When rules are over-ruled: Virtual bargaining as a contractualist method of moral judgment.

Rules help guide our behavior-particularly in complex social contexts. But rules sometimes give us the "wrong" answer. How do we know when it is okay to break the rules? In this paper, we argue that we sometimes use contractualist (agreement-based) mechanisms to determine when a rule can be broken. Our model draws on a theory of social interactions - "virtual bargaining" - that assumes that actors engage in a simulated bargaining process when navigating the social world. We present experimental data which suggests that rule-breaking decisions are sometimes driven by virtual bargaining and show that these data cannot be explained by more traditional rule-based or outcome-based approaches.

Caring by lying.

Caring for loved ones with dementia can sometimes necessitate a loose relationship with the truth. Some might view such deception as categorically immoral, and a violation of our general truth-telling obligations. I argue that this view is mistaken. This is because truth-telling obligations may be limited by the particular relationships in which they feature. Specifically, within caregiving relationships, we are often permitted (and sometimes obligated) to deceive the people with whom we share them. Our standing to deceive follows from certain features of caregiving relationships. Specifically, they are relationships that involve obligations to promote a person's interests and values (and not simply their autonomy), that often permit us to assume the hypothetical consent of the person with whom we share them, and in which we are often entitled to act out of self-interest. Once we appreciate these features, we will be able to recognize that the truth-telling norms governing our relationships with loved ones with dementia do not represent a radical departure from our general truth-telling obligations, but are instead consistent with truth-telling norms that feature in other caregiving relationships. In addition, we will be able to understand why we may feel conflicted about lying to loved ones with dementia, even when lying is permissible.

Respect for persons and the allocation of lifesaving healthcare resources.

Many ethicists argue that we should respect persons when we distribute resources. Yet it is unclear what this means in practice. For some, the idea of respect for persons is synonymous with the idea of respect for autonomy. Yet a principle of respect for autonomy provides limited guidance for how we should distribute scarce medical interventions. In this article, however, I sketch an alternative conception of respect for persons-one that is based on an ethic of mutual accountability. I draw in particular upon Stephen Darwall's writings on respect and the second-person standpoint. I consider the implications of this conception of respect for the distribution of scarce, lifesaving healthcare resources. A second-personal account of respect rules out aggregative approaches to distribution, and instead requires that we give individual consideration to the claims that persons in need make on the resources in our control. The principles that we use to govern our allocation of resources, furthermore, should be principles that are acceptable to all reasonable agents. Building on this insight, the final section of this paper considers how a principle of need can be used as a means to make decisions about the allocation of lifesaving resources.

Educating future scientists towards post-patrimonial governance.

In this article, I use the idea of post-patrimonial governance to consider the science education of future scientists. I argue, with Anna Yeatman, that the politics of our time is structured by a contest between two kinds of post-patrimonial contractualism. Data are reported from a study of contemporary Australian scientists to show that some scientists are successfully conducting professional relationships with their publics that are consistent with what Yeatman has called the new contractualism. These approaches contrast with the neopatrimonial contractualism that typifies neoliberal governance and which is prevalent in many societies today. Science educators face a choice to provide accounts of science that acknowledge the work of these scientists and that prepare both future scientists and their future publics for professional relationships of reciprocal respect. I suggest approaches for school science education that are consistent with such a choice.

Contractualist age rationing under outbreak circumstances.

Age rationing is a central issue in the health care priority-setting literature, but it has become ever more salient in the light of the Covid-19 outbreak, where health authorities in several countries have given higher priority to younger over older patients. But how is age rationing different under outbreak circumstances than under normal circumstances, and what does this difference imply for ethical theories? This is the topic of this paper. The paper argues that outbreaks such as that of Covid-19 involve special circumstances that change how age should influence our prioritization decisions, and that while this shift in circumstances poses a problem for consequentialist views such as utilitarianism and age-weighted consequentialism, contractualism is better equipped to cope with it. The paper then offers a contractualist prudential account of age rationing under outbreak circumstances.

Inequality and antibiotic resistance: A contractualist perspective.

There are substantial inequalities associated with antibiotics and the determinants of their effectiveness, including the risk of exposure to antibiotic-resistant microbes, access to relevant treatment advice, diagnostic facilities, risk of life-threatening infectious disease, and access to antibiotics. Current arrangements (social, political, economic) allow inequalities in the distribution of antibiotic benefits and burdens. This article focuses on the justification of relevant inequalities from a contractualist perspective.

