Justice Everywhere

a blog about philosophy in public affairs

Category: Economics (Page 1 of 7)

The Capitalist Cage: Rethinking Structural Domination in the Market

In this post, Nicholas Vrousalis discusses his recent article in Journal of Applied Philosophy on structural domination and collective agency.

In his 1938 film The Grand Illusion, Jean Renoir depicts the relationship between French prisoners of war and their German gaolers during World War I. Renoir’s anti-war masterpiece invites the question how fundamentally decent humans, on both sides of the conflict, can end up enslaving each other. Renoir’s answer is that war is a class phenomenon, such that all participants, including the ruling classes, get caught up in its vile machinery. It follows that Renoir does not want to lay the blame for the machinations of war on any particular individual or class. War is the upshot of a structural relationship, in which no individual or collective ascription of blame or wrongdoing suffices to account for the sum total of wrongdoing.

How are we to make sense of this idea? In a recent article, I provide an account of what it means to be ‘caught up’ in a pattern of domination, such that the wrongs involved do not disaggregate without remainder into the wrongdoing of agents, the groups they belong to, and the relations between them. And I show that the very concerns that motivate Renoir’s depiction of domination may apply to many other unjust structural relations, including those of sexism, white supremacy, and capitalism.

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Against Pharmaceutical Libertarians

In this post, David Teira discusses his recent article in Journal of Applied Philosophy defending pharmaceutical paternalism.

On January 11, 2020 The New York Times (NYT) published an opinion piece by their Editorial Board: “The F.D.A. Is in Trouble. Here’s How to Fix It”. The F.D.A. is the US Food and Drug Administration, a regulatory body with gatekeeping powers over pharmaceutical markets. Since 1962, patients can access new medical treatments only after the F.D.A. has declared them safe and effective, on the basis of evidence gathered in clinical trials. This is a form of pharmaceutical paternalism: patients’ right to try whatever treatment they see fit is partially restricted – they will find in chemists only those drugs that the F.D.A. judge good for them. Yet, argues the NYT Editorial Board, “libertarian groups bent on deregulation at any cost” are exploiting the frustration of patients who don’t find any treatment option in the market to put pressure on the F.D.A., curtailing its “already diminished powers.” I think that the NYT is right to be concerned with this trend, and in a recent article, I provide an account of why exactly we should value pharmaceutical paternalism.

Let’s begin by considering what could thought wrong with the FDA’s remit. Several philosophers have recently put together a battery of arguments to show that patients would be better off without regulatory paternalism. What patients need is reliable information on the safety and efficacy of drugs so that they can decide on their own whether it is worth trying them. Jessica Flanigan contends that the F.D.A. should just provide that information without any gatekeeping prerogatives. Julian Reiss, more radically, defends that markets alone will deliver the necessary evidence. If, in a worst case scenario, patients feel they have been cheated, they can always litigate.

Libertarian arguments have some appeal. Who would not want to have the last word on what pharmaceutical risks to take? Yet, I argue, there is something that all but the staunchest libertarian should fear: the asymmetries of information that pervade pharmaceutical markets.

First, nobody (except chemists) can tell apart a legitimate and a fake treatment, and this provides a huge incentive for rogue manufacturers to flood markets with cheap counterfeit drugs that crowd out the real treatments. Economists call this adverse selection.

Second, gathering the necessary evidence to prove in court that a drug is defective is too costly for the average patient. After all, pharmaceutical companies spend millions of dollars to generate this evidence in long and expensive clinical trials, and they are rarely beaten in court.

Think, for instance of the class actions against the analgesic Vioxx, usually considered a success story about patients obtaining redress thanks from pharmaceutical companies. Indeed, Merck, the manufacturing company, reached a settlement compensating patients with $4.85 billion. Yet, Merck’s initial strategy was precisely not to settle, winning in 11 of the first 16 trials completed. Merck’s line of defence hinged on lack of evidence about Vioxx being the proximate cause of death. Jurors occasionally declared Merck guilty, perhaps moved by the claims of alleged corporate dishonesty (withholding information about cardiac risks). But after the first sixteen trials, it became clear for the plaintiffs that it was too difficult to show that Vioxx had actually caused the patients’ death against Merck’s legal and scientific firepower. The company then offered $4.85 billion settlement just to avoid further legal costs. The settlement imposed tight conditions on the plaintiffs –e.g. they had to accept it without a clear estimate of the compensation they would individually receive. If the number of plaintiffs had been smaller (around 50.000), Merck could have chosen to defeat them in court. When the evidence of harm is not sustained by big numbers, litigation may simply fail and impose serious costs for plaintiffs.

Given this huge asymmetries of information, I argue, it is better for patients to defer on an impartial regulatory agency to test treatments and, like Ulysses, tie themselves up to the mast of the agency’s verdict, consuming only approved drugs. Courts or markets provide no viable alternative for most patients to obtain redress from snake oil seller exploiting their uncertainty.

If patients are indeed frustrated with the lack of treatment options, compromising on safety is usually not a good solution. The F.D.A. has done an extraordinary job at keeping truly dangerous compounds outside pharmaceutical markets: less than 2% of the drugs approved by the F.D.A. between 1950 and 2011 have been withdrawn for a mistaken assessment of safety. Yet, according to the World Health Organization database, just in between 2000 and 2005, the United States contributed 953.919 adverse effects reports (or 537.6 reports per million inhabitants). In other words, even with drugs tested for safety and efficacy there is real uncertainty. Weakening the regulatory paternalism of the F.D.A. will make the uncertainty bigger and it will work no miracles for those who need a cure.

