Romanell Fellows Blog

Romanell Fellows are currently blogging about selected papers, including, but not limited to, those listed on this page and available for download. Additional blog papers are forthcoming.

For further information, contact David Hershenov,


  • 8/16/20
    The initial Romanell Fellows blog, The Ethics of Rationing, was open to discussion in a one-week forum, at the end of April, 2020. Although this paper is prior to Covid-19, it is an article that will give the “lay of the land”  on the ethics of rationing. The paper touches on plenty of topics, albeit briefly, it will provide Romanell Fellows with their varied interests and specializations with many issues to pursue in their comments.
  • 8/16/20
    This paper reviews existing responses to the QALY trap and argues that all are problematic. Authors argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination. Keywords: QALY, disability, priority setting, health care, prioritarianism.
  • 8/16/20
    Author states: "I develop an analogy to random gunfire to illustrate this point. Vaccine refusal, I argue, is morally similar to firing a weapon into the air and endangering innocent bystanders."
  • 8/16/20
    This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health.
  • 8/16/20
    The author aims to discuss Nagle's paper 'Equality' as a "kind of egalitarian reasoning."
  • 8/16/20
    The 2016 CIOMS International ethical guidelines for health‐related research involving humans states that ‘health‐related research should form an integral part of disaster response’ and that, ‘widespread emergency use (of unproven interventions) with inadequate data collection about patient outcomes must therefore be avoided’ (Guideline 20). Keywords: CIOMS guidelines, Ebola, equipoise, public health emergencies, research ethics, right to try.
  • 8/16/20
    This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health.
  • 8/25/20
    Wakefield’s harmful dysfunction analysis asserts that the concept of medical disorder includes a naturalistic component of dysfunction (failure of biologically designed functioning) and a value (harm) component, both of which are required for disorder attributions. Muckler and Taylor, defending a purely naturalist, value-free understanding of disorder, argue that harm is not necessary for disorder. They provide three examples of dysfunctions that, they claim, are considered disorders but are entirely harmless: mild mono- nucleosis, cowpox that prevents smallpox, and minor perceptual deficits. They also reject the proposal that dysfunctions need only be typically harmful to qualify as disorders. We argue that the proposed counterexamples are, in fact, considered harmful; thus, they fail to disconfirm the harm requirement: incapacity for exertion is inherently harmful, whether or not exertion occurs, cowpox is directly harmful irrespective of indirect benefits, and colorblindness and anosmia are considered harmful by those who consider them dis- orders. We also defend the typicality qualifier as viably addressing some apparently harmless disorders and argue that a dysfunction’s harmfulness is best understood in dispositional terms.
  • 9/8/20
    Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, if they have a high baseline risk of natural infection, and if during the trial they receive frequent monitoring and, following any infection, the best available care. Paper 10 is here.


Paper 1. Principles for allocation of scarce medical interventions, by Govind Persad, Alan Wertheimer, Ezekiel J Emanuel

Paper 2. How to Allocate Scarce Health Resources Without Discriminating Against People With Disabilities

Paper 3. A Defense of Compulsory Vaccination by Jessica Flanigan

Paper 4. Solidarity and Responsibility in Health Care by Ben Davies and Julian Savulescu

Paper 5. Equality or Priority by Derek Parfit

Paper 6. Social value, clinical equipoise, and research in a public health emergency by A. J. London

Paper 7. Pre-publication review of work by Christopher Boorse (limited circulation)

Paper 8. The relativity of ‘placebos’: defending a modified version of Grünbaum’s definition by Jeremy Howick

Paper 9. Harm as a Necessary Component of the Concept of Medical Disorder: Reply to Muckler and Taylor by Wakefield and Conrad

Paper 10. Human Challenge Studies to Accelerate Coronavirus Vaccine Licensure by Marc Lipsitch, Nir Eyal, Peter G Smith

Paper 11. Institutions, Beliefs and Ethics: Eugenics as a Case Study by Allen Buchanan