James Wilson | University College London (original) (raw)
Papers by James Wilson
Health economics, policy, and law, Jan 10, 2015
In this article we consider the conclusions and recommendations of the World Health Organisation&... more In this article we consider the conclusions and recommendations of the World Health Organisation's report Making Fair Choices from a philosophical perspective. In particular we reflect on the report's return to substantive claims about justice in the allocation of health care resources and its argument that certain trade-offs are…
Planned and unplanned migrations, diverse social practices, and emerging disease vectors transfor... more Planned and unplanned migrations, diverse social
practices, and emerging disease vectors transform how
health and wellbeing are understood and negotiated.
Simultaneously, familiar illnesses—both communicable
and non-communicable—continue to aff ect individual
health and household, community, and state economies.
Together, these forces shape medical knowledge and how
it is understood, how it comes to be valued, and when
and how it is adopted and applied.
Perceptions of physical and psychological wellbeing
diff er substantially across and within societies. Although
cultures often merge and change, human diversity
assures that diff erent lifestyles and beliefs will persist so
that systems of value remain autonomous and distinct. In
this sense, culture can be understood as not only habits
and beliefs about perceived wellbeing, but also political,
economic, legal, ethical, and moral practices and values. [...]
The Lancet, 2012
The Healthy Cities movement has been in process for almost 30 years, and the features needed to t... more The Healthy Cities movement has been in process for almost 30 years, and the features needed to transform a city into a healthy one are becoming increasingly understood. What is less well understood, however, is how to deliver the potential health benefits and how to ensure that they reach all citizens in urban areas across the world. This task is becoming increasingly important because most of the world's population already live in cities, and, with high rates of urbanisation, many millions more will soon do so in the coming decades.
Although health outcomes are, on average, better in higher-income than in lower-income countries,... more Although health outcomes are, on average, better in
higher-income than in lower-income countries, urban
health outcomes in specifi c cities cannot be assumed to
improve with economic growth and demographic
change. The so-called urban advantage—a term that
encapsulates the health benefi ts of living in urban as
opposed to rural areas—has to be actively created and
maintained through policy interventions. Furthermore,
average levels of health hide the eff ect of socioeconomic
inequality within urban areas. Rich and poor people live
in very diff erent epidemiological worlds, even within the
same city. And such disparity occurs in both high-income
and low-income countries.
Through case studies of sanitation and wastewater
management, urban mobility, building standards and
indoor air quality, the urban heat island eff ect (the
diff erence in average temperatures between city
centres and the surrounding countryside), and urban agriculture, we draw attention to the complexities
involved in the achievement of urban health improvement
through urban planning policies. Complexity
thinking stresses that the development of a plan that
anticipates all future change for these issues will not be
possible. Instead, incremental attempts to reach a goal
need to be tried and tested.
This paper provides an examination of the ethics of disease eradication policies. It examines thr... more This paper provides an examination of the ethics of disease eradication policies. It examines three arguments that have been advanced for thinking that eradication is in some way ethically exceptional as a policy goal. These are (1) global eradication has symbolic importance, (2) disease eradication is a global public good and (3) disease eradication is a form of rescue. It argues that none of these provides a good reason to think that individuals have special duties to facilitate eradication campaigns, or that public health authorities have special permissions to pursue them. But the fact that these arguments fail does not entail that global disease eradication is ethically problematic, or that it should not be undertaken. Global eradication of a disease, if successful, is a way of providing an enormous health benefit that stretches far into the future. There is no need to reach for the idea that there is a special duty to eradicate disease; the same considerations that are in play in ordinary public health policy – of reducing the burden of disease equitably and efficiently – suffice to make global disease eradication a compelling goal where doing so is feasible.
