Kennedy Institute of Ethics Journal

Although researchers generally take great care to ensure that human subjects do not suffer very serious harms from their involvement in research, the situation is different for nonhuman animal subjects. Significant progress has been made in reducing unnecessary animal suffering in research, yet researchers still inflict severe pain and distress on tens of thousands of animals every year for scientific purposes. Some bioethicists, scientists, and animal welfare advocates argue for placing an upper limit on the suffering researchers may impose on animal subjects, with rare exceptions for research that promises critical social benefits...

Guidelines and regulations for medical research recognize that the experiences of humans and animals both matter morally. They thus set a presumption against harming research subjects, whether humans or animals, and mandate that the harms subjects experience should be the minimal necessary for achieving the scientific aims of the study. Beyond this, guidelines and regulations place upper limits on the extent to which human, but not animal, subjects may be harmed. They also mandate that human, but not animal, subjects should be compensated for the harms they experience...

Robert Veatch argues that physician oaths should not be valued as substantive moral commitments, transformational rituals, or symbolic acts. Further, he insists that oath recitation in medical schools is immoral. I respond to Veatch's criticisms and argue that, with alterations to their content and practice, oaths can have value for articulating moral commitments and building a sense of moral community within the profession. I break down Veatch's multitude of objections to oaths over his career, and I suggest how medical schools can avoid the pitfalls identified by Veatch...

In these Conversations, Robert Veatch reveals remarkable moments of his intellectual journey through bioethics. In Part I, he recalls some of the major historical events that contributed to modern bioethics development from the 1970s onward. Going back more than one decade, he emphasizes the impact of the Antiwar and Civil Rights movements, his pacifist ideals, and his engagement as an activist. In Part II, Veatch discusses the core of his theoretical proposal for bioethics, which is based on seven principles...

No abstract text is available yet for this article.

Racial disparities in pain treatment are well documented. Such disparities are explained with reference to factors related to providers, health care structures, and patient behaviors. Racial differences in pain experiences, although well documented, are less well understood. Explanations for such differences usually involve genetic or psychological factors. Here, we argue that racial differences in pain experiences might also be explained by disparities in pain treatment. Based on what we know about the nature of pain, particularly the cognitive and affective aspects of the phenomenon, it is likely that disparities in the treatment of racialized patients can lead to significant racial differences in pain experience that show up at the population level...

Social inequality may obstruct the generation of knowledge, as the rich and powerful may bring about social acceptance of skewed views that suit their interests. Epistemic equality in the context of justification is a means of preventing such obstruction. Drawing on social epistemology and theories of equality and distributive justice, we provide an account of epistemic equality. We regard participation in, and influence over a knowledge-generating discourse in an epistemic community as a limited good that needs to be justly distributed among putative members of the community...

In this article, I argue that adolescent medical transition is ethical by analogizing it to abortion and birth control. The interventions are similar insofar as they intervene on healthy physiological states by reason of the person's fundamental self-conception and desired life, and their effectiveness is defined by their ability to achieve patients' embodiment goals. Since the evidence of mental health benefits is comparable between adolescent medical transition, abortion, and birth control, disallowing transition-related interventions would betray an unacceptable double standard...

No abstract text is available yet for this article.

Medical epistemology lately has seen a strengthening of the view that the construction of evidence should be sensitive to the social context in which it is produced. A poignant illustration of this is the undue influence of the pharmaceutical industry on research results and reporting. I challenge a particular application of this view by examining a common practice in the medical and scientific community: mandatory author disclosure of conflicts of interest (COIs) in published articles. In illustrating problems with COI disclosure policies in biomedical publishing, including unappreciated shortcomings of the scant empirical data supporting mandatory disclosure, I hope to demonstrate that the value given to journal COI disclosure policies as a way to protect the reliability of medical evidence might well be misplaced...

How to deal with non-epistemic values in science presents a pressing problem for science and society as well as for philosophers of science. In recent years, accounts of democratizing science have been proposed as a possible solution to this. By providing a case study on the establishment of the Intergovernmental Science-Policy comment: Platform on Biodiversity and Ecosystem Services comment: (IPBES), I argue that such accounts run into a problem when values are embedded in the general scientific and societal setup to such an extent that they shape the terrain upon which such a democratization needs to take place...

Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists' presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound like a natural proposal, I show it offers guidance that conflicts with standard scientific practices...

Both the distinction between the 'internal' and 'external' phases of science and the concept of 'inductive risk' are core constructs in the values in science literature. However, both constructs have shortcomings, which, we argue, have concealed the unique significance of values in scientific representation. We defend three closely-related proposals to rectify the problem: i) to draw a conceptual distinction between endorsing a 'fact' and making a decision about representation; ii) to employ a conception of inductive risk that aligns with this distinction, not one between internal/external phases in science; iii) to conceptualize 'representational risk' as a unique epistemic risk, no less significant than inductive risk...

No abstract text is available yet for this article.

In "Were Lockdowns Justified? A Return to the Facts and Evidence", we argue that Eric Winsberg, Jason Brennan and Chris Surprenant fail to make their case that initial COVID-19 lockdowns were unjustified, due to the fact their argument rests on erroneous factual claims. As is made clear by a response in this volume, the authors mistakenly take us to have been defending the imposition of lockdowns. Here, we clarify the aims of our original paper, and emphasise the importance of getting the facts right when making philosophical arguments in such a contentious domain...

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.

Were governments justified in imposing lockdowns to contain the spread of the COVID-19 pandemic? We argue that a convincing answer to this question is to date wanting, by critically analyzing the factual basis of a recent paper, "How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis" (Winsberg, Brennan, and Suprenant 2020). In their paper, Winsberg, Brennan, and Suprenant argue that government leaders did not, at the beginning of the pandemic, meet the epistemic requirements necessitated to impose lockdowns...

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...

In this article, I challenge the risk assessment approach to the ethics of pre-exposure prophylaxis (PrEP) as HIV prevention among men who have sex with men (MSM). Traditional risk assessment focuses on the medical risks and benefits of using medical technologies, but this emphasizes certain risks and benefits over others. The medical risks of using PrEP are presently being overblown and its social and political risks are being overlooked. By recontextualizing risk within the history of HIV and considering the lived experiences of MSM with sex, HIV, and HIV prevention, we can broaden the present risk assessment framework to include all of the relevant risks involved in using PrEP...

No abstract text is available yet for this article.