BackgroundNusinersen is one of an increasing number of new, expensive orphan drugs to receive authorization. These drugs strain public healthcare budgets and challenge principles for resource allocation. Nusinersen was introduced in the Norwegian public healthcare system in 2018. A national expert group consisting of physicians was formed to oversee the introduction and continuation of treatment in light of specific start and stop criteria.MethodsWe have studied experiences within the expert group with a special emphasis on their application of the start and (...) stop criteria, rationing of treatment, and experienced moral dilemmas. A research interview with six members of the national expert group was performed, then analysed with manifest content analysis. The analysis was supplemented with publically available sources on priority setting and the process leading up to the introduction of nusinersen and the establishment of the expert group.ResultsSixty-six patients have received treatment within the first 25 months since the national expert group’s establishment. Treatment has not been discontinued for any patient. No patients under 18 years of age have been denied treatment, as those who were referred at this age were all deemed to fulfill the start criteria. The expert group has, however, increased geographical treatment equity and facilitated important cooperation at the national level. Furthermore, it has enhanced open and critical discussions of both medical issues and new ethical dilemmas.ConclusionAlthough facilitating equal access to treatment for SMA patients, the national expert group has not discontinued treatment for any patient. It is suggested that in order for clinicians to be able to ration care for individual patients, they require both adequate support and sufficient formal authority. Start and stop criteria need to be re-evaluated as more knowledge and experience are gained regarding the treatment. (shrink)

The story of the greatest of all philosophical friendships—and how it influenced modern thought David Hume is widely regarded as the most important philosopher ever to write in English, but during his lifetime he was attacked as “the Great Infidel” for his skeptical religious views and deemed unfit to teach the young. In contrast, Adam Smith was a revered professor of moral philosophy, and is now often hailed as the founding father of capitalism. Remarkably, the two were best friends for (...) most of their adult lives, sharing what Dennis Rasmussen calls the greatest of all philosophical friendships. The Infidel and the Professor is the first book to tell the fascinating story of the friendship of these towering Enlightenment thinkers—and how it influenced their world-changing ideas. The book follows Hume and Smith’s relationship from their first meeting in 1749 until Hume’s death in 1776. It describes how they commented on each other’s writings, supported each other’s careers and literary ambitions, and advised each other on personal matters, most notably after Hume’s quarrel with Jean-Jacques Rousseau. Members of a vibrant intellectual scene in Enlightenment Scotland, Hume and Smith made many of the same friends, joined the same clubs, and were interested in many of the same subjects well beyond philosophy and economics—from psychology and history to politics and Britain’s conflict with the American colonies. The book reveals that Smith’s private religious views were considerably closer to Hume’s public ones than is usually believed. It also shows that Hume contributed more to economics—and Smith contributed more to philosophy—than is generally recognized. Vividly written, The Infidel and the Professor is a compelling account of a great friendship that had great consequences for modern thought. (shrink)

In National Responsibility and Global Justice, David Miller defends the view that a member of a nation can be collectively responsible for an outcome despite the fact that: (i) she did not control it; (ii) she actively opposed those of her nation’s policies that produced the outcome; and (iii) actively opposing the relevant policy was costly for her. I argue that Miller’s arguments in favor of this strong externalist view about responsibility and control are insufficient. Specifically, I show that Miller’s (...) two models of synchronic collective responsibility*the like-minded group model and the cooperative practice model*ground neither synchronic nor diachronic national responsibility, nor apply in the case of nations generally speaking. Keywords: collective responsibility; David Miller; nations; historical responsibility; national responsibility (Published: 19 May 2009) Citation: Ethics & Global Politics, Vol. 2, No. 2, 2009, pp. 109-130. DOI: 10.3402/egp.v2i2.1935. (shrink)

In this book Kasper Lippert-Rasmussen address the complexities of his question "Is affirmative action morally justifiable?" by analyzing the prevailing contemporary arguments both for and against affirmative action. The book applies current political philosophy to demonstrate that arguments on both sides justify different conclusions given different specific cases, though it ultimately does argue in favor of affirmative action based on the relative strength and significance of the anti-discrimination- and equality of opportunity-based positions.

