Negligence and omission are closely related: commonly, in cases of negligent action, the agent has failed to turn her attention to some pertinent fact. But that omission is itself typically unwitting. A sufficient condition for blameworthiness for an unwitting omission is offered, as is an account of blameworthiness for negligent action. It is argued that one can be blameworthy for wrongdoing done from ignorance even if one is not blameworthy for that ignorance.

Dr Bawa-Garba, a senior paediatric trainee who had been involved in the care of a child who died shortly after admission to hospital, was convicted of gross negligence manslaughter and subsequently erased from the medical register. We argue that criminalisation of doctors in this way is fraught with ethical tensions at levels of individual blameworthiness, systemic failures, professionalism, patient safety and at the interface of the regulator and doctor. The current response to alleged manslaughter during clinical care is not (...) fit for purpose because of its narrow focus on criminalisation and punishment of individual doctors. The justice system fails to take into account systemic issues in a sufficiently proper and informed way particularly in respect of human factors involved in decision-making. It is easier to convict individual doctors for gross negligence manslaughter than it is to effect legal accountability upon organisations. If educational reflections are used to apportion blame, then this could impact detrimentally on honesty and the duty of candour, with negative implications for patient safety. Regulatory processes should not be deployed without consideration of context. There is an urgent need for a fresh and open evaluation of professional and societal expectations from the regulator that should include positive action as well as those that are proportionately punitive. Justice and patient safety would be served better by more sophisticated contextualisation through an approach that balances accountability in healthcare with failures that can occur within complex systems, and by working to a radical shift towards a just culture. (shrink)

This is a draft of my chapter on Negligence for the forthcoming Oxford Handbook in Moral Psychology. It discusses philosophical, psychological, and legal approaches to the attribution of culpability in cases of negligent wrongdoing.

The counterfactual mental state of negligent criminal activity invites skepticism from those who see mental states as essential to responsibility. Here, I offer a revision of the mental state of criminal negligence, one where the mental state at issue is actual and not merely counterfactual. This revision dissolves the worry raised by the skeptic and helps to explain negligence’s comparatively reduced culpability.

Negligence is both an important concept and an ambiguous one. Here I concentrate upon the sense of creating an unjustifiable, low-probability risk of future harm. This essay attempts to dispel theprevalent view that only a maximizing, utilitarian approach can render intelligible certain features of negligence analysis—its focus on the marginal advantages and disadvantages of the actor's taking a specific precaution, its consideration and balancing of the short-term effects of different actions, and its sensitivity to a multiplicity of factors. (...) Perhaps certain absolutist deontological perspectives are inconsistent with these features; but other deontological perspectives can easily accommodate them. Careful examination of the concept of negligence helps resolve an important debate about the nature of tort law, supporting the view that fault, rather than corrective justice, is the better interpretation and justification of Anglo-American tort doctrine. (shrink)

Why are we accountable for negligent wrongdoing? This paper develops a contractualist account of accountability for negligent wrongdoing rooted in maintaining self-trust. Displays of negligence threaten the self-trust needed to exercise planning agency. People thus have reason to take responsibility for being negligent to defeat higher-order evidence about the unreliability of one’s planning agency. Individuals are rationally required to take responsibility for negligence in virtue of the demands of planning agency. One novel implication of this view is that (...) taking responsibility for negligence grounds our holding others responsible for negligence. (shrink)

This article considers the issue of expanded access to innovative treatments in the context of recent legislative initiatives in the United Kingdom and the United States. In the United Kingdom, the supporters of legislative change argued that the common law principles governing medical negligence are a barrier to innovation. In an attempt to remove this perceived impediment, two bills proposed that innovating doctors sued for negligence should be able to rely in their defence on the fact that their (...) decision to innovate was “responsible.” A decision to innovate would be regarded as responsible if it followed a specified process. Although these changes to the law of medical negligence were not passed, this article argues that the idea of a process-based approach was sound. In the United States, a number of states have passed “Right to Try” laws that permit doctors to prescribe and companies to provide investigational products without the need for FDA approval. These laws do not purport to and nor are they able to alter the obligations of individuals and companies under federal law. They are consequently unlikely to achieve their stated aim of expanding access to investigational products. This article argues that they nevertheless have a cogent rationale in so far as they highlight the need for rights-based reform to federal regulations governing access. (shrink)

