Justice Everywhere

a blog about philosophy in public affairs

Category: Governance (Page 1 of 3)

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.

An Interview with Baroness Onora O’Neill (Beyond the Ivory Tower series)

Aveek Bhattacharya and Fay Niker recently interviewed Baroness Onora O’Neill, asking her about her wide-ranging experiences combining being a professor of philosophy and a member of the House of Lords (among many other things). 

Baroness Onora O’Neill of Bengarve is Emeritus Honorary Professor at the University of Cambridge and has been a cross-bench (i.e. not aligned with any political party) member of the British House of Lords since 2000. She has written widely in ethics and political philosophy, and is particularly known for her work on bioethics, trust and the philosophy of Kant. She was Principal of Newnham College, Cambridge from 1992-2006, President of the British Academy from 2005-9, chaired the Nuffield Foundation from 1998-2010 and chaired the Equality and Human Rights Commission from 2012-2016.

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UK General Election 2019: Spare a Thought for the Badgers

Every election has winners and losers, and this one is no different. These are, however, particularly turbulent times, and while the message of “getting Brexit done” appears to have chimed with many voters, the Conservative victory last Thursday does not bode well for the UK’s most vulnerable. After a decade of Conservative austerity measures, the use of food banks continues to rise, child poverty has soared, and changes to the welfare system have left disabled adults four times worse-off financially than non-disabled adults. More of the same is likely to most hurt those for whom life is getting tougher by the day.

It is clear that things are precarious for many of the UK’s citizens but it is important to keep in mind that humans are not the only ones affected by our governments’ decisions. Though it is tempting to think that we already have enough to worry about without extending concern to the nonhuman animals who live with us, we owe it to those creatures to speak up on their behalf. With no voice of their own, other animals are entirely dependent on us to keep their interests on the political agenda and to hold our leaders to account for the harms visited upon them. With that in mind, I’d like you to spare a thought for British badgers who, like many humans, have been made to suffer terribly by recent political decisions and government policies.

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From Fact-Checking to Value-Checking

Fears over ‘fake news’, targeted disinformation, and the rise of post-truth politics have met with a central mainstream solution: ‘fact-checking’. Fact-checking is featuring prominently in coverage of the 2019 UK General Election. ITV News, for instance, will use FullFact.org to analyse the claims made by Boris Johnson and Jeremy Corbyn in their forthcoming leadership debate, with the aim of better informing their viewers by exposing misleading statements.

This reflects the wider embrace of fact-checking as a panacea against the rise of anti-expert politics. It has been employed in coverage of US presidential and primary debates, as well as the parliamentary theatre of Brexit. Third party fact-checking organisations have also been championed by social media companies in response to demands by regulators and legislatures that they take responsibility for the content circulated on their platforms. Indeed the use of ‘independent’ fact-checkers to flag content was highlighted by Mark Zuckerberg, during his various appearances before Congress, in defence of Facebook’s practices.

However, the concept of fact-checking frames the problems of post-truth politics in narrowly positivist terms – as reducible to a lack of information (‘facts’), leading to sub-optimally rational decision-making by electorates. It has not been underpinned by a sophisticated account of the epistemic conditions for the exercise of democratic citizenship. Fact-checking occupies an increasingly central place in our political culture, but the justification for it remains largely implicit and untheorized.

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Private Wrongs and Public Resignations

Public officials are often called to resign their posts if they commit grave moral or legal wrongs as private persons. Consider a few cases. It is discovered that a Minister of Education had plagiarized multiple parts of his academic work before taking up his position in the government. Another high official is caught expressing bigoted ideas against ethnic and religious minorities in personal Facebook comments and posts. A county prefect is charged for beating his wife. Should such acts call for resignations? Can they ground the decisions of political bosses to sack these individuals, or justify the general public in exerting pressures on the government to drive them out of office?

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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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People versus Parliament: an interpretation

Motto: Would it not be easier

In that case for the government

To dissolve the people

 And elect another? 

(from ‘The Solution’ by Bertolt Brecht)

The UK Parliament has been prorogued from the 9th of September to the 14th of October 2019 – days before the UK’s scheduled exit from the European Union. On its final day before suspension, the Parliament acknowledged Royal Assent on the Benn Bill (which effectively turned an act blocking No Deal into law), made a formal request to the Government to acknowledge obeying the rule of law regarding Brexit, and passed a binding motion for the Government to disclose private communications concerning its decision to prorogue Parliament and its No Deal plans.

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From the Vault: Good Reads on the Ethics and Politics of Technology

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

Here are some good reads on issues relating to the ethics and politics of technology that you may have missed or be interested to re-read:

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.

Nudging and Market Influence: Why the focus on government nudges?

Most moral objections to nudging–the practice of altering choice environments in order to subconsciously steer behavior–have been grounded in the value of personal autonomy. The autonomy of the nudged are claimed to be undermined because the control individuals have over their evaluations, deliberations and decision-making is effectively reduced, if not fully bypassed. More so, nudging seems autonomy-threatening because the architects look to supplant the wills of their targets with their own.

When nudging was first discussed by its main proponents Thaler and Sunstein in their book Nudge in 2008, it was proposed as an innovative supplement to government policy-making. In response, most of the autonomy-related objections focused on the paternalism of governments carrying out the nudging. Surprisingly, few have paid much attention to similar forms of influences in the market setting–behavioral techniques used in advertising, pricing, and other market interactions. I claim the standard autonomy-based objections against nudging raise more worries about current market practices than emerging and prospective policy practices.

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