When collective decisions should be made democratically, which people form the relevant demos? Many theorists think this question is an embarrassment to democratic theory: because any decision about who forms the demos must be made democratically by the right demos, which itself must be democratically constituted and so on ad infinitum; and because neither the concept of democracy, nor our reasons for caring about democracy, determine who should form the demos. Having distinguished between these three versions of the demos problem, (...) we argue that each of them can be solved. (shrink)

Kasper Lippert-Rasmussen tackles all the major questions concerning luck egalitarianism, providing deep, penetrating and original discussion of recent academic discourses on distributive justice as well as responses to some of the main objections in the literature. It offers a new answer to the “Why equality?” and “Equality of what?” questions, and provides a robust luck egalitarian response to the recent criticisms of luck egalitarianism by social relations egalitarians. This systematic, theoretical introduction illustrates the broader picture of distributive justice and (...) enables the reader to understand the core intuitions underlying, or conflicting with, luck egalitarianism. (shrink)

Philosophers analyzing standing to blame have argued that in view of a blamer’s own fault she can lack standing to blame another for an act even if the act is blameworthy and that standingless, hypocritical blame is pro tanto morally wrongful. The bearing of these conclusions on standing to praise is yet to receive the attention it deserves. I defend two claims. The first is the conditional claim that if and are true, so are and. The latter are: a praiser (...) can lack the standing to praise herself for an act even if that act is praiseworthy and standingless, hypocritical praise is pro tanto morally wrongful. So I am suggesting that facts about standing to blame reflect more general facts about standing to hold responsible. The second is the claim that and are true. (shrink)

A notable feature of our practice of blaming is that blamees can dismiss blame for their own blameworthy actions when the blamer is censuring them hypocritically and, as it is often put, lacks standing to blame them as a result. This feature has received a good deal of philosophical attention in recent years. By contrast, no attention has been given the possibility that, likewise, refraining from blaming can be hypocritical and dismissed as standingless. I argue that hypocritical refrainers have a (...) duty to blame, if asked to do so, and possibly even if they are not asked to do so. Acknowledging this fact about hypocritical silence is crucial to an adequate understanding of our practice of blaming. Specifically, it bears on a worry that naturally arises when we consider cases where the blamee is blameworthy yet the blaming is problematic, because standingless. The worry is that, absurdly, the idea of standing justifies our being more interested in silencing preachers of virtue than making wrongdoers overcome vice. However, if one can lack standing not to blame, this concern is unwarranted. If there is such a thing as standing to blame, then sometimes one must, for reasons of standing, speak up in the face of wrongdoing, meaning, in effect, that one lacks the right not to challenge wrongdoers to improve. (shrink)

Against arguments that suggest that Rawls’s notion of reasonability is ‘obscure’ and ‘unclear’ I argue in this essay that the idea of reasonability in the later Rawls can be defended in three ways. First, it can be shown that reasonability is fundamental to the architectonic of the later work. Reasonability, and the subordination of reason to reasonability, is fundamental to the later (post-1980) writings. Second, it can be shown that reasonability is not necessarily a vague term as many have claimed. (...) Third, it can be shown that reasonability is fundamental to what Rawls calls the three major new ideas of Political Liberalism: overlapping consensus; the reconception of the priority of the right over the good; and the idea of public reason. (shrink)

The ethical (and philosophical) issues arising in citizen science are fascinating, challenging, and potentially pathbreaking in that they force us to reconsider the conceptual and regulatory catego...