Philosophers of criminal punishment disagree about whether infliction of punishment for negligence can be morally justified. One contending view holds that it cannot be because punishment requires culpability and culpability requires, at a minimum, advertence to the facts that make one’s conduct wrongful. Larry Alexander and Kim Ferzan are prominent champions of this position. This essay challenges that view and their arguments for it. Invoking a conceptual distinction between an agent’s being _blameworthy_ for an act and their _deserving punishment_ (...) (or suffering) for that act, it explains that an agent can be blameworthy for negligent conduct, and thus liable to reasonable blaming practices, even if negligence is not culpable, hence not sufficient to ground negative desert. Turning from conceptual inquiry to substantive questions of political morality, it then argues that a faulty actor’s lack of culpability does not render them immune from just punishment, but does significantly limit the severity of punishment that may be inflicted, for punishment should not be disproportionately severe relative to an agent’s culpability in relation to wrongdoing. (shrink)

Two professionals who treated Jack Adcock before his death were convicted of gross negligence manslaughter, receiving 24-month suspended sentences. His nurse, Isabel Amaro, was erased from the nursing register; but after reviews in the High Court and Court of Appeal, his doctor, Hadiza Bawa-Garba, was merely suspended. This article explores the proposition that nurses are at greater risk of erasure than doctors after gross negligence manslaughter through a close reading of the guidance for medical and nursing tribunals informed (...) by analysis from the High Court and Court of Appeal in the Bawa-Garba cases. Examination of the relevant sections of the guidance for medical and nursing tribunals reveals no significant differences. An outline of the conduct that amounted to breach of duty of care by Amaro and Bawa-Garba shows that their conduct could satisfy the thresholds for erasure given in their professions’ respective guidelines for tribunals. Both presented similar mitigating evidence, although this cannot be weighed heavily in a professional tribunal setting. Thus, Amaro was treated more harshly than Bawa-Garba without a simple explanation. However, I suggest that the Nursing and Midwifery Council’s Conduct and Competence Committee made a mistaken ‘presumption of erasure’ for gross negligence manslaughter and misinterpreted the sway that sentencing remarks should hold over tribunals. Both of these types of error were criticised by the Court of Appeal in Bawa-Garba. Furthermore, the Conduct and Competence Committee did not flesh out its analysis of ‘public confidence’ or acknowledge Lord Hoffmann’s caution against ending ‘useful’ careers for the sake of public confidence, but Bawa-Garba’s legal team ensured these arguments were taken into account by the Medical Professional Tribunal. The Conduct and Competence Committee’s failures are not inherent to Nursing and Midwifery Council procedure or policy. Rather Amaro’s self-representation appears to have impaired her access to justice. Tribunals must accept their right, and responsibility, to reach their own conclusions. (shrink)

Commentators seemingly agree about what negligence is—and how it is contrasted from recklessness. They also appear to concur about whether particular examples (both real and hypothetical) portray negligence. I am less confident about each of these matters. I explore the distinction between recklessness and negligence by examining a type of case that has generated a good deal of critical discussion: those in which a defendant forgets that he has created a substantial and unjustifiable risk of harm. Even (...) in this limited kind of example, no single perspective on blame and liability proves to be defensible. Nonetheless, a discussion of this type of case is helpful because it enables us to appreciate the difficulties in understanding the nature of negligence and the ensuing uncertainty about whether penal liability for negligence is ever warranted. (shrink)

What is the proper role of cost-benefit analysis in understanding the tort concept of negligence or reasonable care? A straightforward question, you might think. But it is a question that manages to elicit groans of exasperation from those on both sides of the controversy. For most utilitarians and adherents to law and economics, the answer is obvious: to say that people should not be negligent is to say that they should minimize the sum of the costs of accidents and (...) the costs of preventing accidents. Under the economic formulation of the famous Learned Hand test, they should take a precaution if but only if the marginal costs (or burden, B) of that precaution are less than its marginal benefits (in the form of reduced risks of injury, measured by multiplying the probability (P) of the injury times the magnitude (L) of the injury if it occurs). If B>PxL, it would be absurd to require the greater expenditure, B. For many advocates of a fairness, corrective justice, rights-based, or contractualist perspective, the opposite answer is equally obvious. Permitting a person to impose risks of harm on others merely because he would thereby obtain a benefit (or would otherwise incur a burden) greater than the discounted value of the harm he might inflict, amounts to authorizing him to dump the costs of his risky activities on innocent victims. To permit this type of sacrifice of individuals on the altar of aggregate social welfare is morally abhorrent. Both sets of criticism have important elements of truth. Neither an unqualified cost-benefit analysis nor an unqualified rights-based rejection of tradeoffs is defensible - either as a description of tort doctrine and practice or as a normative prescription. However, a qualified (sensitive) consequentialist approach can accommodate legitimate criticisms of cost-benefit analysis: the consequentialist can launder preferences, and can consider the distribution of risk both in the social welfare calculus and in determining whether to compensate. At the same time, a qualified (tough-minded) deontological approach can accommodate the legitimate need to recognize tradeoffs: the deontologist can permit intrapersonal but not interpersonal aggregation of risks and benefits, can apply the concept of threshold deontology to risky activity, and can consider individual rather than population risk. I conclude that the formulation of the Learned Hand test found in the Restatement Third of Torts is broad enough to encompass each of these qualified approaches. (shrink)

