Thesis (Ph. D.)--University of Wisconsin--Madison, 1968. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Medical confidentiality is widely recognised as a concept worth protecting. Problems arise, however, when medical confidentiality conflicts with interests that are equally regarded as important, such as the interests of justice; the interest in criminal prosecution; the interest in crime prevention; or defence rights. In order to develop convincing and workable criteria to balance the competing interests in case of a conflict, the different interests at stake must be clearly defined, and their respective importance assessed. Different ethical approaches to the balancing process will be introduced, followed by an analysis of the law of four legal systems, France, Germany, the UK and the u.s. AIl four legal systems protect medical confidentiality by the means of private law, but only Germany and the U.S. protect medical confidentiality as part of the constitutional right to privacy. In France and Germany, a breach of medical confidentiality by a physician amounts to a criminal offence. Regardless of these differences, all systems agree that medical confidentiality serves both the privacy interests of the patient, and the public interest in protecting public health. Fundamental differences materialise with regard to the recognition of medical privilege, which is recognised in France, Germany, and some States in the U.S., but is rejected by other States in the U.S. and by the UK. While in the U.S., defence rights are regarded as more important than medical confidentiality, the same is not true for France and Germany. All systems agree that medical confidentiality can be outweighed by the interest in preventing a crime that might cause serious harm to a third party, but the criteria according to which the competing interests are balanced, differ. Based on a comparison of the different approaches, criteria for a consistent and morally justified resolution of the conflicts between medical confidentiality and the competing interests will be suggested.

Existing moral reflection on immigration law and policy is caught in an impasse between (1) proponents of an individual right to free international migration and (2) proponents of a state’s right to control its borders. In Chapter 1, I examine arguments supporting an individual right to free international migration. I show that the case for this putative right cannot be settled solely by considering the strength of individuals’ interest in being able to cross international borders according to their choice. Rather, at a crucial point, the argument for an individual right to free migration turns on the truth of a particular conception of global justice. In Chapter 2, I examine arguments supporting a state’s right to control its borders. I contend that these arguments do not seek to defend the substantive justice of restrictive immigration policies, but rather the legitimacy of processes of political decision-making by which states unilaterally determine their own immigration policies. Abandoning this right-versus-right paradigm, I recast the debate by focusing on two distinct questions: (1) the question of justice in immigration, which substantively evaluates immigrant admission policy; and (2) the question of the legitimacy of immigration law enacted by procedures responsive only to states’ internal political decisions. I further propose that in articulating principles of justice in immigration, we should first develop a conception of global justice which will provide the background for our evaluation of immigration policy. In Chapter 3, I develop and defend a conception of global justice I call cooperation-based internationalism. I argue that co-citizens are joint participants in a scheme of cooperation which provides them with the social goods they need to lead autonomous lives. They therefore owe each other special duties of social justice. In addition, I argue for a duty of assistance which applies among all human persons globally. This duty requires developed states to assist developing states in establishing minimally just institutions. In Chapter 4, I develop a conception of justice in immigration against the background of cooperation-based internationalism. I argue that there is no requirement for states to allow open immigration. Nevertheless, I argue that co-citizens owe each other duties which impose significant moral constraints on immigration policy: states must (1) allow for family unification; (2) eschew policies that select immigrants based on criteria that unjustly call into question the fitness for citizenship of certain current members; (3) regulate labour immigration so that all current citizens benefit equally unless unequal gains benefit worse-off citizens. The duty of assistance is also imposes constraints on immigration policy. Developed states should (4) avoid immigration policies which cause brain drain harmful to international development and (5) admit and resettle refugees. In Chapter 5, I turn to the distinct question of the legitimacy of unilaterally-enacted immigration law. I argue that the application and enforcement of immigration law counts as a coercive exercise of political power which stands in need of justification. I examine the consent and natural duty of justice theories of political legitimacy, concluding that these influential theories cannot establish the legitimacy of immigration law. I conclude by considering the implications of the illegitimacy of immigration law for the evaluation of irregular migration.