This long-awaited book sets out the implications of Habermas's theory of communicative action for moral theory. "Discourse ethics" attempts to reconstruct a moral point of view from which normative claims can be impartially judged. The theory of justice it develops replaces Kant's categorical imperative with a procedure of justification based on reasoned agreement among participants in practical discourse.Habermas connects communicative ethics to the theory of social action via an examination of research in the social psychology of moral and interpersonal development. (...) He aims to show that our basic moral intuitions spring from something deeper and more universal than contingent features of our tradition, namely from normative presuppositions of social interaction that belong to the repertoire of competent agents in any society. Jürgen Habermas is Professor of Philosophy at the University of Frankfurt. (shrink)

If “perfectionism” in ethics refers to those normative theories that treat the fulfillment or realization of human nature as central to an account of both goodness and moral obligation, in what sense is “human flourishing” a perfectionist notion? How much of what we take “human flourishing” to signify is the result of our understanding of human nature? Is the content of this concept simply read off an examination of our nature? Is there no place for diversity and individuality? Is the (...) belief that the content of such a normative concept can be determined by an appeal to human nature merely the result of epistemological naiveté? What is the exact character of the connection between human flourishing and human nature? These questions are the ultimate concern of this essay, but to appreciate the answers that will be offered it is necessary to understand what is meant by “human flourishing.” “Human flourishing” is a relatively recent term in ethics. It seems to have developed in the last two decades because the traditional translation of the Greek term eudaimonia as “happiness” failed to communicate clearly that eudaimonia was an objective good, not merely a subjective good. (shrink)

Over the last twenty years, many political philosophers have rejected the idea that justice is fundamentally about distribution. Rather, justice is about social relations, and the so-called distributive paradigm should be replaced by a new relational paradigm. Kasper Lippert-Rasmussen seeks to describe, refine, and assess these thoughts and to propose a comprehensive form of egalitarianism which includes central elements from both relational and distributive paradigms. He shows why many of the challenges that luck egalitarianism faces reappear, once we try (...) to specify relational egalitarianism more fully. His discussion advances understanding of the nature of the relational ideal, and introduces new conceptual tools for understanding it and for exploring the important question of why it is desirable in the first place to relate as equals. Even severe critics of the distributive understanding of justice will find that this book casts important new light on the ideal to which they subscribe. (shrink)

Larry L. Rasmussen offers a dramatic new way of thinking about human society, ethics, and the health of our planet. Rejecting the modern ethical assumption that morality applies to human society alone, Earth-honoring Faith argues that we must derive a system of ethics and morality that accounts for the wellbeing of all creation on Earth.

We investigate the value of persons. Our primary goal is to chart a path from equal and extreme value to infinite value. We advance two arguments. Each argument offers a reason to think that equal and extreme value are best accounted for if we are infinitely valuable. We then raise some difficult but fruitful questions about the possible grounds or sources of our infinite value, if we indeed have such value.

This book addresses these three issues: What is discrimination?; What makes it wrong?; What should be done about wrongful discrimination? It argues: that there are different concepts of discrimination; that discrimination is not always morally wrong and that when it is, it is so primarily because of its harmful effects.

It is commonly believed that blamees can dismiss hypocritical blame on the ground that the hypocrite has no standing to blame their target. Many believe that the feature of hypocritical blame that undermines standing to blame is that it involves an implicit denial of the moral equality of persons. After all, the hypocrite treats herself better than her blamee for no good reason. In the light of the complement to hypocrites and a comparison of hypocritical and non-hypocritical blamers subscribing to (...) hierarchical moral norms, I show why we must reject the moral equality account of the hypocrite’s lack of standing to blame. (shrink)

Journal of Political Philosophy, EarlyView.

In the US context, critics of court use of algorithmic risk prediction algorithms have argued that COMPAS involves unfair machine bias because it generates higher false positive rates of predicted recidivism for black offenders than for white offenders. In response, some have argued that algorithmic fairness concerns, either also or only, calibration across groups–roughly, that a score assigned to different individuals by the algorithm involves the same probability of the individual having the target property across different groups of individuals–and that, (...) for mathematical reasons, it is virtually impossible to equalize false positive rates without impairing the calibration. I argue that in standard non-algorithmic contexts, such as hirings, we do not think that lack of calibration entails unfair bias, and that it is difficult to see why algorithmic contexts, as it were, should differ fairness-wise from non-algorithmic ones in this respect. Hence, we should reject the view that calibration is necessary for fairness in an algorithmic context. (shrink)

