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  • 1.
    Grill, Kalle
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of Philosophy.
    Anti-paternalism and invalidation of reasons2010In: Public Reason, ISSN 2065-7285, Vol. 2, no 2, 3-20 p.Article in journal (Refereed)
    Abstract [en]

    I first provide an analysis of Joel Feinberg’s anti-paternalism in terms of invalidation of reasons. Invalidation is the blocking of reasons from influencing the moral status of actions, in this case the blocking of personal good reasons from supporting liberty-limiting actions. Invalidation is shown to be distinct from moral side constraints and lexical ordering of values and reasons. I then go on to argue that anti-paternalism as invalidation is morally unreasonable on at least four grounds, none of which presuppose that people can be mistaken about their own good: First, the doctrine entails that we should sometimes allow people to unintentionally severely harm or kill themselves though we could easily stop them. Second, it entails that we should sometimes allow perfectly informed and rational people to risk the lives of themselves and others, though they are in perfect agreement with us on what reasons we have to stop them for their own good. Third, the doctrine leaves unexplained why we may benevolently coerce less competent but substantially autonomous people, such as young teens, but not adults. Last, it entails that there are peculiar jumps in justifiability between very similar actions. I conclude that as liberals we should reject anti-paternalism and focus our efforts on explicating important liberal values, thereby showing why liberty reasons sometimes override strong personal good reasons, though never by making them invalid.

  • 2.
    Grill, Kalle
    Division of Philosophy, KTH Royal Institute of Technology.
    Anti-paternalism and public health policy: the case of product safety legislation2009In: The philosophy of public health / [ed] Angus Dawson, Ashgate , 2009, 101-110 p.Chapter in book (Other academic)
  • 3.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Antipaternalism as a filter on reasons2015In: New perspectives on paternalism and health care / [ed] Thomas Schramme, Springer, 2015, 47-63 p.Chapter in book (Refereed)
    Abstract [en]

    The charge of paternalism is a common objection to the actions of political and other authorities. Sometimes the charge is only that the authority has undervalued typical liberal values like freedom and autonomy relative to other values, such as physical, mental or financial wellbeing. Making this objection is consistent with accepting that in some cases, wellbeing outweighs freedom and autonomy and should be furthered at their expense. Other times, however, the charge of paternalism is more principled. The objection is not that wellbeing considerations are overstated, but that they are allowed to weigh in on the matter at all. This is the sort of antipaternalism that I will analyze in this article. My discussion and my proposals are meant to be helpful to the antipaternalist, and to anyone who wants to understand her. However, I should state at the outset that the antipaternalist position I describe and develop is not one I endorse.

  • 4.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Asymmetric population axiology: deliberative neutrality delivered2017In: Philosophical Studies, ISSN 0031-8116, E-ISSN 1573-0883, Vol. 174, no 1, 219-236 p.Article in journal (Refereed)
    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.

  • 5.
    Grill, Kalle
    Division of Philosophy, KTH Royal Institute of Technology.
    Evaluating consequences2009In: Encyclopedia of medical decision making / [ed] Michael W. Kattan, Sage Publications, 2009, 463-467 p.Chapter in book (Other academic)
  • 6.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Expanding the Nudge: Designing Choice Contexts and Choice Contents2014In: Rationality, Markets and Morals, ISSN 1869-778X, Vol. 5, 139-162 p.Article in journal (Refereed)
    Abstract [en]

    To nudge is to design choice contexts in order to improve choice outcomes. Richard Thaler and Cass Sunstein emphatically endorse nudging but reject more restrictive means. In contrast, I argue that the behavioral psychology that motivates nudging also motivates what may be called jolting—i.e. the design of choice content. I defend nudging and jolting by distinguishing them from the sometimes oppressive means with which they can be im- plemented, by responding to some common arguments against nudging, and by showing how respect for preferences over option sets and their aggregate properties may require the trimming of option sets, as well as helpful choice contexts.

