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Grill, K. (2020). Shove and Nudge: A Commentary on Iserson. The Journal of clinical ethics, 31(1)
Open this publication in new window or tab >>Shove and Nudge: A Commentary on Iserson
2020 (English)In: The Journal of clinical ethics, ISSN 1046-7890, E-ISSN 1945-5879, Vol. 31, no 1Article in journal (Other academic) Published
Abstract [en]

In this comment on Kenneth Iserson’s article, ”Do You Believe in Magic? Shove, Don’t Nudge: Advising Patients at the Bedside,” I discuss the definition of and the moral evaluation of nudging. I propose that using persuasive descriptions and intentionally building trust in patients by one’s demeanor is a form of nudging. I argue that nudging is not necessarily morally problematic, but that it can be controlling and can limit liberty, despite proponents’ claims to the contrary. I agree with Iserson that clinicians should give their patients explicit advice, but add that they should ideally also be aware of the more subtle psychological effects of advice giving.

Place, publisher, year, edition, pages
American Society of Bioethics and Humanities, 2020
National Category
Philosophy Ethics
Research subject
Practical Philosophy
Identifiers
urn:nbn:se:umu:diva-169187 (URN)
Available from: 2020-03-24 Created: 2020-03-24 Last updated: 2020-03-26Bibliographically approved
Grill, K. (2019). How Many Parents Should There Be in a Family?. Journal of Applied Philosophy
Open this publication in new window or tab >>How Many Parents Should There Be in a Family?
2019 (English)In: Journal of Applied Philosophy, ISSN 0264-3758, E-ISSN 1468-5930Article in journal (Refereed) Epub ahead of print
Abstract [en]

In this article, I challenge the widespread presumption that a child should have exactly two parents. I consider the pros and cons of various numbers of parents for the people most directly affected – the children themselves and their parents. The number of parents, as well as the ratio of parents to children, may have an impact on what resources are available, what relationships can develop between parents and children, what level of conflict can be expected in the family, as well as the costs involved in parenting and the experience of parenting a child. Indirectly, there is also an effect on who will have the opportunity to be a parent, as well as on wider social issues that I mention but do not discuss. Having considered all these factors, I conclude that there is some reason to believe that three or more parents is usually better than one or two, especially if children are to have siblings, which is typically beneficial. However, these reasons are not strong enough to support a general presumption in favor of any particular number. We should therefore jettison the two‐parent presumption and make different numbers of parents more socially accepted as well as legally possible.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Family structure, Family forms
National Category
Philosophy
Research subject
Practical Philosophy
Identifiers
urn:nbn:se:umu:diva-165798 (URN)10.1111/japp.12401 (DOI)000497108300001 ()
Funder
Swedish Research Council, 2013‐01306
Available from: 2019-12-03 Created: 2019-12-03 Last updated: 2019-12-11
Hanna, J. & Grill, K. (2018). Introduction. In: Kalle Grill and Jason Hanna (Ed.), The Routledge handbook of the philosophy of paternalism: (pp. 1-8). Abingdon, Oxon: Routledge
Open this publication in new window or tab >>Introduction
2018 (English)In: The Routledge handbook of the philosophy of paternalism / [ed] Kalle Grill and Jason Hanna, Abingdon, Oxon: Routledge, 2018, p. 1-8Chapter in book (Other academic)
Abstract [en]

While paternalism has been a long-standing philosophical issue, it has recently received renewed attention among scholars and the general public. The Routledge Handbook of the Philosophy of Paternalism is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising twenty-seven chapters by a team of international contributors the handbook is divided into five parts:

• What is Paternalism?

• Paternalism and Ethical Theory

• Paternalism and Political Philosophy

• Paternalism without Coercion

• Paternalism in Practice

Within these sections central debates, issues and questions are examined, including: how should paternalism be defined or characterized? How is paternalism related to such moral notions as rights, well-being, and autonomy? When is paternalism morally objectionable? What are the legitimate limits of government benevolence? To what extent should medical practice be paternalistic?

