{"title":"Can Treatment for Substance Use Disorder Prescribe the same Substance as that Used? The Case of Injectable Opioid Agonist Treatment.","authors":"Daniel Steel, Şerife Tekin","doi":"10.1353/ken.2021.0022","DOIUrl":"https://doi.org/10.1353/ken.2021.0022","url":null,"abstract":"<p><p>This article examines injectable Opioid Agonist Treatment (iOAT), in which patients suffering from long-term, treatment refractory opioid use disorder (OUD) are prescribed injectable diacetylmorphine, the active ingredient of heroin. While iOAT is part of the continuum of care for OUD in some European countries and in some parts of Canada, it is not an available treatment in the United States. We suggest that one reason for this situation is the belief that a genuine treatment for substance use disorder cannot prescribe the same substance as that used. We examine possible rationales for this belief by considering four combinations of views on the constitutive causal basis of substance use disorders and the definition of effective treatment. We show that all but one combination counts iOAT as a genuine treatment and that there are good reasons to reject the one that does not. Specifically, we claim that medical interventions, such as iOAT, that significantly reduce the severity of a disorder deserve to be categorized as effective treatments and regarded as such in practice.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 3","pages":"271-301"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39450754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Limits of the Rights to Free Thought and Expression.","authors":"Barrett Emerick","doi":"10.1353/ken.2021.0009","DOIUrl":"https://doi.org/10.1353/ken.2021.0009","url":null,"abstract":"<p><p>It is often held that people have a moral right to believe and say whatever they want. For instance, one might claim that they have a right to believe racist things as long as they keep those thoughts to themselves. Or, one might claim that they have a right to pursue any scholarly question they want as long as they do so with a civil tone. This paper rejects those claims and argues that no one has such unlimited moral rights. Part 1 explores the value of the freedoms of thought and expression. Part 2 argues against the unlimited moral right to free expression, focusing in particular on the special obligations and moral constraints that obtain for academics. Part 3 argues against the unlimited moral right to free thought.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 2","pages":"133-152"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/ken.2021.0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39088136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contributors.","authors":"","doi":"10.1353/ken.2021.0000","DOIUrl":"https://doi.org/10.1353/ken.2021.0000","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"27 1","pages":"vi"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138516133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Free to Decide: The Positive Moral Right to Reproductive Choice.","authors":"Tess Johnson","doi":"10.1353/ken.2021.0013","DOIUrl":"https://doi.org/10.1353/ken.2021.0013","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 3","pages":"303-326"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39450760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editor's Note, December 2021.","authors":"Quill Kukla","doi":"10.1353/ken.2021.0025","DOIUrl":"https://doi.org/10.1353/ken.2021.0025","url":null,"abstract":"[...]in “The Epistemic Duties of Philosophers: An Addendum,” van Basshuysen and White wrap up the exchange by clarifying that they are not defending lockdowns and acknowledging the enormous harm that lockdowns have wrought. The quest for epistemically warranted policy responses to the pandemic is an especially pressing one, as COVID refuses to be tamed, and we all are participating in a real-time, world-wide social experiment to figure out what we should do about it. Since cures for COVID are still lacking, our responses to the pandemic have been social interventions. Even the vaccination campaign has turned out to be a complex social intervention. [...]reflection on the social values that shape our assessment of different courses of intervention is crucial.","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 4","pages":"vii-ix"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39716857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"And If It Takes Lying: The Ethics of Blood Donor Non-Compliance.","authors":"Kurt Blankschaen","doi":"10.1353/ken.2021.0027","DOIUrl":"https://doi.org/10.1353/ken.2021.0027","url":null,"abstract":"<p><p>Sometimes, people who are otherwise eligible to donate blood are unduly deferred from donating. \"Unduly\" indicates a gap where a deferral policy misstates what exposes potential donors to risk and so defers more donors than is justified. A number of bioethicists and public health officials have criticized specific deferral policies in order to reformulate or eliminate them. Policy change is undoubtedly the right goal because the policy is what prevents otherwise eligible donors from donating needed blood. But this policy-level focus passes over a largely undiscussed question: if policy change takes time and there is a need for blood now, then what should unduly deferred donors do in the meanwhile? Blood banks and federal agencies recommend that deferred donors donate their time or money until they become eligible, but blood is a non-fungible good: donated cash or volunteered time cannot replace a transfusion. Further, this request ignores the fact that otherwise eligible donors could safely donate their blood in addition to their time and money. If a donor justifiably believes that her blood does not pose a risk to a recipient, but knows that honestly answering a donor questionnaire would unduly defer her, then is she morally justified in lying on the questionnaires in order to donate blood?