  • 7. Grill, Kalle
    Frihet i arbetet2003In: Tidskrift för politisk filosofi, ISSN 1402-2710, Vol. 7, no 1, 45-57 p.Article in journal (Other academic)
  • 8.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Good Parents, Better Babies: An Argument about Reproductive Technologies, Enhancement and Ethics (Review)2012In: Tidskrift för politisk filosofi, ISSN 1402-2710, Vol. 16, no 3, 40-49 p.Article, book review (Other academic)
  • 9.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Incentives, equity and the able chooser problem2017In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 43, no 3, 157-161 p.Article in journal (Refereed)
    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.

  • 10.
    Grill, Kalle
    Department of Philosophy, Uppsala University.
    Individual liberty in public health: no trumping value2011In: Public Health: ethical issues / [ed] Sirpa Soini, Köpenhamn: Nordic Council of Ministers , 2011, 21-33 p.Chapter in book (Other academic)
  • 11.
    Grill, Kalle
    Department of Philosophy, KTH Royal Institute of Technology.
    Liberalism, Altruism and Group Consent2009In: Public Health Ethics, ISSN 1754-9973, E-ISSN 1754-9981, Vol. 2, no 2, 146-157 p.Article in journal (Refereed)
    Abstract [en]

    This article first describes a dilemma for liberalism: On the one hand restricting their own options is an important means for groups of people to shape their lives. On the other hand, group members are typically divided over whether or not to accept option-restricting solutions or policies. Should we restrict the options of all members of a group even though some consent and some do not? This dilemma is particularly relevant to public health policy, which typically target groups of people with no possibility for individuals to opt out. The article then goes on to propose and discuss a series of aggregation rules for individual into group consent. Consideration of a number of scenarios shows that such rules cannot be formulated only in terms of fractions of consenters and non-consenters, but must incorporate their motives and how much they stand to win or lose. This raises further questions, including what is the appropriate impact of altruistic consenters and non-consenters, what should be the impact of costs and benefits and whether these should be understood as gross or net. All these issues are dealt with in a liberal, anti-paternalistic spirit, in order to explore whether group consent can contribute to the justification of option- restricting public health policy.

  • 12.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Mänsklighetens undergång ur ett befolkningsaxiologiskt perspektiv2015In: Filosofisk Tidskrift, ISSN 0348-7482, Vol. 35, no 3, 20-26 p.Article in journal (Other academic)
  • 13.
    Grill, Kalle
    Department of Philosophy, Uppsala University.
    Neutrality as a constraint on political reasoning2012In: Ethical Perspectives, ISSN 1370-0049, Vol. 19, no 3, 547-557 p.Article in journal (Refereed)
  • 14.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Normative and Non-normative Concepts: Paternalism and Libertarian Paternalism2013In: Ethics in Public Health and Health Policy: Concepts, Methods, Case Studies / [ed] Daniel Strech, Irene Hirschberg, Georg Marckmann, Springer, 2013, 27-46 p.Chapter in book (Refereed)
    Abstract [en]

    This chapter concerns the normativity of the concepts of paternalism and libertarian paternalism. The first concept is central in evaluating public health policy, but its meaning is controversial. The second concept is equally controversial and has received much attention recently. It may or may not shape the future evaluation of public health policy. In order to facilitate honest and fruitful debate, I consider three approaches to these concepts, in terms of their normativity. Concepts, I claim, may be considered nonnormative, normatively charged, or normative in that they involve more complex relationships between values or duties. While the last approach is often best, other approaches may be appropriate depending on the context and purpose of discussion. The chapter’s conceptual investigation is illustrated by application to two public health policies: a tax on the consumption of fat and the encouragement of health-promoting food displays in restaurants and supermarkets.

  • 15.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Nudge: improving decisions about health, wealth, and happiness (review)2011In: Tidskrift för politisk filosofi, ISSN 1402-2710, Vol. 15, no 1, 58-62 p.Article, book review (Other academic)
  • 16.
    Grill, Kalle
    Royal Institute of Technology, Stockholm, Sweden.
    Paternalism2011In: Encyclopedia of Applied Ethics / [ed] Ruth Chadwick, Academic Press, 2011, 2, 359-369 p.Chapter in book (Other academic)
    Abstract [en]

    Paternalism means, roughly, benevolent interference: benevolent because it aims at promoting or protecting a person’s good; interference because it restricts his liberty without his consent. The paternalist believes herself superior in that she can secure some benefit for the person that he himself will not secure. Paternalism is opposed by the liberal tradition, at least when it targets sufficiently voluntary behavior. In legal contexts, policies may be paternalistic for some and not for others, forcing trade-offs. In medical contexts, paternalism can be an open or hidden aspect of the relationship between caregiver and patient.