The Routledge Handbook of the Philosophy of Paternalism is essential reading for students and researchers in applied ethics and political philosophy. The handbook will also be very useful for those in related fields, such as law, medicine, sociology and political science.

Place, publisher, year, edition, pages
Abingdon, Oxon: Routledge, 2018
Series
Routledge handbooks in applied ethics
National Category
Philosophy
Research subject
Practical Philosophy
Identifiers
urn:nbn:se:umu:diva-170138 (URN)9781138956100 (ISBN)9781315657080 (ISBN)
Available from: 2020-04-27 Created: 2020-04-27 Last updated: 2020-05-13Bibliographically approved
Grill, K. (2018). Paternalism by and towards groups. In: Kalle Grill and Jason Hanna (Ed.), The Routledge handbook of the philosophy of paternalism: (pp. 46-58). Routledge
Open this publication in new window or tab >>Paternalism by and towards groups
2018 (English)In: The Routledge handbook of the philosophy of paternalism / [ed] Kalle Grill and Jason Hanna, Routledge, 2018, p. 46-58Chapter in book (Refereed)
Abstract [en]

In many or most instances of paternalism, more than one person acts paternalistically, or more than one person is treated paternalistically. This chapter discusses some complications that arise in such group cases, which are largely ignored in the conceptual debate. First, a group of people who together perform an action may do so for different reasons, which makes it more challenging to determine whether the action is paternalistic. This gives us some reason not to pin the property of being paternalistic on actions, since we may alternatively pin it on reasons for actions and allow that these differ between members in the group. Second, the prevention of harmful consensual interactions is sometimes paternalism towards both or all involved, but only if all benefit from interference with themselves rather than with other members in the group, or if all want the harm or risk (more or less) for its own sake. Third, interrelations between three components of paternalism - interference, benvolence and consent - gives us reason to allow that an action can be paternalistic towards some but not others of  those affected. This makes it even more difficult, and less relevant, to determine whether or not actions are paternalistic.

Place, publisher, year, edition, pages
Routledge, 2018
Series
Routledge Handbooks in Applied Ethics
National Category
Philosophy
Identifiers
urn:nbn:se:umu:diva-145053 (URN)978-1-13-895610-0 (ISBN)978-1-315-65708-0 (ISBN)
Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2020-05-13Bibliographically approved
Grill, K. (2018). Paternalism towards children. In: Anca Gheaus, Gideon Calder, Jurgen De Wispelaere (Ed.), The Routledge handbook of the philosophy of childhood and children: (pp. 123-133). Routledge
Open this publication in new window or tab >>Paternalism towards children
2018 (English)In: The Routledge handbook of the philosophy of childhood and children / [ed] Anca Gheaus, Gideon Calder, Jurgen De Wispelaere, Routledge, 2018, p. 123-133Chapter in book (Refereed)
Abstract [en]

Debates on the nature and justifiability of paternalism typically focus only on adults, sometimes presuming without argument that paternalism towards children is a non-issue or obviously justified. Debates on the moral and political status of children, in turn, rarely connect with the rich literature on paternalism. This chapter attempts to bridge this gap by exploring how issues that arise in the general debate on paternalism are relevant also for the benevolent interference with children. I survey and discuss various views and argue for my own: that paternalism towards children is in most respects like paternalism towards adults and stands in the same need of justification, though such justification is more often forthcoming both because children are typically less prudent than adults and so benefit more from interference, and because, in some respects, interference is less harmful to them.

