This open access book discusses individual, collective, and institutional responsibilities with regard to vaccination from the perspective of philosophy and public health ethics. It addresses the issue of what it means for a collective to be morally responsible for the realisation of herd immunity and what the implications of collective responsibility are for individual and institutional responsibilities. The first chapter introduces some key concepts in the vaccination debate, such as ‘herd immunity’, ‘public goods’, and ‘vaccine refusal’; and explains why failure (...) to vaccinate raises certain ethical issues. The second chapter analyses, from a philosophical perspective, the relationship between individual, collective, and institutional responsibilities with regard to the realisation of herd immunity. The third chapter is about the principle of least restrictive alternative in public health ethics and its implications for vaccination policies. Finally, the fourth chapter presents an ethical argument for unqualified compulsory vaccination, i.e. for compulsory vaccination that does not allow for any conscientious objection. The book will appeal to philosophers interested in public health ethics and the general public interested in the philosophical underpinning of different arguments about our moral obligations with regard to vaccination. (shrink)

Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion (...) is, including cases where the newborn is not disabled. (shrink)

I argue that there are significant moral reasons in addition to harm prevention for making vaccination against certain common infectious diseases compulsory. My argument is based on an analogy between vaccine refusal and tax evasion. First, I discuss some of the arguments for compulsory vaccination that are based on considerations of the risk of harm that the non‐vaccinated would pose on others; I will suggest that the strength of such arguments is contingent upon circumstances and that in order to provide (...) the strongest defence possible of compulsory vaccination, such arguments need to be supplemented by additional arguments. I will then offer my additional argument for compulsory vaccination: I will argue that in both cases of vaccine refusal and of tax evasion individuals fail to make their fair contribution to important social and public goods, regardless of whether each individual contribution ‘makes a difference’. While fairness considerations have sometimes been used to support a moral duty to vaccinate, they have not been appealed to in order to argue for a legal duty to vaccinate. I will suggest that this is due, among other things, to a misapplication of the principle of the least restrictive alternative in public health. Finally, I will address nine possible objections to my argument. (shrink)

We argue that, in certain circumstances, doctors might beprofessionallyjustified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors’ positive claims of conscience to provide abortions if they plausibly track what is in the best (...) medical interests of their patients. It is the responsibility of state authorities to enforce the law, but it is the responsibility of professional organisations to uphold the highest standards of medical ethics, even when they conflict with the law. Whatever the legal sanctions in place, healthcare professionals should not be sanctioned by the professional bodies for providing abortions according to professional standards, even if illegally. Indeed, professional organisation should lobby to offer protection to such professionals. Our arguments have practical implications for what healthcare professionals and healthcare professional organisations may or should do in those jurisdictions that legally prohibit abortion, such as some US States after the reversal ofRoe v Wade. (shrink)

We argue that, from the point of view public health ethics, vaccination is significantly analogous to seat belt use in motor vehicles and that coercive vaccination policies are ethically justified for the same reasons why coercive seat belt laws are ethically justified. We start by taking seriously the small risk of vaccines’ side effects and the fact that such risks might need to be coercively imposed on individuals. If millions of individuals are vaccinated, even a very small risk of serious (...) side effects implies that, statistically, at some point side effects will occur. Imposing such risks raises issues about individual freedom to decide what risks to take on oneself or on one’s children and about attribution of responsibility in case of adverse side effects. Seat belt requirements raise many of the same ethical issues as vaccination requirements, and seat belt laws initially encountered some opposition from the public that is very similar to some of the current opposition to vaccine mandates. The analogy suggests that the risks of vaccines do not constitute strong enough reasons against coercive vaccination policies and that the same reasons that justify compulsory seat belt use—a measure now widely accepted and endorsed—also justify coercive vaccination policies. (shrink)

Kant claims that the nominal definition of truth is: “Truth is the agreement of cognition with its object”. In this paper, I analyse the relevant features of Kant's theory of definition in order to explain the meaning of that claim and its consequences for the vexed question of whether Kant endorses or rejects a correspondence theory of truth. I conclude that Kant's claim implies neither that he holds, nor that he rejects, a correspondence theory of truth. Kant's claim is not (...) a generic way of setting aside a correspondence definition of truth, or of considering it uninformative. Being the nominal definition of truth, the formula “truth is the agreement of cognition with its object” illustrates the meaning of the predicate “is true” and people's ordinary conception of truth. True judgements correspond to the objects they are about. However, there could be more to the property of truth than correspondence. (shrink)