This article explores different dimensions of the concept of negligence in the law. The first sections focus on the fundamental distinction between conduct negligence, a conception that dominates tort law; and cognitive negligence, a conception that is much more important in criminal law. The last major section identifies five significant institutional functions served by a legal negligence standard: expressing a legal norm in the form of a standard rather than a rule; personifying fault; empowering the trier (...) of fact to give content to the standard; creating a secondary legal norm parasitic on a primary legal norm; and distinguishing grades of fault. These functions reveal the distinctive significance of negligence, but also disclose numerous problems that the use of such a legal standard can pose. Careful analysis of these different dimensions of negligence clarifies certain misconceptions and has important implications. For example, the question whether "negligence" is an appropriate minimum standard of liability is unanswerable until we identify the type of negligence at issue and its role in norm-definition. Similarly, comparing negligenceto supposedly "more serious" forms of fault, such as recklessness, knowledge, and purpose, is treacherous and sometimes amounts to comparing apples and oranges. A better understanding of the different conceptions of negligence and of the distinctive institutional functions of a legal negligence standard can facilitate the development of more coherent, and more justifiable, fault criteria in criminal law, torts, and other legal domains. (shrink)

Wrongful birth actions aim to compensate litigants who are negligently deprived by health professionals of their right to reproductive choice. Access to safe and legal abortion is integral to the action and wrongful birth claims in the United Kingdom have been facilitated by the Abortion Act 1967 (as amended). The recent Australian case CES v Superclinics (1995) 38 NSWLR 47 shows how judicial confusion about the legality of abortion can result in judges condoning medical negligence. The Superclinics case also (...) suggests that doctors are not required to provide pregnant women with the same standard of care as other patients. These developments show that law can become incoherent and health professionals can act negligently with impunity when reproductive choice does not have a secure legal foundation. (shrink)

The tendency for judges to respond positively to negligence claims advanced by those who have rendered assistance to accident victims has recently come into collision with the judicial impulse to limit the range of circumstances in which recovery can be made for psychiatric injury. The upshot of this collision is identified as a reduction in the range of circumstances in which those rendering assistance to accident victims can recover for psychiatric harm. This development is criticized on the ground that (...) it has compromised pursuit of what is identified as one of the law's subsidiary purposes: namely, the promotion (in a narrow range of circumstances) of strongly altruistic activity. The ground for making this criticism is found in a body of doctrine that supports the claim that the law is informed by a commitment to the altruism principle. This principle is contrasted with the narrower rescue principle and is identified as supporting not only the claims of rescuers but also those of persons who render assistance in the aftermath of particularly harrowing accidents. While the House of Lords» decision is identified as exhibiting insensitivity to the altruism principle, it is none the less concluded that the position staked out by their Lordships is defensible. Support for this conclusion is found in the ideal of distributive justice, which provided one of the grounds for the House's decision in White. Further, the relationship between the ideal of corrective justice and the ideal of distributive justice is identified as a source of significant tension in the law of negligence. (shrink)

At first blush, Sosa’s performance-based approach to epistemic normativity would seem to put us in a position to illuminate important types of epistemic negligence – types whose epistemic significance will be denied by standard evidentialist theories. But while Sosa’s theory does indeed venture beyond standard evidentialism, it fails to provide an adequate account of epistemic negligence. The challenge arises in cases in which a subject is negligent in that she knowingly fails to perform inquiries which it was her (...) responsibility to perform, but where she had good (undefeated) reason to believe that had she done so her judgment would only have been reinforced, and where this higher-order judgment was apt. After arguing that these cases will pose problems for Sosa’s view, I diagnose the difficulty as one that will face any view that treats epistemic negligence either in exclusively performance-theoretic terms or exclusively evidential terms. (shrink)