  • 17.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Respect for What?: Choices, Actual Preferences and True Preferences2015In: Social Theory and Practice, ISSN 0037-802X, Vol. 41, no 4, 692-715 p.Article in journal (Refereed)
    Abstract [en]

    As liberals, we would like each person to direct her own life in accordance with her will. However, because of the complexities of the human mind, it is very often not clear what a person wills. She may choose one thing though she prefers another, while having false beliefs the correction of which would cause her to prefer some third thing. I propose, against this background, that to respect a person’s will or self-direction is to respect both her choices and her preferences, with some priority given to those preferences that are informed and coherent. This is a pluralist answer to the neglected question, “respect for what?”

  • 18.
    Grill, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Shaping the context and content of food choices2013In: The ethics of consumption: the citizen, the market and the law / [ed] Helena Röcklinsberg, Per Sandin, Wageningen: Wageningen Academic Publishers, 2013, 166-171 p.Chapter in book (Refereed)
  • 19.
    Grill, Kalle
    Department of Philosophy, KTH Royal Institute of Technology.
    The Legalization of Drugs2007In: Theoria, ISSN 0040-5825, Vol. 73, no 3, 248-255 p.Article, book review (Refereed)
  • 20.
    Grill, Kalle
    Department of Philosophy, KTH Royal Institute of Technology.
    The Normative Core of Paternalism2007In: Res Publica, ISSN 1356-4765, E-ISSN 1572-8692, Vol. 13, 441-458 p.Article in journal (Refereed)
    Abstract [en]

    The philosophical debate on paternalism is conducted as if the property of being paternalistic should be attributed to actions. Actions are typically deemed to be paternalistic if they amount to some kind of interference with a person and if the rationale for the action is the good of the person interfered with. This focus on actions obscures the normative issues involved. In particular, it makes it hard to provide an analysis of the traditional liberal resistance to paternalism. Given the fact that actions most often have mixed rationales, it is not clear how we should categorize and evaluate interfering actions for which only part of the rationale is the good of the person. The preferable solution is to attribute the property of being paternalistic not to actions, but to compounds of reasons and actions. The framework of action-reasons provides the tools for distinguishing where exactly paternalism lies in the complex web of reasons and actions.

  • 21.
    Grill, Kalle
    et al.
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Dawson, Angus
    Ethical Frameworks in Public Health Decision-Making: Defending a Value-based and Pluralist Approach2015In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394Article in journal (Refereed)
    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.

  • 22.
    Grill, Kalle
    et al.
    Department of Philosophy, Uppsala University.
    Dawson, Angus
    Birmingham University.
    Health promotion: conceptual and ethical issues2012In: Public Health Ethics, ISSN 1754-9973, E-ISSN 1754-9981, Vol. 5, no 2, 101-103 p.Article in journal (Other academic)
  • 23.
    Grill, Kalle
    et al.
    Division of Philosophy, KTH Royal Institute of Technology.
    Eriksson, Anders
    Who owns my avatar: rights in virtual property2005In: Changing views: worlds in play, 2005Conference paper (Refereed)
    Abstract [en]

    This paper presents a framework for discussing issues of ownership in connection to virtual worlds. We explore how divergent interests in virtual property can be mediated by applying a constructivist perspective to the concept ownership. The simple solutions offered today entail that a contract between the game producer and the gamer gives the game developer exclusive rights to all virtual property. This appears to be unsatisfactory. A number of legitimate interests on part of both producers and gamers may be readily distinguished. More complex distributions of rights would allow many of these interests to be consistently respected.

