Publications
Contact me for any of the papers below.
Kidney Sales and Disrespectful Demands: A Reply to Rippon
Journal of Medicine and Philosophy, forthcoming
Simon Rippon, revising an earlier argument against kidney sales, now claims that offers involving the performance of invasive acts, when extended to people under pressure, constitute a kind of rights violation, Impermissibly Disrespectful Demands. Since offers involving kidney sales so qualify, Rippon finds prima facie reason to prohibit them. The present paper levels four independent objections to Rippon’s argument: the account of Impermissibly Disrespectful Demands implausibly condemns kidney donation as much as kidney sales; the normative importance of having autonomous veto control over bodily incursions does not plausibly underwrite a right to not be extended invasive offers under pressure; Impermissibly Disrespectful Demands can easily be transformed into innocuous offers; and the prohibition has greater welfare costs than Rippon acknowledges.
Kidney Donors’ Interests and the Prohibition on Sales
Bioethics, forthcoming
Potential kidney donors may be subject to harmful pressure to donate. This pressure may take almost any form; people have diverse interests, and anything that could set them back may qualify as pressure. Given features of the context—the high stakes, the involvement of family, and the social meaning of donation—such pressure may be especially harmful. The use of such pressure is the predictable consequence of the prohibition on kidney sales. Potential donors have something—a transplantable kidney—that is both valuable and scarce. Many of them, informed about donation, decide against it. Those in need of a transplant may seek to persuade the unwilling. Given the prohibition, the donation cannot be made more attractive in absolute terms by, say, the addition of money. However, it can be made more attractive in relative terms. The application of harmful pressure has the desired effect. Potential donors' interests should figure more prominently in the discussion of transplant policy. Those who defend the prohibition have made virtually no attempt to account for its impact on that group.
The Altruism Requirement as Moral Fiction
Journal of Medicine and Philosophy (forthcoming)
It is widely agreed that living kidney donation is permitted but living kidney sales is not. Call this the Received View. One way to support the Received View is to appeals a particular understanding of the conditions under which living kidney transplantation is permissible. It is often claimed that donors must act altruistically, without the expectation of payment and for the sake of another. Call this the Altruism Requirement. On the conventional interpretation, the Altruism Requirement is a moral fact. It states a legitimate constraint on permissible transplantation and is accepted on the basis of cogent argument. The present paper offers an alternative interpretation. I suggest the Altruism Requirement is a moral fiction – a kind of motivated falsehood. It’s false that transplantation requires altruism. But the Requirement serves a purpose. Accepting it allows kidney donation but not kidney sale. It, in short, rationalizes the Received View.
Exploitation, Coercion, and Other Problems with Kidney Donation
Think (forthcoming)
A Regulated System of Incentives for Living Kidney Donation: Clearing the Way for an Informed Assessment
American Journal of Transplantation, 2022 22(11): 2509-2514
Co-authored with Arthur Matas.
The kidney shortage continues to be a crisis for our patients. Despite numerous attempts to increase living and deceased donation, annually in the United States, thousands of candidates are removed from the kidney transplant waiting list because of either death or becoming too sick to transplant. To increase living donation, trials of a regulated system of incentives for living donation have been proposed. Such trials may show: (1) a significant increase in donation, and (2) that informed, incentivized donors, making an autonomous decision to donate, have the same medical and psycho social outcomes as our conventional donors. Given the stakes, the proposal warrants careful consideration. However, to date, much discussion of the proposal has been unproductive. Objections commonly leveled against it: fail to engage with it; conflate it with underground, unregulated markets; speculate without evidence; and reason fallaciously, favoring rhetorical impact over logic. The present paper is a corrective. It identifies these common errors so they are not repeated, thus allowing space for an assessment of the proposal on its merits.
Relationship Sensitive Consequentialism Is Regrettable
Social Theory and Practice, 2020 46(2):257-276
Personal relationships matter. Traditional Consequentialism, given its exclusive focus on agent-neutral goodness, struggles to account for this fact. A recent variant of the theory—one incorporating agent-relativity—is thought to succeed where its traditional counterpart fails. Yet, to secure this advantage, the view must take on certain normative and evaluative commitments concerning personal relationships. As a result, the theory permits cases in which agents do as they ought, yet later ought to prefer that they had done otherwise. That a theory allows such cases is a serious defect. We thus conclude that, in terms of how the theories handle personal relationships, agent-relative consequentialism fairs no better than its traditional counterpart.