The purpose of this paper is to discuss and to relate to each other two topics: the admissibility of ignorance and mistake of fact as defences against negligence in crime; and the inadmissibility of ignorance and mistake of law as defences against criminal charges. I am in not concerned at all with torts negligence, only with criminal offences which can be committed negligently, where negligence suffices for liability, as in the law of homicide. This produces an untidy (...) classification of elements, one or other of which is needed to provide the required mens rea : intention, knowledge, recklessness and negligence. It is untidy, because the last does not belong on the same list as the other three, each of which can appropriately be called a state of mind in what we might say to be a positive sense, for each of them includes some degree of awareness of and/or attitude to relevant facts. If negligence is to be called a state of mind, it is so in a very stretched and negative way: to be told that a person was not attending to, thinking of or noticing something that he should have been is to be given some information, of a negative sort, about his state of mind, but it tells us very little, for it eliminates only one of an unlimited range of states of mind. His not attending, noticing, etc., is equally compatible with his daydreaming and with his concentrating hard on something else. If negligence requires inadvertence, as is commonly maintained, then there was a state of mind which the agent should have been in but was not; if, as I would argue, it does not require inadvertence, then there was a state of mind which the agent should have been in, and maybe he was not in it, maybe he was in it. would not require it; the definition runs, ‘a person is negligent if he fails to exercise such care, skill or foresight as a reasonable man in his situation would exercise’. However, that is only a proposal; at present advertent negligence is rare in criminal law, although common in torts.) On this view, the questions are whether his performance fell below scratch, what are to be the excusing conditions for such a performance, and if the answer to is yes, whether his performance was covered by the excusing conditions. (shrink)

This collection of essays represents a ground-breaking collaboration between moral philosophers, action theorists, lawyers and legal theorists to set a fresh research agenda on agency and responsibility in negligence. The complex phenomenon of responsibility in negligence is analysed from multi- and interdisciplinary perspectives, shedding light on key ethical and legal issues related to agency and negligence to impact substantive law and policy-making in different jurisdictions. The volume introduces new debates and questions old assumptions, inviting the reader to (...) rethink substantive law and practical ethical reflection. (shrink)

The paper has dual aim: to analyse the structure of negligence, and to use it to offer an explanation of responsibility (for actions, omissions, consequences) in terms of the relations which must exist between the action (omission, etc.) and the agents powers of rational agency if the agent is responsible for the action. The discussion involves reflections on the relations between the law and the morality of negligence, the difference between negligence and strict liability, the role of (...) excuses and the grounds of duties to pay damages. (shrink)

When a plaintiff has been negligent in the sense that he should have acted otherwise, should the same criterion of negligence apply that would apply if he were creating risks only to others? Indeed, are there any persuasive reasons not to apply a radically different criterion of negligence? Moreover, should the plaintiff's recovery be diminished, outside the category of assumption of risk, even when the plaintiff has not been negligent? What are the justifiable criteria and limits of such (...) plaintiff strict responsibility? There are reasons for caution before concluding that a victim's self-regarding conduct is negligent. A victim often deserves special sympathy in the light of his special predicament, choosing between two evils, the immediate costs of which he must personally bear. Indeed, it might appear that the law is unfair or unduly onerous when it places significant demands on a victim with respect to his own self-regarding behavior. On the other hand, we should not forget that the victim's “duty” to use reasonable care is merely conditional: it applies only in case the victim seeks a remedy against the tortfeasor. (shrink)

