Abstract In this short piece, I attempt to respond to some of the challenges raised by Jessica Nihlén Fahlquist and Karen Meagher in their commentaries on my paper, ‘Public Health Virtue Ethics’. While these authors have made many insightful and challenging remarks, I mostly focus on two questions here: first, about the nature of collectives as moral agents, in response to Nihlén Fahlquist, and second, about the concept of a collective-level virtue, in response to Meagher.
在这篇短文中，我试图回应Jessica nihl n Fahlquist和Karen Meagher对我的论文“公共卫生美德伦理”的评论中提出的一些挑战。虽然这些作者发表了许多富有洞察力和挑战性的言论，但我在这里主要关注两个问题:第一，关于集体作为道德行为体的本质，回应nihl Fahlquist;第二，关于集体层面美德的概念，回应Meagher。
{"title":"Response: Collective Moral Agents and Their Collective-Level Virtues","authors":"K. MacKay","doi":"10.1093/phe/phac008","DOIUrl":"https://doi.org/10.1093/phe/phac008","url":null,"abstract":"Abstract In this short piece, I attempt to respond to some of the challenges raised by Jessica Nihlén Fahlquist and Karen Meagher in their commentaries on my paper, ‘Public Health Virtue Ethics’. While these authors have made many insightful and challenging remarks, I mostly focus on two questions here: first, about the nature of collectives as moral agents, in response to Nihlén Fahlquist, and second, about the concept of a collective-level virtue, in response to Meagher.","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"15 1","pages":"23 - 26"},"PeriodicalIF":2.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61606174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Conservative assumptions in medical ethics risk immense harms during a pandemic. Public health institutions and public discourse alike have repeatedly privileged inaction over aggressive medical interventions to address the pandemic, perversely increasing population-wide risks while claiming to be guided by 'caution'. This puzzling disconnect between rhetoric and reality is suggestive of an underlying philosophical confusion. In this paper, I argue that we have been misled by status quo bias-exaggerating the moral significance of the risks inherent in medical interventions, while systematically neglecting the (objectively greater) risks inherent in the status quo prospect of an out-of-control pandemic. By coming to appreciate the possibility and significance of status quo risk, we will be better prepared to respond appropriately when the next pandemic strikes.
{"title":"Pandemic ethics and status quo risk","authors":"R. Chappell","doi":"10.1093/phe/phab031","DOIUrl":"https://doi.org/10.1093/phe/phab031","url":null,"abstract":"Conservative assumptions in medical ethics risk immense harms during a pandemic. Public health institutions and public discourse alike have repeatedly privileged inaction over aggressive medical interventions to address the pandemic, perversely increasing population-wide risks while claiming to be guided by 'caution'. This puzzling disconnect between rhetoric and reality is suggestive of an underlying philosophical confusion. In this paper, I argue that we have been misled by status quo bias-exaggerating the moral significance of the risks inherent in medical interventions, while systematically neglecting the (objectively greater) risks inherent in the status quo prospect of an out-of-control pandemic. By coming to appreciate the possibility and significance of status quo risk, we will be better prepared to respond appropriately when the next pandemic strikes.","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61605811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract With evidence of vaccine hesitancy in several jurisdictions, the option of making COVID-19 vaccination mandatory requires consideration. In this paper I argue that it would be ethical to make the COVID-19 vaccination mandatory for older people who are at highest risk of severe disease, but if this were to occur, and while there is limited knowledge of the disease and vaccines, there are not likely to be sufficient grounds to mandate vaccination for those at lower risk. Mandating vaccination for those at high risk of severe disease is justified on the basis of the harm principle, as there is evidence that this would remove the grave public health threat of COVID-19. The risk–benefit profile of vaccination is also more clearly in the interests of those at highest risk, so mandatory vaccination entails a less severe cost to them. Therefore, a selective mandate would create fairness in the distribution of risks. The level of coercion imposed by a mandate would need to be proportionate, and it is likely that multiple approaches will be needed to increase vaccine uptake. However, a selective mandate for COVID-19 vaccines is likely to be an ethical choice and should be considered by policy-makers.
{"title":"The Ethics of Selective Mandatory Vaccination for COVID-19","authors":"B. Williams","doi":"10.1093/phe/phab028","DOIUrl":"https://doi.org/10.1093/phe/phab028","url":null,"abstract":"Abstract With evidence of vaccine hesitancy in several jurisdictions, the option of making COVID-19 vaccination mandatory requires consideration. In this paper I argue that it would be ethical to make the COVID-19 vaccination mandatory for older people who are at highest risk of severe disease, but if this were to occur, and while there is limited knowledge of the disease and vaccines, there are not likely to be sufficient grounds to mandate vaccination for those at lower risk. Mandating vaccination for those at high risk of severe disease is justified on the basis of the harm principle, as there is evidence that this would remove the grave public health threat of COVID-19. The risk–benefit profile of vaccination is also more clearly in the interests of those at highest risk, so mandatory vaccination entails a less severe cost to them. Therefore, a selective mandate would create fairness in the distribution of risks. The level of coercion imposed by a mandate would need to be proportionate, and it is likely that multiple approaches will be needed to increase vaccine uptake. However, a selective mandate for COVID-19 vaccines is likely to be an ethical choice and should be considered by policy-makers.","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"15 1","pages":"74 - 86"},"PeriodicalIF":2.1,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46534500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-29eCollection Date: 2021-11-01DOI: 10.1093/phe/phab026
David Shaw
In this paper, I summarize the medical evidence regarding the auditory and non-auditory effects of noise and analyse the ethics of noise and personal autonomy in the social environment using a variety of case studies. Key to this discussion is the fact that, contrary to the traditional definition of noise, sound can be noise without being annoying, as the evidence shows that some sounds can harm without being perceived. Ultimately, I develop a theory of 'noisy autonomy' with which to guide us in discussing the public health ethics of noise and other sounds.