This dissertation aims to defend an egalitarian conception of global distributive justice. Many hold that the scope of egalitarian justice should be defined by membership of a single political community but my dissertation will challenge this view. I begin by considering three distinctive arguments against the ideal of global equality. They maintain that egalitarian obligations of justice apply only to those people who are subject to the same sovereign authority which coerces them to abide by its rules; or to those who contribute to the preservation of each other’s autonomy through collectively sustaining a state; or to those who belong to the same nation. The first three chapters deal with these arguments respectively. Central to these arguments is the assumption that the domestic and the global contexts are different in some morally relevant way so egalitarian principles of justice apply to the former but not the latter. After rebutting these anti-egalitarian arguments I turn to the more constructive task of developing a form of global egalitarianism that is grounded in the value of equality as a normative ideal of how human relations should be conducted. I argue in Chapter 4 that relational equality—that is, standing in relations of equality to one another (rather than relations characterized by domination or exploitation)—is a demand of justice in the global context. This ideal of relational equality has distributive implications. In Chapter 5 I try to spell out these implications by defending a set of principles of global distributive justice that would follow from our commitment to global relational equality. In the sixth and final chapter, I discuss what responsibilities we have in relation to global injustice, how to distribute the burdens associated with these responsibilities, and whether they are excessively demanding on complying agents.

This thesis defends John Rawls’s constructivist theory of justice against three distinct challenges. Part one addresses G.A. Cohen’s claim that Rawls’s constructivism is committed to a mistaken thesis about the relationship between facts and principles. It argues that Rawls’s constructivist procedure embodies substantial moral commitments, and offers an intra-normative reduction rather than a metaethical account. Rawls’s claims about the role of facts in moral theorizing in A Theory of Justice should be interpreted as suggesting that some of our moral beliefs, which we are inclined to hold without reference to facts, are, in fact, true, because certain facts obtain. This thesis and the acknowledgement of the moral assumptions of Rawls’s constructivism help to show that Rawls does not, and does not need to, deny Cohen’s thesis. Part two defends the characterization of the decision problem in Rawls’s original position as a decision problem under uncertainty. Rawls stipulates that the denizens of the original position lack information that they could use to arrive at estimates of the likelihood of ending up in any given social position. It has been argued that Rawls does not have good grounds for this stipulation. I argue that given the nature of the value function we should attribute to the denizens of the original position and our cognitive limitations, which also apply to the denizens of the original position, their decision problem can be characterized as one under uncertainty even if we stipulate that they know that they have an equal chance of being in any individual’s place. Part three assesses the claim that a true commitment to Rawls’s difference principle requires a further commitment to an egalitarian ethos. This egalitarian ethos is offered as a means to bring about equality and Pareto-optimality. Accordingly, I try to undermine the case for an egalitarian ethos by challenging the desirability of the ends it is supposed to further or by showing that it is redundant. I argue that if primary goods are the metric of justice, then Pareto optimality in the space of the metric of justice is undesirable. I then argue that if the metric of justice is welfare, depending on the theory of welfare we adopt, an egalitarian ethos will either be redundant or will have objectionably paternalistic consequences.

The introduction (§§1-33) to Hegel’s Philosophy of Right is the key to the work’s structure, its argumentative strategy and it functions as a foundation for Hegel’s practical philosophy in general. Its explanatory potential is best realised by situating it within the systematic context of the Encyclopedia of Philosophical Sciences and the Science of Logic. This interpretative strategy reveals that for Hegel, the true site of agency is ‘the concept’ and that particular individuals and their arbitrary activity are at best the concept’s ‘appearance’. This does not render their activity ‘false’ but describes how willing and freedom are ‘for us’ as self-conscious subjects that confront an external world. For Hegel, ‘true’ freedom in the sense of ‘self-determination to itself’ resides with the universal and singular concept that negatively unites itself with its objectivity to form what he calls the ‘Idea of the will’ or ‘right’. This interpretation contradicts the mainstream of contemporary Hegel scholarship since its proponents either deny the reality of the universal concept as agent or absolutely differentiate between the concept’s activity (subjective action) and its objective reality (norms, institutions). This prevents the interpreter from appreciating that it is Hegel’s concept that is manifest in form of particular willing subjects and their socio-political context. Since most commentators associate ‘activity’ or ‘freedom’ primarily with particular subjects, their notions of freedom are, by Hegel’s standards, either empty and fail to describe actual willing or they fall short of the standard of ‘true freedom’, viz. ‘self-determination to itself’ because their agents’ freedom depends on something that differs from the agents.1 The present commentary argues that such a dilemma can be avoided by an interpretation that attributes agency to Hegel’s concept. By determining itself to be Idea, the universal concept determines itself (as subject) to itself (as object) and rational agency and rational institutions are grasped as aspects of the same entity. This is what Hegel calls the unconditioned Idea of right or ‘objective freedom’.