This article presents the conception of negligent account management, analyses the rules of the criminal act that govern criminal liability for negligent account management, by focussing on the form of guilt and the problem of its content. The plenary session’s conclusion that the two offences – failure to administer bookkeeping and failure to protect the bookkeeping documents – can be committed both intentionally and negligently is disputed in this article. The adoption of the new Criminal Code in 2000, setting the (...) form of guilt and its content in criminal cases for negligent account management, posed no significant problems – the court practice and legal literature followed the attitude that this crime could be committed only negligently. According to Article 16(4) of the Criminal Code 2000, a person is punished for negligent commission of a crime or a misdemeanour only in individual cases stipulated in the Special Part of the Criminal Code. The problem was that no “individual case” was foreseen in Article 223 of the Criminal Code that imposed liability for negligent bookkeeping. This created preconditions for deviating from pre-existing case-law under which this crime could be qualified as negligent. Only in 2009 the Criminal Division of the Lithuanian Supreme Court concluded in its plenary session that Article 223 of the Criminal Code provided liability for criminal record-keeping and accounting only if committed negligently as a form of guilt, and other activities pursuant to this Article might be committed intentionally and recklessly. The plenary session identified a loophole of criminal law and created preconditions for the formation of uniform court practice. Only the legislator can remove the loophole of criminal law identified by the Supreme Court of Lithuania. The author states that all of the acts named in Article 223 of the Criminal Code can be committed negligently and suggests applying the rule contained in Article 16(4) of the Criminal Code to Article 223 of the Criminal Code. All of these findings are based on historical, grammatical and logical interpretation of the “neglect” concept and the analysis of Articles 222 and 223 of the Criminal Code. (shrink)

The question of when a person is culpable for taking an unjustified risk of harm has long been controversial in Anglo-American criminal law doctrine and theory. This survey of the approaches adopted in England and Wales, Canada, Australia, the United States, New Zealand and Scotland argues that they are converging, to differing extents, around a 'Standard Account' of culpable unjustified risk-taking. This Standard Account distinguishes between awareness-based culpability and inadvertence-based culpability for unjustified risk-taking. With reference to criminal law theory and (...) philosophical literature, the author argues that, when explained appropriately, the Standard Account is defensible and practical. Defending the Standard Account involves analysing in depth a number of controversial matters, including the meaning of advertence/awareness, the role of attitudes such as indifference in culpable risk-taking, and the question of whether negligence should be used in the criminal law. (shrink)

Criminalizing unintentional mistakes in medicine as the offence of gross negligence manslaughter has always been a contentious issue. The threshold of prosecution is not well-defined, and even less clear when faced with a situation in which an intern doctor is held liable. This commentary attempts to review the current legal position of holding an intern doctor liable for gross negligence medical manslaughter.

It is widely agreed that the top three Model Penal Code culpability levels suffice for criminal liability, but the fourth is controversial. And it isn’t just the particular MPC wording; that negligence should be on the list at all is controversial. My question is: What makes negligence so different? What is it about negligence that gives rise to the view that it should not suffice for criminal liability? In addressing it, I draw attention to how we conduct (...) the debate, and how our framing of the issues is shaping it. My hope is to prompt thought and discussion on just what we want the element of mens rea to provide, and to draw attention to background assumptions that shape our views of what it should take for negligence to count as a species of mens rea. (shrink)

Introduction : what's the problem? -- The problem may lurk in Aristotle's ethics -- Aristotle's akratic : foreshadowing a solution -- A negligent omission at the root of all sinfulness : Anselm and the Devil -- Negligent vs. non-negligent : a Thomistic distinction directing us toward a solution -- Can I have your divided attention? : Scotus, indistinct intellections, and type-1 negligent omissions almost solved -- I can't get you out of my mind : Scotus, lingering indistinct intellections, and type-2 (...) negligent omissions -- Scotus's affection-ate corrective : a possible final solution to a type-2 variant -- Neglected treatises help solve negligence : the action theory of Francisco Suarez -- An answer that cannot be neglected : the solution -- Appendix A : translation of Nicomachean ethics 1146b31-1147b19. (shrink)

In this paper we attempt to reply to the thoughtful comments made on our book, Responsible Brains, by a stellar group of scholars. Our reply focuses on two topics discussed in the commenting papers: first, the issue of responsibility for negligent behavior; and second, the broad claim that facts about brain function are normatively inert. In response to worries that our theory lacks normative implications, we will concentrate on an area where our theory has clear relevance to law and legal (...) policy: juvenile responsibility. (shrink)

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610, that the heightened remedies available under the Elder Abuse Act, Cal. Welf. & Inst. Code, §§ 15657,15657.2, apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: section 15657, which provides for enhanced remedies for reckless neglect; and section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that (...) reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility, after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death. (shrink)

Recent interest in the epistemic condition on moral responsibility has raised a new challenge to the view that persons are directly responsible for negligent conduct. According to an influential ar...