Understanding Choice, Pressure, and Markets in Kidneys
Journal of Medical Ethics, 2020 46:277-278
Abstract. Here I briefly respond to a recent paper by Julian Koplin, in which he criticizes my earlier work in this journal. I show that Koplin has misunderstood the distinction I’ve made between pressure to vend and pressure with the option to vend. I also show that his pessimism about the market regulations I favor is unwarranted.
Book Review: Taking Utilitarianism Seriously, by Christopher Woodard
Journal of Value Inquiry, 2020 54(4):663-668
When the Patina of Empirical Respectability Wears Off: Motivational Crowding and Kidney Sales
Ethical Theory and Moral Practice, 2019 22(5):1055-1071
An increasingly common objection to kidney sales holds that the introduction of monetary incentives may undermine potential donors’ altruism, discourage donation, and possibly result in a net reduction in the supply of kidneys. To explain why incentives might be counterproductive in this way market opponents marshal evidence from behavioral economics. In particular, they claim that the context of kidney sales is ripe for motivational crowding. However, on inspection it becomes apparent that the evidence touted by market opponents not only lends no credence to their claims, but also provides some positive reason to doubt them.
Organ Donor or Gratuitous Moral Failure? Pick One
Think, 2018 17(50):85-89
Abstract. Many are unwilling to donate their vital organs in death. To affirm this choice is to prefer the integrity of one's corpse over possibly saving and improving the lives of others. This position enjoys no sound defence. Refusing to donate amounts to a gratuitous moral failure
Non-Compliance Shouldn’t Be Better
Australasian Journal of Philosophy, 2018 97(1):46-56
Co-authored with Andrew T. Forcehimes.
Abstract. Agent-relative consequentialism is thought attractive because it can secure agent-centred constraints while retaining consequentialism’s compelling idea – the idea that it is always permissible to bring about the best available outcome. We argue, however, that the commitments of agent-relative consequentialism lead it to run afoul of a plausibility requirement on moral theories. A moral theory must not be such that, in any possible circumstance, were every agent to act impermissibly, each would have more reason (by the lights of the very same theory) to prefer the world thereby actualized over the world that would have been actualized if every agent had instead acted permissibly.
Actualism Doesn’t Have Control Issues: A Reply to Cohen and Timmerman
Philosophia, 2019 47(1):271-277
Co-authored with Andrew T. Forcehimes.
Abstract. Recently, Cohen and Timmerman (2016) argue that actualism has control issues. The view should be rejected, they claim, as it recognizes a morally irrelevant distinction between counterfactuals over which agents exercise the same kind of control. Here we reply on behalf of actualism.
Are There Distinctively Moral Reasons?
Ethical Theory and Moral Practice, 2018 (21)3:699-717
Co-authored with Andrew T. Forcehimes.
Abstract. A dogma of contemporary normative theorizing holds that some reasons are distinctively moral while others are not. Call this view Reasons Pluralism. This essay looks at four approaches to vindicating the apparent distinction between moral and non-moral reasons. In the end, however, all are found wanting. Though not dispositive, the failure of these approaches supplies strong evidence that the dogma of Reasons Pluralism is ill-founded.
A Mistake in the Commodification Debate
Journal of the American Philosophical Association, 2017 3(3):354-371
Abstract. A significant debate has developed around the question: What are the moral limits of the market? This paper argues that this debate proceeds on a mistake. Both those who oppose specific markets, and those who defend them, adopt the same deficient approach. Participants illicitly proceed from an assessment of the transactions comprising a market, to a judgment of that market’s permissibility. This inference is unlicensed. We may know everything there is to know about the transactions in a specific market – they might all be absolutely bad – but we will not yet know whether that market should be prohibited. To discern this one must supply a rather different assessment. One must compare the outcome in which that market is permitted with the best outcome available in its absence. None in this debate has offered such a judgment.
