Can Voluntary Health Insurance for Non-reimbursed Expensive New Treatments Be Just?

Public healthcare systems are increasingly refusing (temporarily) to reimburse newly approved medical treatments of insufficient or uncertain cost-effectiveness. As both patient demand for these treatments and their list prices increase, a market might arise for voluntary additional health insurance (VHI) that covers effective but (very) expensive medical treatments. In this paper, we evaluate such potential future practices of VHI in public healthcare systems from a justice perspective. We find that direct (telic) egalitarian objections to unequal access to expensive treatments based on different ability to afford VHI do not stand up to scrutiny. However, such unequal access might lead to loss of self-respect among individuals, or loss of fraternity within society, rendering it more difficult for citizens to interact on equal moral footing. This would be problematic from a relational egalitarian perspective. Moreover, the introduction of VHI might turn out to have negative consequences for the comprehensiveness and/or the quality of the public healthcare services that are offered to all patients equally through basic health insurance. These consequences must be weighed against potential health gains and the value of liberty. We conclude that governments should be careful when considering the introduction of VHI in public healthcare systems.</p

Employers have a Duty of Beneficence to Design for Meaningful Work:A General Argument and Logistics Warehouses as a Case Study

Artificial intelligence-driven technology increasingly shapes work practices and, accordingly, employees’ opportunities for meaningful work (MW). In our paper, we identify five dimensions of MW: pursuing a purpose, social relationships, exercising skills and self-development, autonomy, self-esteem and recognition. Because MW is an important good, lacking opportunities for MW is a serious disadvantage. Therefore, we need to know to what extent employers have a duty to provide this good to their employees. We hold that employers have a duty of beneficence to design for opportunities for MW when implementing AI-technology in the workplace. We argue that this duty of beneficence is supported by the three major ethical theories, namely, Kantian ethics, consequentialism, and virtue ethics. We defend this duty against two objections, including the view that it is incompatible with the shareholder theory of the firm. We then employ the five dimensions of MW as our analytical lens to investigate how AI-based technological innovation in logistic warehouses has an impact, both positively and negatively, on MW, and illustrate that design for MW is feasible. We further support this practical feasibility with the help of insights from organizational psychology. We end by discussing how AI-based technology has an impact both on meaningful work (often seen as an aspirational goal) and decent work (generally seen as a matter of justice). Accordingly, ethical reflection on meaningful and decent work should become more integrated to do justice to how AI-technology inevitably shapes both simultaneously.</p

Remedial educationalists can do a lot for gender-diverse young people

Dit artikel bespreekt cruciale aspecten die ten onrechte niet besproken worden in ‘Uitdagingen in de zorg voor kinderen en jongeren met genderdiversiteit’ (Vrouenraets et al., 2022a). Namelijk, de mogelijkheid dat behandeling met puberteitsremmers en cross-sekse hormonen zorgt voor een belemmerde breinontwikkeling en verminderd seksueel functioneren, en de zorg dat puberteitsremmers juist zorgen voor het aanhouden van de genderdysforie doordat zij de ontwikkeling pauzeren. Ook bespreekt deze reactie het feit dat de grote stijging van het aantal jongeren met genderproblematiek vooral geboren tienermeisjes betreft. Verder een kritische bespreking van het gebruik van de begrippen ‘geboortegeslacht’ en ‘genderidentiteit’ door Vrouenraets et al. Dit alles mondt uit in een oproep aan orthopedagogen om zich te verdiepen in genderproblematiek zodat zij betreffende jongeren adequaat kunnen helpen zonder meteen te hoeven doorverwijzen

The moral case for intelligent speed adaptation

Speeding is a major problem in road safety. Intelligent Speed Adaptation (ISA) is a potential solution, but the moral acceptability of ISA has been called into question both in the popular media and in academic discussions. In this article, a moral case is made for making warning and limiting versions of ISA obligatory in all cars.The practice of car driving involves frequent speeding, which imposes unacceptable risks of harm on other road users. In this article, I argue that ISA can therefore be justified on the basis of the harm it prevents, as is the current criminalisation of speeding. I defend obligatory ISA against three objections. First, ISA is likely to introduce some additional risk for drivers.However, drivers should accept these risks to reduce the risks from driving for other parties to an acceptable level. Second, although limiting ISA reduces drivers’ options for moral agency and exercising self-restraint to some extent, this consequence is defensible.Third, accepting ISA does not commit us to accepting an entire range of other behaviour-regulating technologies

Orthopedagogen kunnen veel betekenen voor genderdiverse jongeren

Dit artikel bespreekt cruciale aspecten die ten onrechte niet besproken worden in ‘Uitdagingen in de zorg voor kinderen en jongeren met genderdiversiteit’ (Vrouenraets et al., 2022a). Namelijk, de mogelijkheid dat behandeling met puberteitsremmers en cross-sekse hormonen zorgt voor een belemmerde breinontwikkeling en verminderd seksueel functioneren, en de zorg dat puberteitsremmers juist zorgen voor het aanhouden van de genderdysforie doordat zij de ontwikkeling pauzeren. Ook bespreekt deze reactie het feit dat de grote stijging van het aantal jongeren met genderproblematiek vooral geboren tienermeisjes betreft. Verder een kritische bespreking van het gebruik van de begrippen ‘geboortegeslacht’ en ‘genderidentiteit’ door Vrouenraets et al. Dit alles mondt uit in een oproep aan orthopedagogen om zich te verdiepen in genderproblematiek zodat zij betreffende jongeren adequaat kunnen helpen zonder meteen te hoeven doorverwijzen

Danaher's Ethical Behaviourism: An Adequate Guide to Assessing the Moral Status of a Robot?

This paper critically assesses John Danaher's 'ethical behaviourism', a theory on how the moral status of robots should be determined. The basic idea of this theory is that a robot's moral status is determined decisively on the basis of its observable behaviour. If it behaves sufficiently similar to some entity that has moral status, such as a human or an animal, then we should ascribe the same moral status to the robot as we do to this human or animal. The paper argues against ethical behaviourism by making four main points. First, it is argued that the strongest version of ethical behaviourism understands the theory as relying on inferences to the best explanation when inferring moral status. Second, as a consequence, ethical behaviourism cannot stick with merely looking at the robot's behaviour, while remaining neutral with regard to the difficult question of which property grounds moral status. Third, not only behavioural evidence ought to play a role in inferring a robot's moral status, but knowledge of the design process of the robot and of its designer's intention ought to be taken into account as well. Fourth, knowledge of a robot's ontology and how that relates to human biology often is epistemically relevant for inferring moral status as well. The paper closes with some concluding observations