Ordinary morality judges agents blameworthy for negligently produced harms. In this paper I offer two main reasons for thinking that explaining just how negligent agents are responsible for the harms they produce is more problematic than one might think. First, I show that negligent conduct is characterized by the lack of conscious control over the harm, which conflicts with the ordinary view that responsibility for something requires at least some conscious control over it. Second, I argue that negligence is (...) relevantly indistinguishable from inadvertence, which is ordinarily thought to excuse agents from responsibility. I argue that the parallels between negligence and inadvertence suggest that negligent agents are not responsible for the harms they produce, while proposing an alternative model for distinguishing between negligence and inadvertence that does justice to our intuitions. (shrink)

The article examines what has come to be known as "the risk analysis" in Anglo-American tort law and contract law. The risk analysis essentially consists of: viewing negligence as a relational concept, so that a defendant is never simply negligent tout cour, but is negligent only with respect to certain persons and certain harms — other harms suffered by other persons are said not to be "within the risk" that makes the defendant negligent; and the supplanting of proximate cause (...) doctrine with doctrines of duty, the duty question being determined by the question of whether a certain person and a certain harm are within the risk that makes a defendant negligent. The article aims to explode entirely the risk analysis. After beginning with an examination of the historical roots of the risk analysis, we then seek to show that the risk analysis is: conceptually incoherent because it seeks to isolate a risk that makes someone negligent; normatively undesirable because it allows quite blameworthy actors not to pay for the harms they culpably cause; and descriptively inaccurate of the cases decided on the more traditional, proximate cause bases. (shrink)

This essay explains, expands, develops, and reflects on the Razian theory of responsibility and identity, focusing primarily on responsibility for negligent actions. I begin with setting the stage for understanding the importance of Joseph Raz’s theory and what motivates it. Next, the essay lays out the theory itself, and offers some elaboration on some of the less developed features of the theory. The essay closes with two critical reflections.

Negligence, the creation of an unjustifiable risk of harm, plays a pivotal role in both criminal and civil law. This article takes up two negligence-related problems unique to its role in the criminal law. The first has to do with its "harm" component, the second with its "unjustifiability" component. The first problem is why the criminal law distinguishes so sharply between negligent wrongdoing that results in harm and negligent wrongdoing that does not, when it does not distinguish equally (...) sharply between intentional wrongdoing that results in harm and intentional wrongdoing that does not. The answer has to do with a peculiar feature in the logic of intention and with the symmetric way we ascribe responsibility for blameworthy and praiseworthy actions. My second problem is why the criminal law judges the blameworthiness of negligent actions on the basis of the harm wrought rather than the gap between the harm wrought and the justification for risking it. The answer has to do with a more general feature of the criminal law, the refusal to recognize "partial defenses" and "partial offenses.". (shrink)

Negligence reminds us that we often do and cause things unawares, occasionally with grave results. Given the lack of foresight and intention, some authors argue that people should not be judged culpable for negligence. This paper offers a contrasting view. It argues that gaining control is itself a fundamental responsibility, with both collective and individual elements. The paper underlines both sides, focussing on how they relate as we ascribe responsibility or culpability. Following the introduction, Section 2 argues that (...) conscious awareness is neither necessary nor sufficient for control. Control is not a property of deliberate choice, so much as a practical achievement. Section 3 stresses the collective aspects of non-negligence: creating knowledge about risks, structuring environments to guard against them, and developing standards of care. Failings in the collective task, rather than lack of individual control, mean it can often be unfair to pin culpability on a single individual. Section 4 suggests that a basic duty of a responsible person is to acknowledge the ways in which we may do more or less than we mean to, often in ways that create risks. It then sketches an approach to culpability as part of a collective exercise: as we take responsibility for standards of care, and for our own and others’ agency. (shrink)

In the context of clinical and non-clinical biomedical practices, negligence is usually understood as a lapse of a specific professional duty by a healthcare worker or by a medical facility. This paper tries to delineate systemic negligence as another kind of negligence in the context of health systems, particularly in developing countries, that needs to be recognized and addressed. Systemic negligence is not just a mere collection of stray incidences of medical errors and system failures in (...) a health system, but is proposed in this paper as a more pervasive kind of neglect. Several non-medical factors, such as lack of social and political will, also contribute to it and hence is more difficult to address in a health system. This paper argues that recognizing systemic negligence and including it research agenda have special moral importance for researchers in developing world bioethics, public health ethics and for health activists in the developing world. For, it can be a potent health system barrier, and can seriously impair efforts to ensure patient safety, particularly in the weaker health systems. As it erodes accountability in a health system, addressing it is also important for the twin goals of ensuring patient safety and improving health system performance. Above all, it needs to be addressed because the tolerance of its persistence in a health system seems to undervalue health as a social good. (shrink)

1. ‘Agency, Negligence and Responsibility’ is a collection of essays edited by Veronica Rodriguez-Blanco and George Pavlakos on the fascinating topic of negligence. The collection contains twelve p...