Place, publisher, year, edition, pages
Routledge, 2018
National Category
Philosophy, Ethics and Religion
Research subject
Ethics
Identifiers
urn:nbn:se:umu:diva-153287 (URN)9781138915978 (ISBN)
Available from: 2018-11-15 Created: 2018-11-15 Last updated: 2020-05-13Bibliographically approved
Grill, K. & Hanna, J. (Eds.). (2018). The Routledge handbook of the philosophy of paternalism. Routledge
Open this publication in new window or tab >>The Routledge handbook of the philosophy of paternalism
2018 (English)Collection (editor) (Refereed)
Abstract [en]

While paternalism has been a long-standing philosophical issue, it has recently received renewed attention among scholars and the general public. The Routledge Handbook of the Philosophy of Paternalism is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising twenty-seven chapters by a team of international contributors the handbook is divided into five parts:

• What is Paternalism?

• Paternalism and Ethical Theory

• Paternalism and Political Philosophy

• Paternalism without Coercion

• Paternalism in Practice

Within these sections central debates, issues and questions are examined, including: how should paternalism be defined or characterized? How is paternalism related to such moral notions as rights, well-being, and autonomy? When is paternalism morally objectionable? What are the legitimate limits of government benevolence? To what extent should medical practice be paternalistic?

The Routledge Handbook of the Philosophy of Paternalism is essential reading for students and researchers in applied ethics and political philosophy. The handbook will also be very useful for those in related fields, such as law, medicine, sociology and political science.

Place, publisher, year, edition, pages
Routledge, 2018. p. 368
Series
Routledge Handbooks in Applied Ethics
National Category
Philosophy
Identifiers
urn:nbn:se:umu:diva-145054 (URN)978-1-13-895610-0 (ISBN)978-1-317-32699-1 (ISBN)
Available from: 2018-02-19 Created: 2018-02-19 Last updated: 2019-01-16Bibliographically approved
Grill, K. (2017). Asymmetric population axiology: deliberative neutrality delivered. Philosophical Studies, 174(1), 219-236
Open this publication in new window or tab >>Asymmetric population axiology: deliberative neutrality delivered
2017 (English)In: Philosophical Studies, ISSN 0031-8116, E-ISSN 1573-0883, Vol. 174, no 1, p. 219-236Article in journal (Refereed) Published
Abstract [en]

Two related asymmetries have been discussed in relation to the ethics of creating new lives: First, we seem to have strong moral reason to avoid creating lives that are not worth living, but no moral reason to create lives that are worth living. Second, we seem to have strong moral reason to improve the wellbeing of existing lives, but, again, no moral reason to create lives that are worth living. Both asymmetries have proven very difficult to account for in any coherent moral framework. I propose an impersonal population axiology to underpin the asymmetries, which sidesteps the problematic issue of whether or not people can be harmed or benefited by creation or non-creation. This axiology yields perfect asymmetry from a deliberative perspective, in terms of expected value. The axiology also yields substantial asymmetry for large and realistic populations in terms of their actual value, beyond deliberative relevance.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Intuition of neutrality, Person-affecting view, Population axiology, Procreation, Repugnant conclusion, The asymmetry
National Category
Philosophy
Research subject
Practical Philosophy
Identifiers
urn:nbn:se:umu:diva-119831 (URN)10.1007/s11098-016-0678-3 (DOI)000393594100014 ()
Available from: 2016-04-28 Created: 2016-04-28 Last updated: 2018-06-07Bibliographically approved
Grill, K. & Dawson, A. (2017). Ethical frameworks in public health decision-making: defending a value-based and pluralist approach. Health Care Analysis, 25(4), 291-307
Open this publication in new window or tab >>Ethical frameworks in public health decision-making: defending a value-based and pluralist approach
2017 (English)In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 25, no 4, p. 291-307Article in journal (Refereed) Published
Abstract [en]