El Contractualismo como fundamento de implicación en cuestiones morales sobre la naturaleza y el ambiente / Contractualism as the foundation of involvement in moral issues about nature and the environment / O contratualismo como base para o envolvimento em questões morais sobre a natureza e o meio ambiente

El presente texto busca hacer un recorrido a través de una propuesta ética antropocéntrica, con el fin de establecer un tipo de vínculo moral que incluya a todos los agentes racionales, en el ejercicio de un actuar moral en pro del ambiente y los animales. Para ello, se analiza, define y propone, de manera particular, una ética contractual basada en varios aportes teóricos de diferentes autores contractualistas. Para, posteriormente, derivar las llamadas responsabilidades morales indirectas que recaen sobre los pacientes morales, que, para este caso, son los animales y el medio ambiente, de manera que se confirme la existencia de principios de acción moral, que puedan ser aceptados de manera razonable por todos los agentes contractuales.

The present text seeks to make a journey through an anthropocentric ethical proposal, in order to establish a type of moral bond that includes all rational agents, in the exercise of a moral act in favor of the environment and animals. For this purpose, a contractual ethical proposal based on several theoretical contributions of different contractarian authors is analyzed, defined and established in a particular way. To, subsequently, derive the so-called indirect moral responsibilities that fall on moral patients, which for this case are the animals and the environment, so that the existence of principles of moral action, which can be reasonably accepted by all parties, is confirmed contractual agents.

O presente texto busca fazer uma jornada através de uma proposta ética antropocêntrica, a fim de estabelecer um tipo de vínculo moral que inclua todos os agentes racionais, no exercício de um ato moral a favor do meio ambiente e dos animais. Para isso, uma proposta ética contratual baseada em diversas contribuições teóricas de diferentes autores contratuais é analisada, definida e estabelecida de maneira particular. Para, posteriormente, derivar as chamadas responsabilidades morais indiretas que se enquadram em pacientes morais, que, neste caso, são os animais e o meio ambiente, de modo que a existência de princípios de ação moral, que pode ser razoavelmente aceita por todas as partes, seja confirmada agentes contratuais.

Evaluation as institution: a contractarian argument for needs-based economic evaluation.

BACKGROUND: There is a gap between health economic evaluation methods and the value judgments of coverage decision makers, at least in Germany. Measuring preference satisfaction has been claimed to be inappropriate for allocating health care resources, e.g. because it disregards medical need. The existing methods oriented at medical need have been claimed to disregard non-consequentialist fairness concerns. The aim of this article is to propose a new, contractarian argument for justifying needs-based economic evaluation. It is based on consent rather than maximization of some impersonal unit of value to accommodate the fairness concerns. MAIN TEXT: This conceptual paper draws upon contractarian ethics and constitution economics to show how economic evaluation can be viewed as an institution to overcome societal conflicts in the allocation of scarce health care resources. For this, the problem of allocating scarce health care resources in a society is reconstructed as a social dilemma. Both disadvantaged patients and affluent healthy individuals can be argued to share interests in a societal contract to provide technologies which ameliorate medical need, based on progressive funding. The use of needs-based economic evaluation methods for coverage determination can be interpreted as institutions for conflict resolution as far as they use consented criteria to ensure the social contract's sustainability and avoid implicit rationing or unaffordable contribution rates. This justifies the use of needs-based evaluation methods by Pareto-superiority and consent (rather than by some needs-based value function per se). CONCLUSION: The view of economic evaluation presented here may help account for fairness concerns in the further development of evaluation methods. This is because it directs the attention away from determining some unit of value to be maximized towards determining those persons who are most likely not to consent and meeting their concerns. Following this direction in methods development is likely to increase the acceptability of health economic evaluation by decision makers.

