On the child’s right to bodily integrity: when is the right infringed?

This article considers two competing types of conceptions of the pre-autonomous child's right to bodily integrity. The first, which I call encroachment conceptions, holds that any physically serious bodily encroachment infringes on the child's right to bodily integrity. The second, which I call best-interests conceptions, holds that the child's right to bodily integrity is infringed just in case the child is subjected to a bodily encroachment that substantially deviates from what is in the child's best interests. I argue in this article that best-interests conceptions are more plausible than encroachment conceptions. They have more attractive implications regarding the permissibility of interventions in children's bodies that are beneficial for the child but are not medically necessary. They are better able to explain the moral distinction between cases in which an encroachment on a child's body is needed to benefit that child and cases in which an encroachment on one child's body is needed to benefit another. Finally, best-interests conceptions are more consonant than encroachment conceptions with our understanding of adults' right to bodily integrity

The case for citizen duty

This article defends a novel type of institutionalized mass deliberation: Citizen Duty. Citizen Duty would legally require every citizen to engage in one day of diverse, moderated political deliberation prior to major elections. This deliberation would realize a variety of benefits, including wiser electoral decisions and a more respectful electoral process, while avoiding the dangers of citizen deliberation. A comparison with jury duty and with non- deliberative alternatives suggests that Citizen Duty’s substantial economic and liberty costs are justified. Finally, an examination of citizen attitudes towards politics and deliberation suggests that Citizen Duty is not as quixotic as it first appears

Libertarianism, left and right

This chapter explores the libertarian account of distributive justice. It explains the self-ownership thesis and then considers criticisms relating to indeterminacy, small incursions, and enforceable duties of assistance. It then turns to questions relating to natural resources, including whether they are initially owned, the conditions under which they may be appropriated, and the right vs left libertarian debate over whether or not they should ultimately be owned in an egalitarian manner. The chapter then lays out the libertarian account of just economic activity and considers criticisms based on the role of luck, the moral limits of markets, discrimination, paternalism, unjust prices, alternative notions of freedom, the plight of the desperately poor, and market failures. The chapter then concludes by raising important topics for future research, including the moral status of minors, future people, global justice, property rights in non-divisible natural resources, and rectificatory justice

Can liberal egalitarians protect the occupational freedom of the economically talented?

This article considers and ultimately rejects three prominent liberal egalitarian strategies for safeguarding the occupational freedom of the economically talented. First, Dworkinian concerns regarding the envy of the talented for the less talented are shown to be insufficient to rule out occupationally coercive taxation. Second, Rawlsian arguments about the priority of basic liberties in general and freedom of occupation in particular are shown to be unsuccessful, primarily because Rawls lacks the theoretical resources to protect freedom of occupation as a basic liberty. Finally, concerns about the practical difficulty and moral undesirability of gathering the information necessary to implement occupationally coercive taxation are shown to be insufficient to rule out such taxation. The aim of the article is not to lead liberal egalitarians to reject freedom of occupation. Rather, the aim is to highlight the difficulties in protecting freedom of occupation and to motivate work on alternative liberal egalitarian strategies for safeguarding this important economic liberty. At the end of the article, a hypothesis is put forward for why occupationally coercive taxation should be rejected that appeals to the prohibition on using people as means

Income redistribution, body-part redistribution, and respect for the separateness of persons

This article considers the question of why labor income may be permissibly redistributed to the poor but body parts should generally not be redistributed to the sick (the body-income puzzle). It argues that solutions to this puzzle that affirm self-ownership but reject labor-income ownership are unsuccessful as are solutions that appeal to the greater welfare loss associated with body-part takings. It defends instead a solution grounded in a novel conception of respect for the separateness of persons. This conception views the sphere of individual moral authority protected by respect for the separateness of persons as encompassing both the person’s body and her labor income. And it views the negative rights that constitute this sphere as varying in strength based on their importance to the right-holder’s personal identity. Since our body parts are generally more intimately connected to our personal identity compared with moderate portions of our labor income, our separateness-based rights against the taking of our body parts are stronger. Thus, while the disadvantaged’s weighty claims to assistance can justify substantial redistribution of labor income, these claims to assistance are insufficiently robust to justify seizing even non-essential parts of others’ bodies

On the strength of children's right to bodily integrity: the case of circumcision

This article considers the question of how much weight the infringement of children's right to bodily integrity should be given compared with competing considerations. It utilises the example of circumcision to explore this question, taking as given this practice's opponents' view of circumcision's harmfulness. The article argues that the child's claim against being subjected to (presumably harmful) circumcision is neither a mere interest nor a right so strong that it trumps all competing interests. Instead, it is a right of moderate strength. Indeed, even the aggregate strength of children's rights against the practice of (presumably harmful) circumcision as a whole is not so weighty so as to always trump competing interests. The harms are not sufficiently serious to justify such a status. And the expressive wrongs associated with non-negligently benevolent harming are much less serious than those associated with intentional harming. The debate over banning circumcision thus cannot be conducted only in terms of competing rights. Competing interests, such as those that would be set back by the departure of religious citizens, should be considered as well and might plausibly justify allowing even a rights-infringing practice to continue

Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

CONTEXT: Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented. OBJECTIVE: To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost. DESIGN, SETTING, AND PARTICIPANTS: An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October-December 2010, with 1232 students responding and a response rate of 18%. MAIN OUTCOME MEASURES: Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items. RESULTS: Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided. CONCLUSION: The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment

Clonal expansion and epigenetic reprogramming following deletion or amplification of mutant

IDH1 mutation is the earliest genetic alteration in low-grade gliomas (LGGs), but its role in tumor recurrence is unclear. Mutant IDH1 drives overproduction of the oncometabolite d-2-hydroxyglutarate (2HG) and a CpG island (CGI) hypermethylation phenotype (G-CIMP). To investigate the role of mutant IDH1 at recurrence, we performed a longitudinal analysis of 50 IDH1 mutant LGGs. We discovered six cases with copy number alterations (CNAs) at the IDH1 locus at recurrence. Deletion or amplification of IDH1 was followed by clonal expansion and recurrence at a higher grade. Successful cultures derived from IDH1 mutant, but not IDH1 wild type, gliomas systematically deleted IDH1 in vitro and in vivo, further suggestive of selection against the heterozygous mutant state as tumors progress. Tumors and cultures with IDH1 CNA had decreased 2HG, maintenance of G-CIMP, and DNA methylation reprogramming outside CGI. Thus, while IDH1 mutation initiates gliomagenesis, in some patients mutant IDH1 and 2HG are not required for later clonal expansions