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim's and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Decision-making, Ethical frameworks, Justification, Public health, Value pluralism
National Category
Philosophy
Identifiers
urn:nbn:se:umu:diva-107519 (URN)10.1007/s10728-015-0299-6 (DOI)000413812400001 ()26170178 (PubMedID)2-s2.0-85032573769 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-2189
Available from: 2015-08-24 Created: 2015-08-24 Last updated: 2018-06-07Bibliographically approved
Grill, K. (2017). Incentives, equity and the able chooser problem. Journal of Medical Ethics, 43(3), 157-161
Open this publication in new window or tab >>Incentives, equity and the able chooser problem
2017 (English)In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 43, no 3, p. 157-161Article in journal (Refereed) Published
Abstract [en]

Health incentive schemes aim to produce healthier behaviors in target populations. They may do so both by making incentivized options more salient and by making them less costly. Changes in costs only result in healthier behavior if the individual rationally assesses the cost change and acts accordingly. Not all people do this well. Those that fail to respond rationally to incentives will typically include those who are least able to make prudent choices more generally. This group will typically include the least advantaged more generally, since disadvantage inhibits one's effective ability to choose well and since poor choices tend to cause or aggravate disadvantage. Therefore, within the target population, health benefits to the better off may come at the cost of aggravated inequity. This is one instance of a problem I name the Able Chooser Problem, previously emphasized by Richard Arneson in relation to coercive paternalism. I describe and discuss this problem by distinguishing between policy options and their effects on the choice situation of individuals. Both positive and negative incentives, as well as mandates that are less than perfectly effective, require some sort of rational deliberation and action and so face the Able Chooser Problem. In contrast, effective restriction of what options are physically available, as well as choice context design that makes some options more salient or appealing, do not demand rational agency. These considerations provide an equity-based argument for preferring smart design of our choice and living environment to incentives and mandates.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2017
Keywords
Paternalism, Behaviour Modification, Distributive Justice, Public Health Ethics, Public Policy
National Category
Philosophy
Identifiers
urn:nbn:se:umu:diva-125899 (URN)10.1136/medethics-2016-103378 (DOI)000394569700007 ()27707878 (PubMedID)
Projects
Libertarian Paternalism and the Moral Limits of Public Health Policy
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-2189
Available from: 2016-09-21 Created: 2016-09-21 Last updated: 2018-06-07Bibliographically approved
Grill, K. & Voigt, K. (2016). The case for banning cigarettes. Journal of Medical Ethics, 42(5), 293-301
Open this publication in new window or tab >>The case for banning cigarettes
2016 (English)In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 42, no 5, p. 293-301Article in journal (Refereed) Published
Abstract [en]

Lifelong smokers lose on average a decade of life vis-à-vis non-smokers. Globally, tobacco causes about 5–6 million deaths annually. One billion tobacco-related deaths are predicted for the 21st century, with about half occurring before the age of 70. In this paper, we consider a complete ban on the sale of cigarettes and find that such a ban, if effective, would be justified. As with many policy decisions, the argument for such a ban requires a weighing of the pros and cons and how they impact on different individuals, both current and future. The weightiest factor supporting a ban, we argue, is the often substantial well-being losses many individuals suffer because of smoking. These harms, moreover, disproportionally affect the disadvantaged. The potential gains in well-being and equality, we argue, outweigh the limits a ban places on individuals’ freedom, its failure to respect some individuals’ autonomous choice and the likelihood that it may, in individual cases, reduce well-being.

Place, publisher, year, edition, pages
BMJ Group, 2016
Keywords
Autonomy, Population Policy, Public Health Ethics, Public Policy
National Category
Ethics Philosophy Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-112178 (URN)10.1136/medethics-2015-102682 (DOI)000375093300008 ()26578712 (PubMedID)
Projects
Libertarian Paternalism and the Moral Limits of Public Health Policy
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-2189
Available from: 2015-12-03 Created: 2015-12-03 Last updated: 2018-06-07Bibliographically approved
Projects
FOIP: Libertarian Paternalism and the Moral Limits of Public Health Policy [2009-02189_Forte]; Umeå UniversityRespecting context-dependent preferences [F13-1532:1_RJ]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1689-0648

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