The rapid development of vaccines against COVID‐19 represents a huge achievement, and offers hope of ending the global pandemic. At least three COVID‐19 vaccines have been approved or are about to be approved for distribution in many countries. However, with very limited initial availability, only a minority of the population will be able to receive vaccines this winter. Urgent decisions will have to be made about who should receive priority for access. Current policy in the UK appears to take the (...) view that those who are most vulnerable to COVID‐19 should get the vaccine first. While this is intuitively attractive, we argue that there are other possible values and criteria that need to be considered. These include both intrinsic and instrumental values. The former are numbers of lives saved, years of life saved, quality of the lives saved, quality‐adjusted life‐years (QALYs), and possibly others including age. Instrumental values include protecting healthcare systems and other broader societal interests, which might require prioritizing key worker status and having dependants. The challenge from an ethical point of view is to strike the right balance among these values. It also depends on effectiveness of different vaccines on different population groups and on modelling around cost‐effectiveness of different strategies. It is a mistake to simply assume that prioritizing the most vulnerable is the best strategy. Although that could end up being the best approach, whether it is or not requires careful ethical and empirical analysis. (shrink)

In this paper, we suggest that personalized LLMs trained on information written by or otherwise pertaining to an individual could serve as artificial moral advisors (AMAs) that account for the dynamic nature of personal morality. These LLM-based AMAs would harness users’ past and present data to infer and make explicit their sometimes-shifting values and preferences, thereby fostering self-knowledge. Further, these systems may also assist in processes of self-creation, by helping users reflect on the kind of person they want to be (...) and the actions and goals necessary for so becoming. The feasibility of LLMs providing such personalized moral insights remains uncertain pending further technical development. Nevertheless, we argue that this approach addresses limitations in existing AMA proposals reliant on either predetermined values or introspective self-knowledge. (shrink)

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of care by Joan (...) Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

We provide ethical criteria to establish when vaccine mandates for healthcare workers are ethically justifiable. The relevant criteria are the utility of the vaccine for healthcare workers, the utility for patients (both in terms of prevention of transmission of infection and reduction in staff shortage), and the existence of less restrictive alternatives that can achieve comparable benefits. Healthcare workers have professional obligations to promote the interests of patients that entail exposure to greater risks or infringement of autonomy than ordinary members (...) of the public. Thus, we argue that when vaccine mandates are justified on the basis of these criteria, they are not unfairly discriminatory and the level of coercion they involve is ethically acceptable—and indeed comparable to that already accepted in healthcare employment contracts. Such mandates might be justified even when general population mandates are not. Our conclusion is that, given current evidence, those ethical criteria justify mandates for influenza vaccination, but not COVID-19 vaccination, for healthcare workers. We extend our arguments to other vaccines. (shrink)

We discuss the relationship between expertise, expert authority, and trust in the case of vaccine research and policy, with a particular focus on COVID-19 vaccines. We argue that expert authority is not merely an epistemic notion, but entails being trusted by the relevant public and is valuable if it is accompanied by expert trustworthiness. Trustworthiness requires, among other things, being transparent, acknowledging uncertainty and expert disagreement (e.g., around vaccines’ effectiveness and safety), being willing to revise views in response to new (...) evidence, and being clear about the values that underpin expert recommendations. We explore how failure to acknowledge expert disagreement and uncertainty can undermine trust in vaccination and public health experts, using expert recommendations around COVID-19 vaccines as a case study. (shrink)

Some people have stressed that there is a close analogy between meaning experiences, i.e., experiences as of understanding concerning linguistic expressions, and seeing-in experiences, i.e., pictorial experiences of discerning a certain item – what a certain picture presents, viz. the picture’s subject – in another item – the picture’s vehicle, the picture’s physical basis. Both can be seen as fusion experiences, in the minimal sense that they are experiential wholes made up of different aspects. Actually, two important similarities between such (...) experiences may lead one to think that they are experiences of the same type. In this paper, however, I will try to show that notwithstanding such similarities, these experiences are typologically different. For there are two dissimilarities between such experiences that are more relevant on this typological concern than their similarities. Indeed, unlike meaning experiences, seeing-in experiences are first of all recognitional experiences of a sort that makes them perceptual experiences as well. Moreover, again unlike meaning experiences, seeing-in experiences are fusion experiences in the substantial sense that the experiential whole is more than the sum of its experiential parts taken in isolation, for when such parts figure in that whole, they interact with each other. In a nutshell, unlike meaning experiences, seeing-in experiences are proper fusion experiences. (shrink)