In this paper, I suggest that the wrongness of many—though not at all—cases of microaggressions can be captured as cases of negligence. A case of negligence holds when, regardless of an actor’s intentions, he or she wrongs another in a manner that is both reasonably foreseeable and reasonably avoidable. Thinking of microaggressions as negligence answers some objections of skeptics who focus on the possibility that the alleged microaggressor “meant no offense”. It does so while retaining language explaining (...) why a wrong was committed and suggesting what sort of corrective behavior can reasonably be demanded to avoid these wrongs in the future. I also argue that a negligence framework does a better job of phenomenologically explaining most microaggressions—both why they occur and why they are perceived as the sort of conduct that subjects the microaggressor to agent-level moral criticism. Indeed, I believe that negligence-style logic permeates many accounts that already exist regarding microaggressions, albeit without fully being recognized. Finally, in cases where it applies, the negligence framework has an advantage over alternate accounts in that it provides for consideration of both the moral culpability of the perpetrator as well as the tangible impact of microaggressions on the victim. (shrink)

One popular theory of moral responsibility locates responsible agency in exercises of control. These control-based theories often appeal to tracing to explain responsibility in cases where some agent is intuitively responsible for bringing about some outcome despite lacking direct control over that outcome’s obtaining. Some question whether control-based theories are committed to utilizing tracing to explain responsibility in certain cases. I argue that reflecting on certain kinds of negligence shows that tracing plays an ineliminable role in any adequate control-based (...) theory of responsibility. (shrink)

The problem of undermedication of pain in health care is widely recognized and acknowledged; however, there is an obvious lack of exploration of this problem from an ethical perspective. When undermedication is raised as a moral concern, the underlying premise is that a patient may experience harm or not benefit from ineffective pain management practices. I will argue that the harm is of a particular type, that is, moral negligence. My intention is to increase nurses’ awareness of both the (...) type of moral harm they are causing, and their professional and moral duties to provide appropriate medication, more particularly to avoid undermedication. I hope that this heightened awareness will be incorporated into practice. As a nurse, I chose to focus on nursing for this article, but my claims are applicable to other health professions, such as medicine. (shrink)

Doug Husak suggests that sometimes an actor should be deemed reckless, and not merely negligent, with respect to the risks that she knowingly created but has forgotten at the moment of action. The validity of this conclusion, he points out, depends crucially on what it means to be aware of a risk. Husak’s neutral prompt and counterfactual actual belief criteria are problematic, however. More persuasive is his suggestion that we understand belief, in this moral and criminal law context, as a (...) concept whose meaning is determined by its function as a culpability standard. Husak concludes that inadvertent actors are often less culpable than knowing-but-later-forgetful actors; this is plausible, but there are also numerous counterexamples. Holly Smith focuses on negligence cases in which an agent’s failure to notice a risk stems, not from a prior culpable choice, but from an objectionable attitude or set of attitudes. She is right to emphasize that genuine moral culpability does not depend on conscious choice. However, Smith also asserts that decisions that flow from an actor’s objectionable attitudes are only rarely culpable, because they often do not arise from a reasonably full configuration of the actor’s motives. This last requirement is, I fear, an unrealistic and unnecessarily demanding criterion of culpability. Even when many of the actor’s evaluative attitudes are inactive in Smith’s sense, the actor might deserve blame for not bringing them to bear on his decision. Michael Moore and Heidi Hurd thoroughly explore, and find deficient, H.L.A. Hart’s unexercised capacity theory of negligence. They are correct that that theory requires a further judgment: an actor’s inadvertence is culpable only if he had the capacity to have adverted if X where X is the source of the actor’s moral desert. They overstate, however, in suggesting that the capacity issue falls out of the picture once we identify that underlying desert basis. The authors also worry that if desert is grounded on an underlying vice, we lack a reliable way of ranking the different vices that might explain the actor’s inadvertence; this is not a fatal objection, however, because negligence determinations are quite feasible even in the absence of clear rankings. Moore and Hurd conclude by identifying eight distinct categories in which criminal liability for negligence is justifiable. Negligence is indeed a surprisingly complex and pluralist concept. The three articles in this symposium brightly illuminate some of the most fundamental conceptual and normative issues in the debate over whether it is just to blame and punish the negligently inadvertent. (shrink)