According to an influential account of standing, hypocritical blamers lack standing to blame in virtue of their lack of commitment to the norm etc. which they invoke. Nevertheless, the commitment account has the wrong shape for it to explain why hypocrites lack standing to blame. Building on the lessons of that critique I propose a novel account of what undermines standing to blame – the comparative fairness account. This differs from the commitment account and the other prominent account of why (...) hypocrites lack standing to blame offered in the literature: the moral equality account. Finally, I observe that, intuitively, lack of commitment undermines standing to blame and that many hypocrites might lack standing for that reason also. Moreover, typically the hypocrite's failure to address their own faults is a feature in virtue of which, other things being equal, the hypocrite is less committed to the norm in question. These two observations provide the basis for an error theory of the commitment account's appeal, despite its inability to explain why, qua hypocritical blamer, one lacks standing to blame. (shrink)

In a series of excellent, recent papers, Deborah Hellman expounds the intuitively appealing idea that we have a duty not to compound injustice. Roughly, one compounds injustice when facts that obtain as a result of prior injustice form part of one’s reason for imposing further disadvantages on the victims of this prior injustice. This article identifies several complexities and problems motivating various amendments to Hellman’s formulation of the duty not to compound injustice. Critically, it argues that the intuitions she and (...) others have sought to explain in terms of the duty not to compound injustice are better explained by the duty not to cause additional harm to people who are already unjustly worse off – perhaps in conjunction with a duty not to implicate ourselves in injustice. (shrink)

In a recent JME article, Joona Räsänen makes the case for allowing legal age change. We identify three problems with his argument and, on that basis, propose an improved version thereof. Unfortunately, even the improved argument is vulnerable to the objection that chronological age is a better proxy for justice in health than both legal and what we shall call official age.

Journal of Political Philosophy, Volume 30, Issue 3, Page 395-408, September 2022.

The correspondence theory of truth is a precise and innovative account of how the truth of a proposition depends upon that proposition's connection to a piece of reality. Joshua Rasmussen refines and defends the correspondence theory of truth, proposing new accounts of facts, propositions, and the correspondence between them. With these theories in hand, he then offers original solutions to the toughest objections facing correspondence theorists. Addressing the Problem of Funny Facts, Liar Paradoxes, and traditional epistemological questions concerning how (...) our minds can access reality, he challenges recent objections, and defends what has traditionally been the most popular theory of truth. Written with clarity, precision, and sensitivity to a range of philosophical backgrounds, his book will appeal to advanced students and scholars seeking a deeper understanding of the relationship between truth and reality. (shrink)

Quality control is an important and integrated part of the scientific system. However, developments in science and society are changing quality control into quality monitoring. New, virtual, and fluid organizational forms are emerging. Common boundaries are seen as being broken down as, for example, in the “triple helix” and the “mode 2” concepts. The stakeholders in science are showing an interest in being more involved in science. They want their evaluation criteria to be used, and they want evaluations to be (...) done on a regular basis because they do not trust the new scientific institutions to be left on their own. Quality monitoring changes the requirements for conducting evaluations as part of quality control. Assessing the societal value of research becomes increasingly important. Finally, quality monitoring emphasizes organizational learning rather than controlling quality in scientific organizations. (shrink)

In this essay I consider the normative implications of the notion of reasonability for the construction of an idea of public reason that is cosmopolitan in scope. First, I consider the argument for the distinction between reason and reasonability in the work of Sibley and Rawls. Second, I evaluate the normative implications of reasonability through a consideration of Korsgaard's recent work. Third, I argue for a notion of reasonability that moves us beyond a Kantian concept of autonomy through a consideration (...) of the relationship between reasonability and judgment vis-à-vis Arendt's work on Kant's Third Critique. Finally, I argue for a cosmopolitan appropriation of the notion of reasonability based on Kant's notion of the aesthetic idea. The latter argument relaxes the bonds of public reason, moving us beyond the domain of ethnocentricism. (shrink)