Cameron et al ’s1 ethical considerations about the ‘Dualism of Values’ in pandemic response emphasise the need to strike a fair balance between the interests of the less vulnerable to COVID-19 and the interests of the more vulnerable. Those considerations are at the basis of ethical defences of focused protection strategies.2 One example is the proposal put forward in the Great Barrington Declaration. It presented focused protection strategies as more ethical alternatives to lockdowns which would prevent lockdowns’ ‘irreparable damage, with (...) the underprivileged disproportionately harmed’.3 Here we want to suggest that a version of Cameron et al ’s analysis can be applied to the case of vaccines to support a focused protection vaccination strategy. At this stage, we should limit vaccination to the vulnerable and not target children in COVID-19 vaccination strategies. We argue that, given the current state of knowledge about COVID-19, immunity and vaccines, it would be wrong to pose the costs and risks of vaccines on children for three reasons. First, they are unlikely to benefit from COVID-19 vaccination …. (shrink)

The range of opportunities people enjoy in life largely depends on social, biological, and genetic factors for which individuals are not responsible. Philosophical debates about equality of opportunities have focussed mainly on addressing social determinants of inequalities. However, the introduction of human bioenhancement should make us reconsider what our commitment to equality entails. We propose a way of improving morally relevant equality that is centred on what we consider a fair distribution of bioenhancements. In the first part, we identify three (...) main positions in the debate on bioenhancement and equality, and we show how each of them fails to meet the demands of a serious commitment to equality. In the second part, we formulate a new proposal that we think better promotes equality of opportunities: people from disadvantaged socio-economic backgrounds should be given access to bioenhancements while people from privileged socio-economic background should be prohibited from using them. We argue that those who are concerned about the inequality implications of bioenhancement should embrace this solution, rather than reject bioenhancement. (shrink)

In this paper, I want to argue for two main and related points. First, I want to defend Richard Wollheim’s well-known thesis that the twofold mental state of seeing-in is the distinctive pictorial experience that marks figurativity. Figurativity is what makes a representation pictorial, a depiction of its subject. Moreover, I want to show that insofar as it is a mark of figurativity, all seeing-in is inflected. That is to say, every mental state of seeing-in is such that the characterisation (...) of the properties by which a certain subject is seen in a given picture as having refers to the design properties of the picture’s vehicle, i.e., to the visible surface properties of that vehicle that are responsible for the fact that one such subject is seen in it, precisely taken in such a design role. Finally, I will try to show that seeing-in is qualified by inflection independently of whether it is conscious or unconscious seeing-in. (shrink)

To the extent that antibiotic resistance (ABR) is accelerated by antibiotic consumption and that it represents a serious public health emergency, it is imperative to drastically reduce antibiotic consumption, particularly in high‐income countries. I present the problem of ABR as an instance of the collective action problem known as ‘tragedy of the commons’. I propose that there is a strong ethical justification for taxing certain uses of antibiotics, namely when antibiotics are required to treat minor and self‐limiting infections, such as (...) respiratory tract infections, in otherwise healthy individuals. Taxation would allow a reduction in consumption (given certain behavioural economics assumptions) and/or ensure that individuals internalize or compensate for their contribution to the erosion of the common good of antibiotic effectiveness. I suggest that revenue from the tax could be used to fund conservation and innovation strategies. Taxation might be a coercive policy, especially for certain individuals, but the ethical case for coercive policies is very strong when the good to be preserved is important enough and when they force individuals to do something they have a moral obligation to do anyway. I argue that, in the case of mild and self‐limiting infections, individuals have a moral duty of easy rescue and a moral duty of fairness to make their contribution to the preservation of the common good of antibiotic effectiveness by foregoing antibiotics. I also suggest that taxing antibiotics in such cases is an all things considered ethically justified policy even if it would introduce inequalities in access to healthcare. (shrink)