This paper reflects on the relationship between theory and practice in bioethics, by using variou... more This paper reflects on the relationship between theory and practice in bioethics, by using various concepts drawn from debates on innovation in healthcare research—in particular debates around how best to connect up blue skies ‘basic’ research with practical innovations that can improve human lives. It argues that it is a mistake to assume that the most difficult and important questions in bioethics are the most abstract ones, and also a mistake to assume that getting clear about abstract cases will automatically be of much help in getting clear about more complex cases. It replaces this implicitly linear model with a more complex one that draws on the idea of translational research in healthcare. On the translational model, there is a continuum of cases from the most simple and abstract (thought experiments) to the most concrete and complex (real world cases). Insights need to travel in both directions along this continuum—from the more abstract to the more concrete and from the more concrete to the more abstract. The paper maps out some difficulties in moving from simpler to more complex cases, and in doing so makes recommendations about the future of bioethics.
Research involving human subjects is much more stringently regulated than many other nonresearch ... more Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that research should be treated as a special case. First, research typically involves the imposition of risk on people who do not benefit from this risk imposition. Second, research depends on public trust. Third, the complexity of the moral decision making required favors ethics committees as a regulative solution for research.
The Lancet, 2012
The Healthy Cities movement has been in process for almost 30 years, and the features needed to t... more The Healthy Cities movement has been in process for almost 30 years, and the features needed to transform a city into a healthy one are becoming increasingly understood. What is less well understood, however, is how to deliver the potential health benefits and how to ensure that they reach all citizens in urban areas across the world. This task is becoming increasingly important because most of the world's population already live in cities, and, with high rates of urbanisation, many millions more will soon do so in the coming decades.
Clinical Ethics, 2009
This article examines when deceptive withholding of information is ethically acceptable in resear... more This article examines when deceptive withholding of information is ethically acceptable in research. The first half analyses the concept of deception. We argue that there are two types of accounts of deception: normative and non-normative, and argue that non-normative accounts are preferable. The second half of the article argues that the relevant ethical question which ethics committees should focus on is not whether the person from whom the information is withheld will be deceived, but rather on the reasonableness of withholding the information from the person who is deceived. We further argue that the reasonableness of withholding information is dependent on the context. The last section examines how the context of research should shape our judgements about the circumstances in which withholding information from research participants is ethically acceptable. We argue that some important features of research make it more difficult to justify withholding information in the context of research than elsewhere.
Bioethics, Jan 1, 2010
Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue ... more Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decisionmakers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.
Law and Philosophy, Jan 1, 2009
Intellectual property typically involves claims of ownership of types, rather than particulars. I... more Intellectual property typically involves claims of ownership of types, rather than particulars. In this article I argue that this difference in ontology makes an important moral difference. In particular I argue that there cannot be an intrinsic moral right to own intellectual property. I begin by establishing a necessary condition for the justification of intrinsic moral rights claims, which I call the Rights Justification Principle. Briefly, this holds that if we want to claim that there is an intrinsic moral right to u, we must be able to show that (a) violating this right would typically result in either a wrongful harm or other significant wrong to the holder of the right, and (b) the wrongful harm or other wrong in question is independent of the existence of the intrinsic right we are trying to justify. I then argue that merely creating a new instance of a type is not the kind of action which can wrongfully harm the creator of that type. Insofar as there do seem to be wrongs involved in copying a published poem or computer program, these wrongs presuppose the existence of an intrinsic right to own intellectual property, and so cannot be used to justify it. I conclude that there cannot be an intrinsic right to own intellectual property.
The American journal of bioethics: AJOB, Jan 1, 2010
We would like to thank the commentators for their helpful and useful commentaries on our paper, a... more We would like to thank the commentators for their helpful and useful commentaries on our paper, and the editors for this opportunity to respond to their criticisms and clarify the position we are defending. We do not have the space or scope to respond to the comments in the depth many of them deserve, so we have gathered them into groups of comments which we will respond to as blocks.
American Journal of Bioethics, Jan 1, 2010
Research involving human subjects is much more stringently regulated than many other nonresearch ... more Research involving human subjects is much more stringently regulated than many other nonresearch activities which appear to be at least as risky. A number of prominent figures now argue that research is over-regulated.