A ideia da estrutura básica como objeto primário da justiça em uma teoria da justiça de John Rawls

O objetivo deste artigo é estabelecer uma reflexão sobre a estrutura básica da sociedade (basic structure of society) proposta por John Rawls em sua teoria da justiça como equidade, baseando-se principalmente nas obras Political Liberalism (Lecture VII) e A theory of justice (Part Two. Institutions). Nossa intenção é demonstrar ao longo do texto, que uma sociedade sustentada em princípios e com espírito de cooperação, tem maior possibilidade de atingir estabilidade e legitimidade politica ao longo do tempo.(AU)

The main purpose of this article is to provide a reflection on the basic structure of society proposed by John Rawls in his theory of justice as fairness, mainly based on the following books, Political Liberalism (Lecture VII) and A theory of justice (Part Two. Institutions). The intention is to demonstrate throughout the text, that a society which is based on principles and spirit of cooperation, is more likely to achieve political legitimacy and stability over time.(AU)

O “contrato sexual” e a promoção dos direitos e garantias fundamentais da mulher na sociedade contemporânea

O artigo visa contribuir para a reflexão acerca das desigualdades de gênero e consequente violação dos direitos e garantias fundamentais da mulher. Foi desenvolvido com base na teoria de justiça de John Rawls que defende que as desigualdades que se justificam são as destinadas a favorecer os menos favorecidos.(AU)

The paper aims to contribute to a reflection about gender inequalities and consequent violation of fundamental rights and guarantees of women. Was developed based on the theory of justice of John Rawls who argues that inequalities are justified are designed to favor the poor.(AU)

O “contrato sexual” e a promoção dos direitos e garantias fundamentais da mulher na sociedade contemporânea / The \" sexual contract \" and the promotion of the rights and fundamental guarantees of the woman in contemporary society

O artigo visa contribuir para a reflexão acerca das desigualdades de gênero e consequente violação dos direitos e garantias fundamentais da mulher. Foi desenvolvido com base na teoria de justiça de John Rawls que defende que as desigualdades que se justificam são as destinadas a favorecer os menos favorecidos.

The paper aims to contribute to a reflection about gender inequalities and consequent violation of fundamental rights and guarantees of women. Was developed based on the theory of justice of John Rawls who argues that inequalities are justified are designed to favor the poor.

A ideia da estrutura básica como objeto primário da justiça em uma teoria da justiça de John Rawls / The idea of the basic structure as the primary object of justice in a theory of justice of John Rawls

O objetivo deste artigo é estabelecer uma reflexão sobre a estrutura básica da sociedade (basic structure of society) proposta por John Rawls em sua teoria da justiça como equidade, baseando-se principalmente nas obras Political Liberalism (Lecture VII) e A theory of justice (Part Two. Institutions). Nossa intenção é demonstrar ao longo do texto, que uma sociedade sustentada em princípios e com espírito de cooperação, tem maior possibilidade de atingir estabilidade e legitimidade politica ao longo do tempo.

The main purpose of this article is to provide a reflection on the basic structure of society proposed by John Rawls in his theory of justice as fairness, mainly based on the following books, Political Liberalism (Lecture VII) and A theory of justice (Part Two. Institutions). The intention is to demonstrate throughout the text, that a society which is based on principles and spirit of cooperation, is more likely to achieve political legitimacy and stability over time.

How the contractualist account of preconception negligence undermines prenatal reproductive autonomy.

Suppose a physician advises a woman to delay her planned pregnancy for a few months in order to significantly reduce the likelihood that her baby will suffer with Spina Bifida. If the woman chooses to ignore this advice and conceives soon after, I believe most people would consider it a matter of common sense that the child thus born is a victim of this woman's negligence, even if it is fortunate enough to not be burdened with Spina Bifida. This common sense judgement appeared to have been done in by the fact that the timing of conception can be identity-influencing, and so the child that is born only exists because of its mother's decision to ignore her physician's advice. However, recently, contemporary contractualist theories have been used to make sense of preconception negligence towards persons whose existence is a result of that same negligence. I will briefly discuss this interesting development and then show how this retrieval of the common sense judgement comes at a great cost to prenatal reproductive autonomy.

Medical ethics and the Romanian law. Surrogate decisions regarding life-saving medical interventions.

Romanian doctors who encounter controversial surrogate decisions such as refusal of life-saving interventions react differently from an ethical perspective. Some do not take into account the surrogates' rejection of treatment, while others respect and abide by the surrogates' decision and withhold the refused procedures, forgoing their ethical responsibilities. In this article we will defend the ethical position that doctors should consider and, therefore, thoroughly evaluate the surrogate decisions in cases where the medical intervention is life-saving and the benefits for the patient are significant and certain. The doctors who choose to obey the controversial decisions of surrogates usually invoke the Romanian medical law. In the following we argue that in today's Romanian medical framework there is a conflict between ethical (professional) obligations and the some of the legal provisions and we provide two ethical arguments, one principlist and one contractualist, that prompt for the overriding of refusals which concern life-saving interventions.