Many scholars claimed that, according to Immanuel Kant, some judgements lack a truth-value: analytic judgements, judgements about items of which humans cannot have experience, judgements of perception, and non-assertoric judgements. However, no one has undertaken an extensive examination of the textual evidence for those claims. Based on an analysis of Kant's texts, I argue that: (1) according to Kant, only judgements of perception are not truth-apt. All other judgements are truth-apt, including analytic judgements and judgements about items of which humans (...) cannot have experience. (2) Kant sometimes states that truth-apt judgements are actual bearers of truth or falsity only when they are taken to state what is actually the case. Kant calls these judgements assertoric. Other texts ascribe truth and falsity to judgements, regardless of whether they are assertoric. Kant's views on truth-aptness raise challenges for correspondentist and coherentist interpretations of Kant's theory of truth; they rule out the identification of Kant's crucial notion of objective validity with truth-aptness; and they imply that Kant was not a verificationist about truth or meaning. (shrink)

Conflict of interests in medicine are typically taken to be financial in nature: it is often assumed that a COI occurs when a healthcare practitioner’s financial interest conflicts with patients’ interests, public health interests, or professional obligations more generally. Even when non-financial COIs are acknowledged, ethical concerns are almost exclusively reserved for financial COIs. However, the notion of “interests” cannot be reduced to its financial component. Individuals in general, and medical professionals in particular, have different types of interests, many of (...) which are non-financial in nature but can still conflict with professional obligations. The debate about healthcare delivery has largely overlooked this broader notion of interests. Here, we will focus on health practitioners’ moral or religious values as particular types of personal interests involved in healthcare delivery that can generate COIs and on conscientious objection in healthcare as the expression of a particular type of COI. We argue that, in the healthcare context, the COIs generated by interests of conscience can be as ethically problematic, and therefore should be treated in the same way, as financial COIs. (shrink)

The debate around lockdowns as a response to the recent pandemic is typically framed in terms of a tension between freedom and health. However, on some views, protection of health or reduction of virus‐related risks can also contribute to freedom. Therefore, there might be no tension between freedom and health in public health restrictions. I argue that such views fail to appreciate the different understandings of freedom that are involved in the trade‐off between freedom and health. Grasping these distinctions would (...) allow to appreciate why different people give more weight to different aspects of limitations of freedom, including whether certain options are made simply risky or impossible, whether limitations of freedom are posed intentionally or happen accidentally, whether risks are beyond a threshold of acceptability, and who gets to decide that. I provide a conceptual analysis of the relationship between different types of freedom, public health policies, viruses and diseases. As I argue, identifying what freedom‐based reasons count for and against different types of public health restrictions requires distinguishing between viruses and diseases, between lockdowns and other types of restrictive policies, and between risks posed by viruses and threats of penalties involved by restrictive policies. (shrink)

The first half of this article follows Mario Bunge’s early realist moves, his efforts to articulate the achievements of theoretical physics as gains in the quest for objective truth and understanding, particularly in the context of the fights against the idealist and subjectivist interpretations of quantum mechanics that, at least until the mid-1970s, prevailed in physics. Bunge’s answers to the problems of quantum mechanics provide a good angle for understanding how his realist positions grew on the “battlefield.” The second half (...) discusses Bunge’s general conception of the scientific realist stance and confronts it with some current approaches to realism in the mainstream literature. (shrink)

I argue that appeals to conscience do not constitute reasons for granting healthcare professionals exemptions from providing services they consider immoral (e.g. abortion). My argument is based on a comparison between a type of objection that many people think should be granted, i.e. to abortion, and one that most people think should not be granted, i.e. to antibiotics. I argue that there is no principled reason in favour of conscientious objection qua conscientious that allows to treat these two cases differently. (...) Therefore, I conclude that there is no principled reason for granting conscientious objection qua conscientious in healthcare. What matters for the purpose of justifying exemptions is not whether an objection is ‘conscientious’, but whether it is based on the principles and values informing the profession. I provide examples of acceptable forms of objection in healthcare. (shrink)

