Justice Everywhere

a blog about philosophy in public affairs

Category: Health (Page 1 of 4)

Vaccine Equity and the Responsibility of Rich Countries

What We Owe to Each Other is the title of Tim Scanlon’s famous work on contractualism. As the title reveals, Scanlon seeks to investigate how to treat others with the due respect and dignity they deserve. This post is not about contractualism or about the TV show. Rather, borrowing Scanlon’s book title, I suggest what rich nations should do to address the global vaccine inequity that is hampering poorer nations’ efforts to combat the pandemic. The account sketched here must stand a good chance of being accepted by the relevant rich states. To this end, the following constraints must be accepted. First, governments are primarily driven by concerns for their own citizens and residents. This means that, as non-ideal as it may sound, global egalitarian ideals would not be realised, at least for now. Second, and relatedly, access to vaccines would always likely to be decided by free market principles. Again, legitimate objections, especially egalitarian ones, can be raised against this but this is a constraint that must be accepted, given the dominance of free market thinking in Western countries. Third, as a result, COVAX’s original goal – ‘to ensure that people in all corners of the world will get access to COVID-19 vaccines once they are available, regardless of their wealth’ – was always a wishful thinking.

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Nicotine Vaccines and Childrens’ Rights to an Open Future

That smoking significantly contributes to preventable death and loss in quality of life is obvious, and it is the starting point of many governmental interventions aimed at curbing national smoking rates. Cigarette smoking – and consumption of other nicotine (and tobacco) products – has been and continues to be in the focus of attention of state governments, public policy makers, and public health officials, and remains as one of the main targets of public health interventions.

The most familiar types of tobacco control and anti-smoking interventions include legal age limits, taxation, restrictions on sale and advertisement of nicotine products, educational campaigns, and smoking bans in public and semi-public places. However, the impact of these efforts is far from ideal. Simply put, people start and continue to smoke, thereby contributing to the expected rise in the number of smokers and to the increase of smoking-related fatalities worldwide.

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Dementia, Truthfulness, and Respecting Agency

In this post, Jeanette Kennett and Steve Matthews discuss their recent article in Journal of Applied Philosophy on respecting agency in dementia care.


Years before entering the nursing home Mr Q had been a janitor at a boarding school. With the progression of dementia, he came to perceive the nursing home – with its distinctly institutional décor – as his old place of work. And so, throughout the day he would act out his janitorial role, with its many tasks of checking windows and doors, and making sure that all was running smoothly. The neurologist Oliver Sacks, writing about the case, noted that ‘the Sisters [who ran the home]…though perceiving his confusion and delusion, respected and even reinforced [his] identity. They assisted him [by] giving him keys to certain closets and encouraging him to lock up at night before he retired.’ Did the sisters do the right thing? Perhaps they should have been more truthful by reminding Mr Q that in fact he was a declining patient with dementia. Sacks thought otherwise. Occupying his role helped Mr Q to make sense of his surroundings. In fulfilling this role, says Sacks, ‘[Mr Q] seemed to be organized and held together in a remarkable way…’

The case of Mr. Q raises a thorny problem for caregivers: should truthfulness give way when people with dementia form false beliefs about their circumstances? This moral dilemma is usually presented as a choice between acting on a principle of respect for persons – which requires truthfulness – versus acting out of a concern for their welfare – which might require going along with a false belief. In our recent article, however, we argue that the debate should be framed in a different way. It seems to us, that in going along with Mr Q, the Sisters were scaffolding and protecting his sense of identity, something that thereby respected his agency. This of course had the added effect of attending to Mr Q’s welfare. We argue that when we support a person’s agency in these ways their welfare needs are simultaneously addressed.

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A Puzzle about Disability and Old Age

In this post, Kasper Lippert-Rasmussen discusses their recent article in Journal of Applied Philosophy on the connections between disability-related disadvantages and old-age-related disadvantages.


Many think that being disabled and being old are worse for a person than being able-bodied and being young respectively. However, many think differently about these two disadvantages. Specifically, they think that while the disadvantages of disabled people are (largely) due to ableism, the disadvantages of old age are not due to ageism, but simply reflects a regrettable, unavoidable fact of life. In a recent article, I argue that this view is untenable. More generally, I suggest in the light of how our thinking of one of these forms of disadvantages constrains our thinking about the other that much of the previous debate about the badness of disability and old is misdirected.

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We have a duty to pay for kidneys

In this post, Aksel Sterri discusses their recent article in Journal of Applied Philosophy on the ethics of a government-monopsony market in kidneys.


Two million people suffer from kidney failure worldwide. They either die or live difficult lives on dialysis while waiting for kidneys to become available for transplant, from dead or living donors. Our failure to meet the need for kidney transplants is a moral failure that calls for a change in how we procure kidneys. In a recent paper, I argue members of nation states have a collective duty to pay kidney donors to ensure that people in need receive a new kidney.