A popular way to try to justify holding defendants criminally responsible for inadvertent negligence is via an indirect or ‘tracing’ approach, i.e. an approach which traces the inadvertence back to prior culpable action. I argue that this indirect approach to criminal negligence fails because it can’t account for a key feature of how criminal negligence should be (and sometimes is) assessed. Specifically, it can’t account for why, when considering whether a defendant is negligent, what counts as a (...) risk should be assessed relative to the defendant’s evidence. (shrink)

Judgments of blame for others are typically sensitive to what an agent knows and desires. However, when people act negligently, they do not know what they are doing and do not desire the outcomes of their negligence. How, then, do people attribute blame for negligent wrongdoing? We propose that people attribute blame for negligent wrongdoing based on perceived mental control, or the degree to which an agent guides their thoughts and attention over time. To acquire information about others’ mental (...) control, people self-project their own perceived mental control to anchor third-personal judgments about mental control and concomitant responsibility for negligent wrongdoing. In four experiments (N = 841), we tested whether perceptions of mental control drive third-personal judgments of blame for negligent wrongdoing. Study 1 showed that the ease with which people can counterfactually imagine an individual being non-negligent mediated the relationship between judgments of control and blame. Studies 2a and 2b indicated that perceived mental control has a strong effect on judgments of blame for negligent wrongdoing and that first-personal judgments of mental control are moderately correlated with third-personal judgments of blame for negligent wrongdoing. Finally, we used an autobiographical memory manipulation in Study 3 to make personal episodes of forgetfulness salient. Participants for whom past personal episodes of forgetfulness were made salient judged negligent wrongdoers less harshly compared to a control group for whom past episodes of negligence were not salient. Collectively, these findings suggest that first-personal judgments of mental control drive third-personal judgments of blame for negligent wrongdoing and indicate a novel role for counterfactual thinking in the attribution of responsibility. (shrink)

Negligence law is built around the paradigmatic case of a person who unreasonably preferred his own interests to those of others and, as a result, caused damage to another person. However, this case is not representative of all instances of negligence. In some cases, the negligent injurer failed in balancing between the interests of the victim alone; in other cases, he failed in balancing between the victim’s interests and those of a third party; sometimes the injurer failed in (...) balancing the victim’s interests and the interests of the public or of society as a whole; and in yet other instances, he failed in balancing between his own interests. This article argues that the law should not treat in the same manner the different types of instances of failure in balancing between interests. Both justice and deterrence considerations mandate different treatment for the different types of instances, in accordance with the type of interests that the negligent injurer failed to balance. The article focuses on the typical types of balances of interests that the potential injurer is required to conduct before taking action, with the aim of determining the degree to which it is crucial to impose tort liability in each type of case. The article also examines whether prevailing negligence law is compatible with the thesis developed in the article and proposes tools for achieving such compatibility. (shrink)

We seem to be responsible for our beliefs in a distinctively epistemic way. We often hold each other to account for the beliefs that we hold. We do this by criticising other believers as ‘gullible’ or ‘biased’, and by trying to persuade others to revise their beliefs. But responsibility for belief looks hard to understand because we seem to lack control over our beliefs. In this paper, I argue that we can make progress in our understanding of responsibility for belief (...) by thinking about it in parallel with another kind of responsibility: legal responsibility for criminal negligence. Specifically, I argue that that a popular account of responsibility for belief, which grounds it in belief’s reasons-responsiveness, faces a problem analogous to one faced by H.L.A. Hart’s influential capacity-based account of culpability. This points towards a more promising account of responsibility of belief, though, if we draw on accounts of negligence that improve on Hart’s. Broadly speaking, the account of negligence that improves on Hart’s account grounds culpability in a concern for others’ interests, whereas my account of epistemic responsibility grounds responsibility for belief in a concern for the truth. (shrink)