</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 4","pages":"373-404"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39716859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rationing, Responsibility and Blameworthiness: An Ethical Evaluation of Responsibility-Sensitive Policies for Healthcare Rationing.","authors":"Xavier Symons, Reginald Chua","doi":"10.1353/ken.2021.0004","DOIUrl":"https://doi.org/10.1353/ken.2021.0004","url":null,"abstract":"<p><p>Several ethicists have defended the use of responsibility-based criteria in healthcare rationing. Yet in this article we outline two challenges to the implementation of responsibility-based healthcare rationing policies. These two challenges are, namely, that responsibility for past behavior can diminish as an agent changes, and that blame can come apart from responsibility. These challenges suggest that it is more difficult to hold someone responsible for health related actions than proponents of responsibility-sensitive healthcare policies suggest. We close by discussing public health policies that could function as an alternative to contentious, responsibility-sensitive rationing policies.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 1","pages":"53-76"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/ken.2021.0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25485790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Were lockdowns justified? A return to the facts and evidence.","authors":"Philippe van Basshuysen, Lucie White","doi":"10.1353/ken.2021.0028","DOIUrl":"https://doi.org/10.1353/ken.2021.0028","url":null,"abstract":"<p><p>Were governments justified in imposing lockdowns to contain the spread of the COVID-19 pandemic? We argue that a convincing answer to this question is to date wanting, by critically analyzing the factual basis of a recent paper, \"How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis\" (Winsberg, Brennan, and Suprenant 2020). In their paper, Winsberg, Brennan, and Suprenant argue that government leaders did not, at the beginning of the pandemic, meet the epistemic requirements necessitated to impose lockdowns. We focus on Winsberg, Brennan, and Suprenant's contentions that knowledge about COVID-19 resultant projections were inadequate; that epidemiologists were biased in their estimates of relevant figures; that there was insufficient evidence supporting the efficacy of lockdowns; and that lockdowns cause more harm than good. We argue that none of these claims are sufficiently supported by evidence, thus impairing their case against lockdowns, and leaving open the question of whether lockdowns were justified.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 4","pages":"405-428"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39716860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Truthfulness and Deceit in Dementia Care: An argument for truthful regard as a morally significant human bond.","authors":"Philippa Byers","doi":"10.1353/ken.2021.0020","DOIUrl":"https://doi.org/10.1353/ken.2021.0020","url":null,"abstract":"<p><p>This paper presents a challenge to the view that benign 'white lies' may be therapeutic in dementia care and preferable to more truthful alternatives. Drawing on Sissela Bok and Bernard Williams, the paper develops three key points: first, that another person's dementia is not a reason to suspend one's customary reluctance to deceive others; second, that the commonly drawn contrast between benign deceit and blunt disclosure is too simple to frame arguments for the acceptability of deceit in dementia care; and third, truthful regard-regard for a person living with dementia as one for whom truth matters, as it does for oneself-is a foundation for beneficent concern that is neither infantilizing nor condescending. The paper proposes that a morally significant human bond is established through regard for another person as one for whom truth matters, just as it does for oneself, irrespective of another's dementia, and that within dementia care, the commission of deceit should be seen as an unsettling exception to a general principle of truthfulness.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 3","pages":"223-246"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39450752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editor's Note, September 2021.","authors":"Quill Kukla","doi":"10.1353/ken.2021.0019","DOIUrl":"https://doi.org/10.1353/ken.2021.0019","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"31 3","pages":"vii-x"},"PeriodicalIF":1.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39450756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}