Journal of Agricultural and Environmental Ethics, Jan 1, 2007
This paper focuses on the ethical justifiability of patents on Genetically Modified (GM) crops. I... more This paper focuses on the ethical justifiability of patents on Genetically Modified (GM) crops. I argue that there are three distinguishing features of GM crops that make it unethical to grant patents on GM crops, even if we assume that the patent system is in general justified. The first half of the paper critiques David ResnikÕs recent arguments in favor of patents on GM crops. Resnik argues that we should take a consequentialist approach to the issue, and that the best way to do so is to apply the Precautionary Principle, and that the Precautionary Principle, in this case, supports patents on GM crops. I argue that his argument in favor of a consequentialist treatment is invalid; his Precautionary Principle in any case appears to be incompatible with consequentialism; and his conception of reasonable precautions is too ill-defined to have any argumentative purchase. In the second half of the paper, I argue against GM crop patents, on three grounds. First, there is insufficient evidence to say whether allowing patents on GM crops will make research go faster than not having patents, whilst there is a good reason to think that, other things being equal, a society that allows patents on GM crops will be less just than one that does not. Second, even assuming that patents on GM crops will increase the pace of GM crop research, there is no social need to do so. Third, patents on GM crops will frequently have ethically unacceptable side effects.
Bioethics, Jan 1, 2007
Conservative thinkers such as Francis Fukuyama have produced a battery of objections to the trans... more Conservative thinkers such as Francis Fukuyama have produced a battery of objections to the transhumanist project of fundamentally enhancing human capacities. This article examines one of these objections, namely that by allowing some to greatly extend their capacities, we will undermine the fundamental moral equality of human beings. I argue that this objection is groundless: once we understand the basis for human equality, it is clear that anyone who now has sufficient capacities to count as a person from the moral point of view will continue to count as one even if others are fundamentally enhanced; and it is mistaken to think that a creature which had even far greater capacities than an unenhanced human being should count as more than an equal from the moral point of view.
Public Health Ethics, Jan 1, 2009
This paper aims to shed some light on the difficulties we face in constructing a generally accept... more This paper aims to shed some light on the difficulties we face in constructing a generally acceptable normative framework for thinking about public health. It argues that there are three factors which combine to make theorising about public health difficult, and which when taken together defeat simplistic top-down and bottom-up approaches to the design of public health policies.
Journal of medical ethics, Jan 1, 2009
Health economics, policy, and law, Jan 10, 2015
In this article we consider the conclusions and recommendations of the World Health Organisation&... more In this article we consider the conclusions and recommendations of the World Health Organisation's report Making Fair Choices from a philosophical perspective. In particular we reflect on the report's return to substantive claims about justice in the allocation of health care resources and its argument that certain trade-offs are…
Planned and unplanned migrations, diverse social practices, and emerging disease vectors transfor... more Planned and unplanned migrations, diverse social
practices, and emerging disease vectors transform how
health and wellbeing are understood and negotiated.
Simultaneously, familiar illnesses—both communicable
and non-communicable—continue to aff ect individual
health and household, community, and state economies.
Together, these forces shape medical knowledge and how
it is understood, how it comes to be valued, and when
and how it is adopted and applied.
Perceptions of physical and psychological wellbeing
diff er substantially across and within societies. Although
cultures often merge and change, human diversity
assures that diff erent lifestyles and beliefs will persist so
that systems of value remain autonomous and distinct. In
this sense, culture can be understood as not only habits
and beliefs about perceived wellbeing, but also political,
economic, legal, ethical, and moral practices and values. [...]
The Lancet, 2012
The Healthy Cities movement has been in process for almost 30 years, and the features needed to t... more The Healthy Cities movement has been in process for almost 30 years, and the features needed to transform a city into a healthy one are becoming increasingly understood. What is less well understood, however, is how to deliver the potential health benefits and how to ensure that they reach all citizens in urban areas across the world. This task is becoming increasingly important because most of the world's population already live in cities, and, with high rates of urbanisation, many millions more will soon do so in the coming decades.
Although health outcomes are, on average, better in higher-income than in lower-income countries,... more Although health outcomes are, on average, better in
higher-income than in lower-income countries, urban
health outcomes in specifi c cities cannot be assumed to
improve with economic growth and demographic
change. The so-called urban advantage—a term that
encapsulates the health benefi ts of living in urban as
opposed to rural areas—has to be actively created and
maintained through policy interventions. Furthermore,
average levels of health hide the eff ect of socioeconomic
inequality within urban areas. Rich and poor people live
in very diff erent epidemiological worlds, even within the
same city. And such disparity occurs in both high-income
and low-income countries.
