unduly defer her, then is she morally justified in lying on the questionnaires in order to donate blood?