How can we establish a political/legal order that in principle does not require the human flourishing of any person or group to be given structured preference over that of any other? Addressing this question as the central problem of political philosophy,_ Norms of Liberty_ offers a new conceptual foundation for political liberalism that takes protecting liberty, understood in terms of individual negative rights, as the primary aim of the political/legal order. Rasmussen and Den Uyl argue for construing individual rights (...) as metanormative principles, directly tied to politics, that are used to establish the political/ legal conditions under which full moral conduct can take place. These they distinguish from normative principles, used to provide guidance for moral conduct within the ambit of normative ethics. This crucial distinction allows them to develop liberalism as a metanormative theory, not a guide for moral conduct. The moral universe need not be minimized or morality grounded in sentiment or contracts to support liberalism, they show. Rather, liberalism can be supported, and many of its internal tensions avoided, with an ethical framework of Aristotelian inspiration—one that understands human flourishing to be an objective, inclusive, individualized, agent-relative, social, and self-directed activity. (shrink)

This article presents two rejoinders to Frankfurt’s arguments against egalitarianism. In developing the first, I introduce a novel relational view of justice: relational sufficiency. This is the view that justice requires us to relate to one another as people with sufficient, but not necessarily equal, standing. I argue that if Frankfurt’s objections to distributive equality are sound, so are analogous objections to relational equality. However, in a range of cases involving comparative justice (punishment, equal pay, and family relations) we should (...) be relational egalitarians, not relational sufficientarians, and that we must therefore reject Frankfurt’s objections to distributive equality. The second rejoinder takes the form of a demonstration that all of Frankfurt’s objections to distributive equality (and relational equality) are unsound. In effect, the article rehabilitates the ideal of distributive equality in the face of Frankfurt’s objections. (shrink)

s admirable new book, Justice, Luck, and Knowledge , brings together recent developments in the fields of responsibility and egalitarian justice. This article focuses on Hurley’s critique of luck-neutralizing egalitarianism. The article concludes that the bad-luck-neutralizing aim serves better as a justificatory basis for egalitarianism than the more general luck-neutralizing aim. Since the former does not simply assume that we should aim for equality, Hurley has not demonstrated (nor indeed does she claim to have shown) that this concern cannot form (...) the justificatory basis of egalitarianism in a non-question-begging way. This, however, does not detract from the fact that Hurley’s book provides a very insightful discussion of the relationship between luck and justice. Key Words: Hurley • Dworkin • Cohen • luck • justice • egalitarianism. (shrink)

In recent years, neuroscience has been making dramatic progress. The discipline holds great promise but also raises a number of important ethical concerns. Among these is the concern that, some day in the distant future, we will have brain scanners capable of reading our minds, thus making our inner thoughts transparent to others. There are at least two reasons why we might regret our resulting loss of privacy. One is, so the argument goes, that this would undermine our ability to (...) form intimate relations. Another is that the omnipresent gaze of others would render an authentic inner life impossible. I argue that both of these concerns are exaggerated. First, intimacy might flourish through the differential acknowledgement of knowledge as common knowledge; for example, even if I know that both a friend and my taxi driver know that I have kinky sexual fantasies, I might only acknowledge this as common knowledge and, thus, an admissible piece of conversation with my friend, and this differential acknowledgement might be enforced by norms of social interaction. Second, the gaze of others would become much less oppressive if everyone’s inner lives were transparent to everyone else. I also argue that our minds are already partly transparent to others through the use of non-neuroscience-assisted mindreading techniques and, thus, that the latter offer no distinct threat to mind privacy. I offer an additional argument for this conclusion; to wit, that our minds extend beyond our brains. (shrink)