Feminism for Working-Class Women Is the Best Feminism

This extended post is a response to a recent Boston Review article by Gina Schouten, called “‘Flexible’ Family Leave is Lousy Feminism”.

This must be one of the most animated debates amongst feminists: how to find the best remedial policies for women who are disadvantaged because they serve as main care-givers for their children, elderly parents, sick relatives or friends. They are disadvantaged in many ways. Some are economic: lower lifetime earnings and fewer work-related benefits compared to people without care commitments – hence more dependency on spouses. Others are social: part-time workers take a hit in status, stay-at-home mums even more so. Finally, there are the relational and psychological disadvantages: women who are economically dependent on their partners have less negotiating power than their partners, and many face tremendous difficulties when they want to leave abusive relationships.

The gendered division of labour – women’s assignment to the hands-on care that we all need at different periods of our lives – explains, to a large extent, not only the gender pay gap but also the feminisation of poverty and the private domination to which many women are subjected. No surprise, then, that feminists have two distinct aims: to protect women from the risks of being a care-giver, and also to do away with the gendered division of labour, which is a main source of the problem. I am one of these feminists; I would like to see women and men equally engaged in the labour market, and looking after anybody who needs care.

But I’m also adamant that we should pursue these two aims in the right order: we should give priority to protecting women from the worst consequences of the gendered division of labour over the abolition of the gendered division of labour itself. Moreover, we should be aware of the unavoidable tension between the two aims, and keep this in mind when advocating for particular gender policies.

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What do we owe the victims of exploitation?

In this post, Erik Malmqvist and András Szigeti discuss their recent article in Journal of Applied Philosophy on the remedial duties arising from exploitation.

We tend to think that exploiting people is morally wrong. And yet, this kind of wrong is uncomfortably close to home for many of us. Likely, the clothes you wear today or the computer you use to read this piece were produced by workers who received meagre pay for dangerous and exhausting work. Since exploitation is so widespread and not something most of us can wash our hands of, we have to ask what is required to set things straight after exploitation has happened. This is the question we have raised in a recent article.

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Should central banks create their own cryptocurrency?

Bitcoin, Ethereum and other cryptocurrencies have attracted widespread media attention. Interestingly, their advent has also triggered reflection among central bankers. Their first reaction was, unsurprisingly, to warn consumers against the dangers of unregulated private money. However, almost ten years after the creation of Bitcoin, central bankers now see the huge potential of these currencies for monetary policy and the control of payments. Is this enthusiasm justified? Should central banks create their own digital currency?

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Announcement: MOOC on ‘Inequality and Democracy’

This is an announcement on behalf of the Private Property and Political Power project at Utrecht University. Its members have developed a freely-available Massive Open Online Course (MOOC) entitled “Inequality and Democracy” that may be of interest to our subscribers, readers, and/or their students.

Most countries are getting more and more unequal. But the core of democracy is political equality: that everyone should have an equal say in how their country is run. Can we really expect these things to go together? Can people have equal political power while economic inequality grows and grows? Take this course and decide for yourself.

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Multi-parenting: what would it take for it to work?

Earlier this year I published a short article arguing that multi-parenting can provide a solution to a contemporary conundrum: on the one hand, many people are increasingly worried about climate change and environmental destruction. They know that having fewer children is, for a majority of people, the most effective individual action they can take to reduce their carbon footprint. Some women go on “birth strikes” – they decide not to bring children into the world. On the other hand, life without children can be terribly impoverished. Parenting may be the most important – and creative! – act one can engage in, a non-substitutable occasion for personal growth and, for many, the central source of meaning in life. (Which is not to deny that, for many other people, a childless life is perfectly fine.)

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My pension fund, my conscience

In some situations, society permits individual citizens to not fulfil otherwise binding requirements when the latter conflict with the individual’s deeply held ethical convictions. The classic example are pacifists who obtain an exemption from military service. I submit that an argument along these lines also applies to collective pension plans. Such plans need to offer their participants a minimal level of influence over their portfolios to be legitimate.

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Child Poverty through Philosophers’ Eyes

In this post, Justice Everywhere’s Nicolás Brando and his co-editor Gottfried Schweiger introduce their recently-published collection on philosophy and child poverty.

Philosophy and Child Poverty: Reflections on the Ethics and Politics of Poor Children and their Families (2019) is the first full volume to address child poverty from a philosophical perspective. It brings together contributions from a plurality of philosophical approaches, providing an ample exploration into the conceptual, ontological, normative and applied questions that arise when looking at child poverty as a philosophical subject.

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From the Vault: The “Just Wages” Series

While Justice Everywhere takes a break over the summer, we recall from our archives some memorable posts from our 2018-2019 season.

In a first for Justice Everywhere, we hosted a colloquium on the topic of “just wages”. This discussion was sparked by a paper by Joseph Heath in the Erasmus Journal for Economics and Philosophy. Our colloquium – a précis to a full special issue on the topic – included three critical engagements with Heath’s argument, as well as a response from Heath:

Justice Everywhere will return in full swing on 2nd September with fresh weekly posts by our regular authors. If you have a suggestion for a topic or would like to contribute a guest post on a topical subject in political philosophy (broadly construed), please feel free to get in touch with us at justice.everywhere.blog@gmail.com.

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