  • 24.
    Grill, Kalle
    et al.
    Division of Philosophy, KTH Royal Institute of Technology.
    Hansson, Sven Ove
    Division of Philosophy, KTH Royal Institute of Technology.
    Epistemic paternalism in public health2005In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 31, 648-653 p.Article in journal (Refereed)
    Abstract [en]

    Receiving information about threats to one’s health can contribute to anxiety and depression. In contemporary medical ethics there is considerable consensus that patient autonomy, or the patient’s right to know, in most cases outweighs these negative effects of information. Worry about the detrimental effects of information has, however, been voiced in relation to public health more generally. In particular, information about uncertain threats to public health, from e.g. chemicals, are said to entail social costs that have not been given due consideration. This criticism implies a consequentialist argument for withholding such information from the public in their own best interest. In evaluating the argument for this kind of epistemic paternalism, the consequences of making information available must be compared to the consequences of withholding it. Consequences that should be considered include epistemic effects, psychological effects, effects on private decisions, and effects on political decisions. After giving due consideration to the possible uses of uncertain information and rebutting the claims that uncertainties imply small risks and that they are especially prone to entail misunderstandings and anxiety, it is concluded that there is a strong case against withholding of information about uncertain threats to public health.

  • 25.
    Grill, Kalle
    et al.
    Department of Philosophy, Uppsala University.
    Nihlén Fahlquist, Jessica
    Delft University of Technology.
    Responsibility, paternalism and alcohol interlocks2012In: Public Health Ethics, ISSN 1754-9973, E-ISSN 1754-9981, Vol. 5, no 2, 116-127 p.Article in journal (Refereed)
    Abstract [en]

    Drink driving causes great suffering and material destruction. The alcohol interlock promises to eradicate this problem by technological design. Traditional counter-measures to drink driving such as policing and punishment and information campaigns have proven insufficient. Extensive policing is expensive and intrusive. Severe punishment is disproportionate to the risks created in most single cases. If the interlock becomes inexpensive and convenient enough, and if there are no convincing moral objections to the device, it may prove the only feasible as well as the only justifiable solution to the problem of drink driving. A policy of universal alcohol interlocks, in all cars, has been proposed by several political parties in Sweden and is supported by the National Road Administration and the 2006 Alcohol Interlock Commission. This article assesses two possible moral objections to a policy of universal interlocks: (i) that it displaces the responsibility of individual drivers and (ii) that it constitutes a paternalistic interference with drivers. The first objection is found unconvincing, while the second has only limited bite and may be neutralized if paternalism is accepted for the sake of greater net liberty. Given the expected technological development, the proposed policy seems a commendable health promotion measure for the near future.

  • 26.
    Grill, Kalle
    et al.
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Scoccia, Danny
    Introduction2015In: Social Theory and Practice, ISSN 0037-802X, Vol. 41, no 4, 577-578 p.Article in journal (Other academic)
  • 27.
    Grill, Kalle
    et al.
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Voigt, Kristin
    University of Oxford.
    The case for banning cigarettes2016In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 42, no 5, 293-301 p.Article in journal (Refereed)
    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.

  • 28. Nihlén-Fahlquist, Jessica
    et al.
    Grill, Kalle
    Filosofiska institutionen, Uppsala universitet.
    Risker, ansvar och rattfylleri2012In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 89, no 6, 462-470 p.Article in journal (Refereed)
    Abstract [sv]

    Nollvisionen innebar i huvudsak två nya synsätt. För det första övergav man delvis den utilitaristiska tanken att risker bör vägas mot nytta till förmån för en deontologisk idé om att alla har rätt till liv och hälsa. För det andra tilldelades systemutformarna det yttersta ansvaret för trafiksäkerheten. Vi analyserar ansvarsbegreppet i ljuset av denna nya syn. Mot bakgrund av detta diskuterar vi därefter alkolåset, vilket är en av flera åtgärder som syftar till att bygga bort riskerna istället för att låta enskilda trafikanter bära det huvudsakliga ansvaret för de risker de utsätter andra för. Vi tar upp ett antal möjliga invändningar mot ett införande av obligatoriskt alkolås i alla bilar och konstaterar att ingen av dessa är särskilt övertygande.

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