{"title":"Noisy Autonomy: The Ethics of Audible and Silent Noise.","authors":"David Shaw","doi":"10.1093/phe/phab026","DOIUrl":"https://doi.org/10.1093/phe/phab026","url":null,"abstract":"<p><p>In this paper, I summarize the medical evidence regarding the auditory and non-auditory effects of noise and analyse the ethics of noise and personal autonomy in the social environment using a variety of case studies. Key to this discussion is the fact that, contrary to the traditional definition of noise, sound can be noise without being annoying, as the evidence shows that some sounds can harm without being perceived. Ultimately, I develop a theory of 'noisy autonomy' with which to guide us in discussing the public health ethics of noise and other sounds.</p>","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"14 3","pages":"288-297"},"PeriodicalIF":2.1,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/10/phab026.PMC8661078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39719273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures (RAND) to allocate scarce life-saving resources (SLSR). In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims to these resources rather than use RAND to allocate such resources.
{"title":"We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources","authors":"Roberto Fumagalli","doi":"10.1093/phe/phab025","DOIUrl":"https://doi.org/10.1093/phe/phab025","url":null,"abstract":"In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures (RAND) to allocate scarce life-saving resources (SLSR). In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims to these resources rather than use RAND to allocate such resources.","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"10 10","pages":""},"PeriodicalIF":2.1,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138506809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this article, I argue for a novel understanding of compassion—what I call a ‘compassion towards thriving’ approach—to inform public mental health ethics. The argument is developed through two main parts. In the first part, I develop an account of compassion towards thriving that builds upon Martha Nussbaum’s philosophical work on compassion. This account expands the ambit of compassion from a focus on the alleviation of existing suffering to the prevention of potential future suffering through the facilitation of personal growth based on a ‘psychosocial’ understanding of mental health. In the second part of the article, I discuss the aims of public mental health and examine compassion towards thriving’s normative synergies with existing approaches in public health ethics. I explain how compassion towards thriving supports a vision of public health ethics which is concerned with solidarity, social justice and flourishing. I then apply this compassion towards thriving approach to evaluate the ‘Every Mind Matters’ public mental health campaign in England, highlighting its affinities with the ethos of the campaign. I also identify and explain two ways in which the application of a compassion towards thriving approach could enhance its delivery.
在这篇文章中，我主张对同情有一种新颖的理解——我称之为“对繁荣的同情”的方法——为公共心理健康伦理提供信息。这个论点分为两个主要部分。在第一部分中，我在玛莎·努斯鲍姆关于同情的哲学著作的基础上，对繁荣的同情进行了阐述。这篇报道将同情的范围从关注减轻现有痛苦扩展到通过促进基于对心理健康的“心理社会”理解的个人成长来预防未来潜在的痛苦。在文章的第二部分，我讨论了公共心理健康的目标，并考察了对繁荣的同情与公共卫生伦理中现有方法的规范协同作用。我解释了对繁荣的同情如何支持与团结、社会正义和繁荣有关的公共卫生伦理愿景。然后，我运用这种对繁荣的同情的方法来评估英国的“Every Mind Matters”公共心理健康运动，强调其与运动精神的密切关系。我还确定并解释了两种方式，在这两种方式中，对繁荣的方法应用同情可以加强其交付。
{"title":"Beyond Surviving to Thriving: The Case for a ‘Compassion towards Thriving’ Approach in Public Mental Health Ethics","authors":"Phil Bielby","doi":"10.1093/phe/phab023","DOIUrl":"https://doi.org/10.1093/phe/phab023","url":null,"abstract":"\u0000 In this article, I argue for a novel understanding of compassion—what I call a ‘compassion towards thriving’ approach—to inform public mental health ethics. The argument is developed through two main parts. In the first part, I develop an account of compassion towards thriving that builds upon Martha Nussbaum’s philosophical work on compassion. This account expands the ambit of compassion from a focus on the alleviation of existing suffering to the prevention of potential future suffering through the facilitation of personal growth based on a ‘psychosocial’ understanding of mental health. In the second part of the article, I discuss the aims of public mental health and examine compassion towards thriving’s normative synergies with existing approaches in public health ethics. I explain how compassion towards thriving supports a vision of public health ethics which is concerned with solidarity, social justice and flourishing. I then apply this compassion towards thriving approach to evaluate the ‘Every Mind Matters’ public mental health campaign in England, highlighting its affinities with the ethos of the campaign. I also identify and explain two ways in which the application of a compassion towards thriving approach could enhance its delivery.","PeriodicalId":49136,"journal":{"name":"Public Health Ethics","volume":"1 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41413104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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