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It’s so crazy that you called me a psycho: Why are we still using mental illness slurs?

In this post Zsuzsanna Chappell discusses some problematic aspects of mental illness slurs.


“Sweet but Psycho”, an upbeat pop song by Ava Max, topped the charts in 22 countries in 2019. Both the lyrics and the music video reinforce popular stereotypes of the madwoman as manipulative, sexually attractive, dangerous and ultimately violent. At the same time, “crazy golf” (a colloquial UK term for minigolf) is working hard to re-brand itself as “adventure golf”.

copyright Atlantic Records.

Both “psycho” and “crazy” can be used to describe people with mental illness, but the two words have very different connotations in everyday speech. “Psycho” is a negative term used to describe someone dangerous, – it could be applied as an insult to someone driving recklessly, for example, – whereas “crazy” is used much more broadly and often benignly. “Crazy golf” is meant to be fun, not violent.

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Political Philosophy in a Pandemic (Book Announcement)

We have some exciting news to share: the first ever Justice Everywhere book is on its way. Entitled Political Philosophy in a Pandemic: Routes to a More Just Future, it will be published in  print in September by Bloomsbury Academic (pre-order here). We are hoping that the e-book version will be out in the summer. Edited by Fay Niker and Aveek Bhattacharya, two of the convenors of the blog, the idea for the book developed out of the ‘Philosophers’ Rundown on the Coronavirus Crisis’ that we published here in April last year.

Political Philosophy in a Pandemic contains 20 essays on the moral and political implications of COVID-19 and the way governments have responded to it, arranged around five themes: social welfare, economic justice, democratic relations, speech and misinformation and the relationship between justice and crisis. Almost all of the contributors have featured on Justice Everywhere in recent years in form or another, either as authors or interviewees.

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The Political Power of Food as Medicine

What is the inter-relationship between food and medicine? At various points in history, such as in the Byzantine empire, food and medicine were seen as almost the same thing. The basic idea was that medicine and food both performed the same function of balancing bodily humors. In contemporary countries, such as the US, many people are aware that food has a significant impact on health. But, I think that it’s fair to say, food and medicine are increasingly construed as very different things. Crudely speaking, medicine is a public good that requires great scientific expertise; food is a private affair that depends on different people’s cultures, whims, and private financial resources.

I want to discuss a new policy development that raises questions about what the inter-relationship between food and medicine could and should be. This policy development has largely been overlooked by philosophers. But, I will argue, it raises interesting theoretical questions about the framing of public policies, feasibility, and justice.

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The COVID-19 crisis: a vulnerability perspective

The idea of vulnerability has been discussed regularly throughout the pandemic. This aligns with a more general trend towards considering issues in law, bioethics and philosophy from a vulnerability perspective – especially among those dissatisfied with human rights theory. Can thinking in terms of vulnerability help us understand the current crisis?

The term vulnerability captures cases of risk of harm. To restrict attention to morally significant forms of vulnerability, theorists often refer to harms to vital interests or needs. The concept of vulnerability carries an inherent ambiguity, which is reflected in both ordinary use and theory. On the one hand, we are all vulnerable due to our embodiment and our nature as social beings. This is what theorists call ontological universal vulnerability. On the other hand, particular groups or individuals experience heightened vulnerability in particular respects due to their specific circumstances. This is often called circumstantial vulnerability. An especially problematic kind of circumstantial vulnerability is pathogenic vulnerability, which is the product of injustice. People and groups experience different types of vulnerabilities arising from a variety of sources, which interact with each other, often creating new vulnerabilities.

Because it captures the idea of being under threat of harm and circumstances where an agent is not in the position to protect her vital interests, vulnerability seems to be particularly apt to describe the current situation in connection to the risk of contracting Covid-19, as well as the risks of socio-economic harms and social isolation that have accompanied the pandemic. Distinguishing between different kinds of vulnerability also helps us in reflecting on various aspects of the present crisis. 

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How should we think about the Irrevocability of Capital Punishment and Euthanasia?

In this post, Saranga Sudarshan discusses their recent article in Journal of Applied Philosophy on the issue of irrevocability in arguing about capital punishment and euthanasia.


Working out our moral and political views on things is a messy business. Sometimes, when we think our arguments for why certain things are right or wrong, just or unjust are really persuasive we find they have no effect on others. Other times we realise that these arguments lead to moral and political judgements that make us question whether they were good arguments to begin with. Although it is often uncomfortable, when we live in a shared social world and we exert our authority to make coercive laws to govern ourselves and others it is helpful to take a step back and think about how some of our arguments work at their core. This sort of reflection is precisely what I do in a recently published article in relation to a particular argument against Capital Punishment.

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