Reassessing Likely Harms to Vendors in Regulated Kidney Markets
Journal of Medicine & Philosophy, 2017 42:634-652
With a reply by Julian Koplin.
Abstract: Julian Koplin, drawing extensively on empirical data, has argued that vendors, even in well-regulated kidney markets, are likely to be significantly harmed. I contend his reasoning to this conclusion is dangerously mistaken. I highlight two failures. First, Koplin is insufficiently attentive to the differences between existing markets and the regulated markets proposed by advocates. On the basis of this error he wrongly concludes that many harms will persist even in a well-regulated system. Second, Koplin misunderstands the utilitarian assessment of the market. He focuses on the costs and benefits of the transaction for the vendor. But the relevant comparison is between an individual’s welfare across different courses of action, namely vending and the non-vending alternative.
Book Review: Markets Without Limits, by Jason Brennan and Peter Jaworski
Economics and Philosophy, 2016 33(2):326-332
Beneficence: Does Agglomeration Matter?
Journal of Applied Philosophy, 2017 34(4):17-33
Co-authored with Andrew T. Forcehimes.
Abstract. When it comes to the duty of beneficence, a formidable class of moderate positions holds that morally significant considerations emerge when one’s actions are seen as part of a larger series. Agglomeration, according to these moderates, limits the demands of beneficence, thereby avoiding the extremely demanding view of Singer. This idea has much appeal. What morality can demand of people is, it seems, appropriately modulated by how much they’ve already done. A number of recent proposals appeal to agglomeration. None of them, we argue in this essay, succeed.
Misplaced Paternalism and Other Mistakes in the Debate Over Kidney Sales
Bioethics, 2015 31(3):190-198
Abstract. Erik Malmqvist defends the prohibition on kidney sales as a justifiable measure to protect individuals from harms they have not autonomously chosen. This appeal to ‘group soft paternalism’ requires that three conditions be met. It must be shown that some vendors will be harmed, that some will be subject to undue pressure to vend, and that we cannot feasibly distinguish between the autonomous and the non-autonomous. I argue that Malmqvist fails to demonstrate that any of these conditions are likely to obtain.
Well-Being: Reality’s Role
Journal of the American Philosophical Association, 2015 2(3): 456-468
Co-authored with Andrew T. Forcehimes.
Abstract. A familiar objection to mental state theories of well-being proceeds as follows: Describe a good life. Contrast it with one identical in mental respects, but lacking a connection to reality. Then observe that mental state theories of well-being implausibly hold both lives in equal esteem. Conclude that such views are false. Here we argue this objection fails. There are two ways reality may be thought to matter for well-being. We want to contribute to reality, and we want our experience of the world to be veridical. Yet, if one accepts that reality matters in either of these ways, one must posit differences in well-being where no such differences exist.
The Difference We Make: A Reply to Pinkert
Journal of Ethics & Social Philosophy, 2015 September.
Co-authored with Andrew T. Forcehimes.
The Best Argument Against Kidney Sales Fails
Journal of Medical Ethics, 2015 41(6):443-446 Editor’s Choice
Abstract. Simon Rippon has recently argued against kidney markets on the grounds that introducing the option to vend will result in many people, especially the poor, being subject to harmful pressure to vend. Though compelling, Rippon’s argument fails. What he takes to be a single phenomenon—social and legal pressure to vend—is actually two. Only one of these forms of pressure is, by Rippon’s own account, harmful. Further, an empirically informed view of the regulated market suggests that this harmful pressure is easily avoided. Thus, the harm that is the lynchpin of Rippon’s opposition is neither a necessary feature of the market nor is it likely to play a significant role in its operation.
Your Mother Doesn’t Love You For Who You Are
Think, 2015 14(29):95-97
Abstract. There are good reasons to think that mothers love their children, and love them for who they are. There are also good reasons to think that contingent events can decisively influence who one becomes. This entails, I argue, that your mother does not love you for who you are.
Kidneys Save Lives. Markets Would Probably Help
Public Affairs Quarterly, 2014 28(1):71-95