This article reconstructs Kant's view on the existential import of categorical sentences. Kant is widely taken to have held that affirmative sentences (the A and I sentences of the traditional square of opposition) have existential import, whereas negative sentences (E and O) lack existential import. The article challenges this standard interpretation. It is argued that Kant ascribes existential import only to some affirmative synthetic sentences. However, the reasons for this do not fall within the remit of Kant's formal logic. Unlike (...) traditional logic and modern standard quantification theory, Kant's formal logic is free from existential commitments. (shrink)

The definition of love given by Descartes in the Passions of the Soul has never stopped puzzling commentators. If the first Cartesian textbooks discreetly evoke or even fail to discuss Descartes’s account of love, Spinoza harshly criticizes it, pointing out that it is ‘on all hands admitted to be very obscure’. More recently several scholars have noticed the puzzling character of the articles of the Passions of the Soul on love and hate. In this paper, I would like to propose (...) a reassessment of the definition of love provided by the Passions of the Soul and the Letters to Elisabeth and Chanut. By tracing back Descartes’s scholastic sources, I will demonstrate how Descartes builds up his definition of love by displacing or subverting the meaning of several major elements of the thomistic vulgata on love. Hence, a significant part of the obscurity of the definition given by the Passions of the Soul possibly finds its ultimate rationale in this attempt to recover some traditional questions of the scholastic debate on love, while advancing new answers to them. (shrink)

This chapter discusses the relation between Christian Wolff's philosophy and the methodological views of early modern experimental philosophers. The chapter argues for three claims. First, Wolff's system relies on experience at every step and his views on experiments, observations, hypotheses, and the a priori are in line with those of experimental philosophers. Second, the study of Wolff's views demonstrates the influence of experimental philosophy in early eighteenth-century Germany. Third, references to Wolff's empiricism and rationalism are best identified or replaced with (...) references to his endorsement of the tenets of experimental philosophers and of a mathematical demonstrative method. (shrink)

How do we form concepts like those of three, bicycle and red? According to Kant, we form them by carrying out acts of comparison, reflection and abstraction on information provided by the senses. Kant's answer raised numerous objections from philosophers and psychologists alike. "Kant e la formazione dei concetti" argues that Kant is able to rebut those objections. The book shows that, for Kant, it is possible to perceive objects without employing concepts; it explains how, given those perceptions, we can (...) form categories and empirical concepts; and it argues that theories like Kant's - abstractionist theories of concept formation - are more plausible than is often assumed. (shrink)

This paper discusses Immanuel Kant’s views on the role of experiments in natural science, focusing on their relationship with hypotheses, laws of nature, and the heuristic principles of scientific enquiry. Kant’s views are contrasted with the philosophy of experiment that was first sketched by Francis Bacon and later developed by Robert Boyle and Robert Hooke. Kant holds that experiments are always designed and carried out in the light of hypotheses. Hypotheses are derived from experience on the basis of a set (...) of heuristic principles. The function of experiments is testing hypotheses in order to either reject them as false, or else to transform them into empirical laws of nature. To this end, we must integrate the hypotheses that are confirmed by experiments with the a priori principles which are the foundations of natural science. Compared with Bacon, Boyle, and Hooke, Kant has elaborate views on the one hand, on how our theoretical and pre-theoretical assumptions bear on experimental practice, and on the other hand, on how the results of experimental activity can be integrated with theories to advance our knowledge of nature. However, Kant overstates the dependence of experiments on theories. (shrink)

A comparison is given between two conditions used to define logical constants: Belnap's uniqueness and Hacking's deducibility of identicals. It is shown that, in spite of some surface similarities, there is a deep difference between them. On the one hand, deducibility of identicals turns out to be a weaker and less demanding condition than uniqueness. On the other hand, deducibility of identicals is shown to be more faithful to the inferentialist perspective, permitting definition of genuinely proof-theoretical concepts. This kind of (...) analysis is driven by exploiting the Curry–Howard correspondence. In particular, deducibility of identicals is shown to correspond to the computational property of eta expansion, which is essential in the characterization of propositional identity. (shrink)