Can contemporary liberalism justify antidiscrimination law? The question seems impertinent until we consider contemporary liberalism’s commitment to limited government. Once we do, we realize that contemporary liberals may not complacently assume that their theories justify antidiscrimination law simply because discrimination based on race or sex is so obviously wrongful. Rather, they must scrutinize antidiscrimination law just as they do other regulation of individual conduct. Providing such scrutiny, this thesis argues that three of the most prominent contemporary liberal doctrines of political legitimacy—John Rawls’s “political liberalism,” an antiperfectionist version of the “harm principle,” and Joseph Raz’s “liberal perfectionism”—all fail to justify core applications of antidiscrimination law, applications that we intuitively consider perfectly legitimate. In light of this failure, contemporary liberalism faces a dilemma: it must jettison either its commitment to comprehensive, uniform antidiscrimination regimes or its antiperfectionism and overriding commitment to personal autonomy. This thesis argues for the latter course by providing an account of the wrongfulness of discrimination based on race or sex that condemns all instances of the conduct. According to this account, discrimination is wrong because acting on discriminatory intentions is wrong. More specifically, by taking another person’s race or sex as a reason to treat her less favorably than one would treat people of other races or the other sex, one fails to respect her as a person, to regard her as a being of ultimate value. Unlike contemporary liberal accounts, this account is fully perfectionist, since it defines discrimination in terms of the intentions of discriminators, and the intentions of discriminators in terms of their attitudes, which partly constitute their moral characters. So long as we remain committed to antidiscrimination law in its current form, we must attend to discriminators’ characters. And to attend to discriminators’ characters, we must be willing to espouse perfectionism.

This licentiate thesis consists of three essays which all concern the ethics of imprisonment and what constitutes an ethically defensible treatment of criminal offenders. Paper 1 defends the claim that prisoners have a right to privacy. I argue that the right to privacy is important because of its connection to moral agency. For that reasons is the protection of inmates’ right to privacy also warranted by different established philosophical theories about the justification of legal punishment. I discuss the practical implications of this argument. Ultimately I argue the invasion of privacy should be minimized to the greatest extent possible without compromising other important values and rights to safety and security. In defending this position, I argue that respect for inmates’ privacy should be part of the objective of creating and upholding a secure environment to better effect in the long run. Paper 2 discusses whether the collateral harm of imprisonment to the close family members and children of prison inmates may give rise to special moral obligations towards them. Several collateral harms, including decreased psychological wellbeing, financial costs, loss of economic opportunities, and intrusion and control over their private lives, are identified. Two competing perspectives in moral philosophy are applied in order to assess whether the harms are permissible. The first is consequentialist and the second is deontological, and it is argued that both of them fails and therefore it is hard to defend the position that allowing for these harms would be morally permissible, even for the sake of the overall aims of incarceration. Instead, it is argued that these harms imply that imprisonment should only be used as a last resort. Where it is necessary, imprisonment should give rise to special moral obligations towards families of prisoners. Using the notion of residual obligation, these obligations are defended, categorized and clarified. Paper 3 evaluates electronic monitoring (EM) from an ethical perspective and discusses whether it could be a promising alternative to imprisonment as a criminal sanction for a series of criminal offenses. EM evaluated from an ethical perspective as six initial ethical challenges are addressed and discussed. It is argued that since EM is developing as a technology and a punitive means, it is urgent to discuss its ethical implications and incorporate moral values into its design and development. / <p>QC 20140519</p>