Through case studies of sanitation and wastewater
management, urban mobility, building standards and
indoor air quality, the urban heat island eff ect (the
diff erence in average temperatures between city
centres and the surrounding countryside), and urban agriculture, we draw attention to the complexities
involved in the achievement of urban health improvement
through urban planning policies. Complexity
thinking stresses that the development of a plan that
anticipates all future change for these issues will not be
possible. Instead, incremental attempts to reach a goal
need to be tried and tested.
This paper provides an examination of the ethics of disease eradication policies. It examines thr... more This paper provides an examination of the ethics of disease eradication policies. It examines three arguments that have been advanced for thinking that eradication is in some way ethically exceptional as a policy goal. These are (1) global eradication has symbolic importance, (2) disease eradication is a global public good and (3) disease eradication is a form of rescue. It argues that none of these provides a good reason to think that individuals have special duties to facilitate eradication campaigns, or that public health authorities have special permissions to pursue them. But the fact that these arguments fail does not entail that global disease eradication is ethically problematic, or that it should not be undertaken. Global eradication of a disease, if successful, is a way of providing an enormous health benefit that stretches far into the future. There is no need to reach for the idea that there is a special duty to eradicate disease; the same considerations that are in play in ordinary public health policy – of reducing the burden of disease equitably and efficiently – suffice to make global disease eradication a compelling goal where doing so is feasible.
This paper reflects on the relationship between theory and practice in bioethics, by using variou... more This paper reflects on the relationship between theory and practice in bioethics, by using various concepts drawn from debates on innovation in healthcare research—in particular debates around how best to connect up blue skies ‘basic’ research with practical innovations that can improve human lives. It argues that it is a mistake to assume that the most difficult and important questions in bioethics are the most abstract ones, and also a mistake to assume that getting clear about abstract cases will automatically be of much help in getting clear about more complex cases. It replaces this implicitly linear model with a more complex one that draws on the idea of translational research in healthcare. On the translational model, there is a continuum of cases from the most simple and abstract (thought experiments) to the most concrete and complex (real world cases). Insights need to travel in both directions along this continuum—from the more abstract to the more concrete and from the more concrete to the more abstract. The paper maps out some difficulties in moving from simpler to more complex cases, and in doing so makes recommendations about the future of bioethics.
Research involving human subjects is much more stringently regulated than many other nonresearch ... more Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that research should be treated as a special case. First, research typically involves the imposition of risk on people who do not benefit from this risk imposition. Second, research depends on public trust. Third, the complexity of the moral decision making required favors ethics committees as a regulative solution for research.
The Lancet, 2012
The Healthy Cities movement has been in process for almost 30 years, and the features needed to t... more The Healthy Cities movement has been in process for almost 30 years, and the features needed to transform a city into a healthy one are becoming increasingly understood. What is less well understood, however, is how to deliver the potential health benefits and how to ensure that they reach all citizens in urban areas across the world. This task is becoming increasingly important because most of the world's population already live in cities, and, with high rates of urbanisation, many millions more will soon do so in the coming decades.
Clinical Ethics, 2009
This article examines when deceptive withholding of information is ethically acceptable in resear... more This article examines when deceptive withholding of information is ethically acceptable in research. The first half analyses the concept of deception. We argue that there are two types of accounts of deception: normative and non-normative, and argue that non-normative accounts are preferable. The second half of the article argues that the relevant ethical question which ethics committees should focus on is not whether the person from whom the information is withheld will be deceived, but rather on the reasonableness of withholding the information from the person who is deceived. We further argue that the reasonableness of withholding information is dependent on the context. The last section examines how the context of research should shape our judgements about the circumstances in which withholding information from research participants is ethically acceptable. We argue that some important features of research make it more difficult to justify withholding information in the context of research than elsewhere.
Bioethics, Jan 1, 2010
Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue ... more Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decisionmakers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.