Although the COVID-19 pandemic is a serious public health and economic emergency, and although effective vaccines are the best weapon we have against it, there are groups and individuals who oppose certain kinds of vaccines because of personal moral or religious reasons. The most widely discussed case has been that of certain religious groups that oppose research on COVID-19 vaccines that use cell lines linked to abortions and that object to receiving those vaccine because of their moral opposition to abortion. (...) However, moral opposition to COVID-19 vaccine research can be based on other considerations, both secular and religious. We argue that religious or personal moral objections to vaccine research are unethical and irresponsible, and in an important sense often irrational. They are unethical because of the risk of causing serious harm to other people for no valid reason; irresponsible because they run counter to individual and collective responsibilities to contribute to important public health goals; and in the case of certain kinds of religious opposition, they might be irrational because they are internally inconsistent. All in all, our argument translates into the rather uncontroversial claim that we should prioritize people’s lives over religious freedom in vaccine research and vaccination roll out. (shrink)

We argue that we should provide extra payment not only for extra time worked but also for the extra risks healthcare workers (and those working in healthcare settings) incur while caring for COVID‐19 patients—and more generally when caring for patients poses them at significantly higher risks than normal. We argue that the extra payment is warranted regardless of whether healthcare workers have a professional obligation to provide such risky healthcare. Payment for risk would meet four essential ethical requirements. First, assuming (...) healthcare workers do not have a professional obligation to take on themselves the risks, payments in the form of incentives would preserve autonomy in deciding what risks to take on oneself. Second, even assuming that healthcare workers do have a professional obligation to take on themselves the risks, payments for risk would create fair working conditions by avoiding exploitation. Third, payments for risk would make it more likely that public healthcare systems can discharge their institutional responsibility to provide healthcare in circumstances where healthcare workers may otherwise (perhaps legitimately) opt out. Fourth, payments for risk would guarantee an efficient healthcare system in pandemic situations. Finally, we address two likely objections that some might raise against our proposal, particularly with regard to incentives, namely that such payments or incentives can themselves be coercive and that they represent a form of undue inducement. (shrink)

Many parents are hesitant about, or face motivational barriers to, vaccinating their children. In this paper, we propose a type of vaccination policy that could be implemented either in addition to coercive vaccination or as an alternative to it in order to increase paediatric vaccination uptake in a non-coercive way. We propose the use of vaccination nudges that exploit the very same decision biases that often undermine vaccination uptake. In particular, we propose a policy under which children would be vaccinated (...) at school or day-care by default, without requiring parental authorization, but with parents retaining the right to opt their children out of vaccination. We show that such a policy is likely to be effective, at least in cases in which non-vaccination is due to practical obstacles, rather than to strong beliefs about vaccines, ethically acceptable and less controversial than some alternatives because it is not coercive and affects individual autonomy only in a morally unproblematic way, and likely to receive support from the UK public, on the basis of original empirical research we have conducted on the lay public. (shrink)

This note makes a contribution to the issue raised in a paper by Popper and Miller (1983) in which it was claimed that probabilistic support is purely deductive. Developing R. C. Jeffrey's remarks, a new general approach to the crucial concept of "going beyond" is here proposed. By means of it a quantitative measure of the inductive component of a probabilistic inference is reached. This proposal leads to vindicating the view that typical predictive probabilistic inferences by enumeration and analogy are (...) purely inductive. (shrink)

Conscientious objection in healthcare is often granted by many legislations regulating morally controversial medical procedures, such as abortion or medical assistance in dying. However, there is virtually no protection of positive claims of conscience, that is, of requests by healthcare professionals to provide certain services that they conscientiously believe ought to be provided, but that are ruled out by institutional policies. Positive claims of conscience have received comparatively little attention in academic debates. Some think that negative and positive claims of (...) conscience deserve equal protection in terms of measures that institutions ought to take to accommodate them. However, in this issue of The Journal of Clinical Ethics (JCE), Abram Brummett argues against this symmetry thesis. He suggests that the relevant distinction is not between negative and positive claims of conscience, but between negative and positive rights of conscience. He argues that conscientious refusals and positive claims of conscience are both already protected as negative rights of conscience, but that this does not require institutions to accommodate positive claims of conscience. In this article I will argue that both Brummett and the authors he criticizes share a wrong view about the existence of conscience rights in healthcare. I will argue that there is no right to conscientious objection in healthcare, whether positive or negative. Thus, contra Brummett, I argue that the question whether such rights are positive or negative is as irrelevant as the question whether the claims of conscience are positive or negative. (shrink)