There are many objections to statistical discrimination in general and racial profiling in particular. One objection appeals to the idea that people have a right to be treated as individuals. Statistical discrimination violates this right because, presumably, it involves treating people simply on the basis of statistical facts about groups to which they belong while ignoring non-statistical evidence about them. While there is something to this objection—there are objectionable ways of treating others that seem aptly described as failing to treat (...) them as individuals—it needs to be articulated carefully. First, most people accept that many forms of statistical discrimination are morally unproblematic, let alone morally justified all things considered. Second, even treating people on the basis of putative non-statistical evidence relies on generalizations. Once we construe treating someone as an individual in a way that respects this fact, it becomes apparent: (1) that statistical discrimination is compatible with treating people as individuals, and (2) that one may fail to treat people as individuals even without engaging in statistical discrimination. Finally, there are situations involving the expression of messages of inclusion where we think it is good, morally speaking, that we are not treated as individuals. (shrink)

Heloise Robinson argues that pregnant women have a higher moral status than non-pregnant persons and that, for this reason, pregnant women ought to be treated ‘noticeably’ better than non-pregnant persons.1 In this commentary, we present two challenges to Robinson’s argument. First, the compounding disadvantage objection: treating involuntarily, non-pregnant women worse than voluntarily pregnant women unjustly compounds their disadvantage. Second, the identity objection: treating non-pregnant people worse than pregnant people amounts to pro tanto wrongful discrimination based on a fundamental aspect of (...) people’s identity. We conclude that either pregnant persons do not have a higher moral status than non-pregnant persons, or they do, but higher moral status so grounded does not justify better treatment. According to the standard view of moral status: (1) most human beings are persons; (2) persons have a higher moral status than non-persons; and (3) persons have an equal moral status. Many believe: (1) is true because most human beings have a sufficiently high level of personhood-generating psychological capacities; (2) is true because moral status is tied to personhood; and (3) is true because variations in the level of personhood-generating psychological capacities do not matter to an individual’s moral status once that individual’s level surpasses the threshold required for personhood.2 (3) is significant …. (shrink)

Many, if not almost all political theorists, think that there are groups such that states are under a norm enjoining them: not to discriminate against members of these groups; to adopt a policy of...

Pluralist egalitarians think that luck and relational egalitarianism each articulates a component in a pluralist account of egalitarian justice. However, this ecumenical view appears problematic in the light of Elizabeth Anderson's claim that the divide arises because two incompatible views of justification are in play, which in turn generates derivative disagreements – e.g. about the proper currency of egalitarian justice. In support of pluralist egalitarianism I argue that two of Anderson's derivative disagreements are not rooted in the disagreement over justification (...) she identifies, and that the disagreement over justification cuts across standard disagreements between luck and relational egalitarian justice. (shrink)

The much endorsed idea that reasons are facts, gives raise to several issues, not least when it is applied to the distinction between agent-neutral and agent-relative reasons. The paper distinguish in broad terms between two important views on the nature of facts. Given in particular a view that conceives of facts as abstract entities, the dichotomy is not particularly problematic. We might run into problems when it comes to identifying which facts are reasons and which are not, but the very (...) dichotomy itself seems sound. On this, the so-called thin approach, it is at least a possibility that some reasons will be (in some sense of the dichotomy) agent-neutral and some will be agent-relative. The second approach, the thick account, is, much less popular. It is argued that the thin approach trivializes an interesting issue among practical philosophers. The thin account is also in one respect less appealing than its thick cousin. The thick account is not flawless, though. At the end, a couple of objections to it will be considered. (shrink)

This paper expounds and defends a relational egalitarian account of the moral wrongfulness of vote markets according to which such markets are incompatible with our relating to one another as equals qua people with views on what we should collectively decide. Two features of this account are especially interesting. First, it shows why vote markets are objectionable even in cases where standard objections to them, such as the complaint that they result in inequality in opportunity for political influence across rich (...) and poor people, are inapplicable. Second, it specifies the sense in which, politically speaking, we should relate as equals, and in doing provides a richer version of recent relational egalitarian accounts of the ideal of democracy. (shrink)