Law and Philosophy, Jan 1, 2009
Intellectual property typically involves claims of ownership of types, rather than particulars. I... more Intellectual property typically involves claims of ownership of types, rather than particulars. In this article I argue that this difference in ontology makes an important moral difference. In particular I argue that there cannot be an intrinsic moral right to own intellectual property. I begin by establishing a necessary condition for the justification of intrinsic moral rights claims, which I call the Rights Justification Principle. Briefly, this holds that if we want to claim that there is an intrinsic moral right to u, we must be able to show that (a) violating this right would typically result in either a wrongful harm or other significant wrong to the holder of the right, and (b) the wrongful harm or other wrong in question is independent of the existence of the intrinsic right we are trying to justify. I then argue that merely creating a new instance of a type is not the kind of action which can wrongfully harm the creator of that type. Insofar as there do seem to be wrongs involved in copying a published poem or computer program, these wrongs presuppose the existence of an intrinsic right to own intellectual property, and so cannot be used to justify it. I conclude that there cannot be an intrinsic right to own intellectual property.
The American journal of bioethics: AJOB, Jan 1, 2010
We would like to thank the commentators for their helpful and useful commentaries on our paper, a... more We would like to thank the commentators for their helpful and useful commentaries on our paper, and the editors for this opportunity to respond to their criticisms and clarify the position we are defending. We do not have the space or scope to respond to the comments in the depth many of them deserve, so we have gathered them into groups of comments which we will respond to as blocks.
American Journal of Bioethics, Jan 1, 2010
Research involving human subjects is much more stringently regulated than many other nonresearch ... more Research involving human subjects is much more stringently regulated than many other nonresearch activities which appear to be at least as risky. A number of prominent figures now argue that research is over-regulated.
Journal of Agricultural and Environmental Ethics, Jan 1, 2007
This paper focuses on the ethical justifiability of patents on Genetically Modified (GM) crops. I... more This paper focuses on the ethical justifiability of patents on Genetically Modified (GM) crops. I argue that there are three distinguishing features of GM crops that make it unethical to grant patents on GM crops, even if we assume that the patent system is in general justified. The first half of the paper critiques David ResnikÕs recent arguments in favor of patents on GM crops. Resnik argues that we should take a consequentialist approach to the issue, and that the best way to do so is to apply the Precautionary Principle, and that the Precautionary Principle, in this case, supports patents on GM crops. I argue that his argument in favor of a consequentialist treatment is invalid; his Precautionary Principle in any case appears to be incompatible with consequentialism; and his conception of reasonable precautions is too ill-defined to have any argumentative purchase. In the second half of the paper, I argue against GM crop patents, on three grounds. First, there is insufficient evidence to say whether allowing patents on GM crops will make research go faster than not having patents, whilst there is a good reason to think that, other things being equal, a society that allows patents on GM crops will be less just than one that does not. Second, even assuming that patents on GM crops will increase the pace of GM crop research, there is no social need to do so. Third, patents on GM crops will frequently have ethically unacceptable side effects.
Bioethics, Jan 1, 2007
Conservative thinkers such as Francis Fukuyama have produced a battery of objections to the trans... more Conservative thinkers such as Francis Fukuyama have produced a battery of objections to the transhumanist project of fundamentally enhancing human capacities. This article examines one of these objections, namely that by allowing some to greatly extend their capacities, we will undermine the fundamental moral equality of human beings. I argue that this objection is groundless: once we understand the basis for human equality, it is clear that anyone who now has sufficient capacities to count as a person from the moral point of view will continue to count as one even if others are fundamentally enhanced; and it is mistaken to think that a creature which had even far greater capacities than an unenhanced human being should count as more than an equal from the moral point of view.
Public Health Ethics, Jan 1, 2009
This paper aims to shed some light on the difficulties we face in constructing a generally accept... more This paper aims to shed some light on the difficulties we face in constructing a generally acceptable normative framework for thinking about public health. It argues that there are three factors which combine to make theorising about public health difficult, and which when taken together defeat simplistic top-down and bottom-up approaches to the design of public health policies.
Journal of medical ethics, Jan 1, 2009