In his (2001a) and in some related papers, Tim Crane has maintained that intentional objects are schematic entities, in the sense that, insofar as being an intentional object is not a genuine metaphysical category, qua objects of thought intentional objects have no particular nature. This approach to intentionalia is the metaphysical counterpart of the later Husserl's ontological approach to the same entities, according to which qua objects of thought intentionalia are indifferent to existence. But to buy a metaphysically deflationary approach (...) does not mean to buy an ontologically deflationary approach, according to which we have to accept all the intentional objects there apparently are. Being metaphysically deflationary on intentionalia rather means that from the ontological point of view one must really allow only for those intentionalia for which one is entitled to say that there are such things; typically, for which an ontological proof is available. From metaphysical schematism plus conditional, or partial, ontological committment to intentionalia, further interesting consequences follow. First, this theoretical combination allows one to deal with the ‘too-many entities’ problem (may one fail to accept an ontological proof for an entity of a given kind if she thinks that the entity we would have to be committed to is an entity of another kind?). Second, it allows one to deal with the ‘genuinely true report’ problem (how is it that if we exercise mindreading with respect to a somehow deluded person, we want our reports to come out as really, not merely fictionally, true?). (shrink)

GRW models of the physical world are criticized in the literature for involving wave function "tails" that allegedly create fatal interpretive problems and even compromise standard arithmetic. I find such objections both unfair and misguided. But not all is well with the GRW approach. One complaint I articulate in this paper does not have to do with tails as such but with the specific way in which past physical structures linger forever in the total GRW wave function. By pushing the (...) total proposal towards either the "Many Worlds" approach or the Bohmian approach, this feature diminishes extant GRW claims to preferability. I suggest, however, that the problem here is just an artifact of the particular and ultimately optional genre of collapse mechanism chosen by GRW. (shrink)

The scientific literature on Wigner’s Friend extended paradox rapidly grew in the last years. A sign that Frauchiger and Renner (2018)’s argument caught an important point. Indeed, they conclude that either we must abandon the universal validity of quantum mechanics, or a certain kind of traditional objective knowledge is impossible. We investigate this contradiction through a logico-epistemic toolbox. We show that abandoning the transmissibility of knowledge, as proposed by many kinds of relational approaches to quantum mechanics, is a heavy epistemological (...) renouncement. Perhaps, it is better to bite the bullet and accept Frauchiger and Renner’s contradiction, until a new revolutionary solution will appear. (shrink)

A common assumption in non-relativistic quantum mechanics is that self-adjoint operators mathematically represent properties of quantum systems. Focusing on spin, we argue that a natural view considers observables as determinable properties and their eigenvalues as their corresponding determinates. We provide a taxonomy of the different views that one can hold, once it is accepted that spin can be modelled with the determinable-determinate relation. In particular, we present the two main families of views, dubbed Spin Monism and Pluralism, and we show (...) that the current literature does not take a stance between the two. Then we put forward two arguments in favour of the former. Finally, we present a new account of Spin Monism, that is absent in current literature; such a view is worth discussing, or so we contend, because several compelling considerations support it, and it opens new ways of thinking about the ontology of quantum mechanics. (shrink)

We discuss whether and under what conditions people should be allowed to choose which COVID-19 vaccine to receive on the basis of personal ethical views. The problem arises primarily with regard to some religious groups’ concerns about the connection between certain COVID-19 vaccines and abortion. Vaccines currently approved in Western countries make use of foetal cell lines obtained from aborted foetuses either at the testing stage or at the development stage. The Catholic Church’s position is that, if there are alternatives, (...) Catholic people have a moral obligation to request the vaccine whose link with abortion is more remote, which at present means that they should refuse the Oxford/AstraZeneca vaccine. We argue that any consideration regarding free choice of the vaccine should apply to religious and non-religious claims alike, in order to avoid religion-based discrimination. However, we also argue that, in a context of limited availability, considering the significant differences in costs and effectiveness profile of the vaccines available, people should only be allowed to choose the preferred vaccine if: 1) this does not risk compromising vaccination strategies; and 2) they internalize any additional cost that their choice might entail. The State should only subsidize the vaccine that is more cost-effective for any demographic group from the point of view of public health strategies. (shrink)

In this paper I want to hold, first, that one may suitably reconstruct the relevant kind of mental representational states that fiction typically involves, make-beliefs, as contextually unreal beliefs that, outside fiction, are either matched or non-matched by contextually real beliefs. Yet moreover, I want to claim that the kind of make-believe that may yield the mark of fictionality is not Kendall Walton’s invitation or prescription to imagine. Indeed, in order to appeal in terms of make-believe to a specific form (...) of imagination that fiction distinctively involves, one must move away from the realm of norms in order to attain a cognitive realm; namely, one must look at a specific form of metarepresentational state. This metarepresentational state of make-believe is a second-order representation that is about both real beliefs and make-beliefs, as the first-order representations it compares by acknowledging their contextual distinctness. (shrink)

Clinical ethics consultation has become an integral part of healthcare, serving as a mechanism to navigate complex moral dilemmas that arise in medical practice. The critical dialogue method, as described by Delany et al 1, presents a structured approach that emphasises the role of dialogue in resolving ethical issues. This method is designed to enhance moral clarity and confidence among healthcare professionals, thus improving clinical decision-making. The following commentary delves into the practical application of the critical dialogue method’s seven facilitation (...) steps, analysing real-world cases to illustrate its effectiveness and identifying potential challenges, particularly in culturally diverse settings. The critical dialogue method is structured around seven facilitation steps that steer the ethical deliberation process. These steps are intended to foster a systematic and reflective discussion, prompting participants to consider diverse perspectives and work towards a consensus on ethical matters. The seven steps,1 initiation of dialogue,2 exploration of perspectives,3 identification of ethical principles,4 deliberation on options,5 consensus building, (6) implementation of the decision and (7) reflection and evaluation, are outlined in figure 1. Figure 1 The seven facilitation steps in practice by Delany et al.1 The critical dialogue method has the potential to significantly enhance clinical …. (shrink)

The ‘tobacco-free generation’ policy, which bans cigarette sales based on birth year, presents a bold public health initiative but raises significant ethical and practical concerns. As behaviours like drug use become legal and criminal penalties are reduced, singling out smoking for generational restriction appears inconsistent within an increasingly permissive society. Kniess1 critiques this approach for creating inequities by selectively limiting freedoms, conflicting with principles of fairness and adult autonomy. A more balanced public health strategy could involve uniform restrictions on harmful (...) substances or prioritising informed personal choice, supported by harm reduction and education to encourage healthier alternatives. The generational smoking ban targets specific birth cohorts, prohibiting tobacco sales to those born after a certain year. Unlike universal bans, it creates two distinct adult classes—those permitted to smoke and those who are not—resulting in an apparently arbitrary division. Critics, including Schmidt,2 point to the ethical inconsistency of restricting liberties for some while leaving others untouched. This policy design has been defended as a pragmatic compromise, aiming to protect future generations without infringing on the established habits of current smokers (Grill and Voigt).3 Kniess1 evaluates this selective restriction through relational egalitarianism which emphasises the importance of equal social relationships. The cut-off, …. (shrink)

Spartan institutions were pictured as a model of political stability from the Classical period onwards. The so-called Spartan ‘mirage’ did not involve only its constitutional order but also social and economic institutions. Xenophon begins hisConstitution of the Lacedaemoniansby associating Spartan fame with thepoliteiaset up by Lycurgus, which made the Laconian city the most powerful (δυνατωτάτη) and famous (ὀνομαστοτάτη)polisin Greece (Xen.Lac.1.1). In Aristotle'sPolitics, in which the assessment of Sparta is more complex and nuanced, one finds a critique of contemporary Spartan institutions (...) as well as praise for Lycurgus as a great lawgiver who established the laws of Sparta (Arist.Pol.2.1269a69, 2.1273b20). Most other ancient sources often remark upon the unchangeable features of some Spartan institutions as a key aspect of Spartan εὐνομία. Thucydides maintains that, after a long period of war andstasis, the Dorians established excellent laws and Sparta employed the same constitution for more than four hundred years (Thuc. 1.18.1: τετρακόσια καὶ ὀλίγῳ πλείω ἐς τὴν τελευτὴν τοῦδε τοῦ πολέμου ἀφ᾽ οὗ Λακεδαιμόνιοι τῇ αὐτῇ πολιτείᾳ χρῶνται). (shrink)