COVID-19 elicited a rapid emergence of new mutual aid networks in the US, but the practices of these networks are understudied. Using qualitative methods, we explored the empirical ethics guiding US-based mutual aid networks' activities, and assessed the alignment between principles and practices as networks mobilized to meet community needs during 2020-21. We conducted in-depth interviews with 15 mutual aid group organizers and supplemented these with secondary source materials on mutual aid activities and participant observation of mutual aid organizing efforts. We analyzed participants' practices in relation to key mutual aid principles as defined in the literature: 1) solidarity not charity; 2) non-hierarchical organizational structures; 3) equity in decision-making; and 4) political engagement. Our data also yielded a fifth principle, "mutuality," essential to networks' approaches but distinct from anarchist conceptions of mutualism. While mutual aid networks were heavily invested in these ethical principles, they struggled to achieve them in practice. These findings underscore the importance of as an intersection between ethical principles and practices, and the challenges that contemporary, and often new, mutual aid networks responding to COVID-19 face in developing praxis during a period of prolonged crisis. We develop a theory-of-change model that illuminates both the opportunities and the potential pitfalls of mutual aid work in the context of structural inequities, and shows how communities can achieve justice-oriented mutual aid praxis in current and future crises.

This study describes the results of a social analysis of mutual aid solidarity during Nigeria's #EndSARSprotests against Special Anti-Robbery Squad (SARS) brutality in Nigeria. The results reveal that the protests achieved success with the assistance of mutual aid solidarity networks. Yet there is a dearth of literature exploring the reasons for this accomplishment. Nigeria is a country where everything done usually has a religious coloration and interpretation; however, the 2020 mutual aid solidarity in the #EndSARS protests proved otherwise. Using in-depth interviews, data were elicited from 20 youths, including participants and observers during the #EndSARS mutual aid solidarity protests. Using a phenomenological approach, this study found that the mutual aid support group transcended traditional geopolitical, gender, and religious barriers, and youth and the elderly participated in the protest. Further results show that the 2020 #End-SARS mutual aid solidarity brought about an accountable and transparent civil society, including the financial disbanding of the Nigerian Police Force, the SARS unit responsible for extrajudicial killings. The findings also indicate that Nigerian politicians are the real problem, not religion. Recommendations are discussed.

Effective Altruism is a popular social movement that encourages individuals to donate to organizations that effectively address humanity's most severe poverty. However, because Effective Altruists are committed to doing the most good in the most effective ways, they often argue that it is wrong to help those nearest to you. In this article, I target a major subset of Effective Altruists who consider it a moral obligation to do the most good possible. Call these Obligation-Oriented Effective Altruists (OOEAs), and their movement Obligation-Oriented Effective Altruism (OOEA). I argue that, insofar as this variety of OOEA seems to commit us to refrain from helping the people right in front of us, there is something intuitively wrong about it. In response, I introduce an alternative model that embraces partiality: Mutual Aid. Mutual Aid is a network of community members, usually from the same geographical region, who share a commitment to offer, receive, and exchange material goods, wealth, and social support. I recommend Mutual Aid as a liberatory model, which-through empathy, solidarity, and care-mobilizes community-building and provides a catalyst for community advocacy. As such, we should resist the claims of OOEAs that partially distributing our funds to people or causes we care about is morally wrong or even less than ideal. We do not have a moral obligation to use our funds "effectively"; rather, we have a broader obligation to address human suffering, and Mutual Aid is one moral alternative for discharging this duty.

Effective altruism has a strategy problem. Overreliance on a strategy of donating to the most effective charities keeps us on the firefighter's treadmill, continually pursuing the next-highest quantifiable marginal gain. But on its own, this is politically shortsighted. Without any long-term framework within which these individual rescues fit together to bring about the greatest overall impact, we are almost certainly leaving a lot of value on the table. Thus, effective altruists' preferred means undercut their professed aims. Alongside the charity framework, the more effective altruist ought to consider a mutual aid framework, which better acknowledges and honors the unavoidably political commitments of effective altruism to reimagine and remake the world.

This article analyzes the meaning of solidarity for bioethics and healthcare. Drawing on the anthropology of embodiment, it argues that solidarity arises upon relations of care for our vulnerable bodies and transforms it into our common democratic project. Its main focus is, therefore, not on distribution, which is the purpose of justice, but on the recognition and democratic inclusion of persons who-due to the vulnerable condition of their bodies-are still deprived of full participation in the public sphere. By reorienting caring relationships around the horizontal axis, solidarity obliges us to treat a person who is cared for not only as a passive recipient of healthcare goods, but as a fellow citizen and a partner in the process of care. It is argued that the model of narrative citizenship, by establishing discursive equality between a patient and a physician, can contribute to greater inclusion of vulnerable individuals into our societies.

In the last two decades it has become increasingly common to advocate for a complete ban on the sale of cigarettes. One reason in favor of such a ban is egalitarian: differences in the prevalence of smoking between socioeconomic groups go a long way in explaining health inequality, and a complete ban might be effective in reducing this inequality. However, a complete ban might also be objectionable on egalitarian grounds if issued with a discriminatory intent or if it is selectively paternalistic. This article argues that a complete ban is likely to be guilty of both, especially when one of its aims is to reduce unequal rates of smoking between groups. A complete ban on the sale of cigarettes thus exhibits a curious feature: in aiming to reduce inequality it threatens to be inegalitarian. This is characteristic of a wider class of public health policies that deserves further attention by egalitarians.

Several suggestions have been made to embolden and reorient the concept of solidarity given the emergence of data-driven medicine. Recently, the European Union introduced a new consent model for so-called data altruism to motivate people to make their data available for purposes such as scientific research or improving public services. Others have introduced the alternative concept of data solidarily, which assumes that people's interests in data sharing result from a collective commitment to assist others. What those perspectives have in common is a focus on top-down organizational structures to deal with data-driven medicine. In this article, I offer an alternative reading of data solidarity, drawing on anarchist theory that highlights the disposition of mutual aid as a broader characteristic of solidarity. I begin by briefly indicating how the existing approaches to data solidarity in healthcare remain legalistic and state-centered without thoroughly considering socially critical notions of solidarity that highlight the impact of structural injustices. I then sketch out how an anarchist understanding of mutual aid could inform the conceptualization of solidarity. Finally, I focus on two implications for the practice of data-driven medicine: (1) current proposals of data altruism seem to engender a form of reversed charity; and (2) data solidarity practices could arise from the bottom-up through spontaneous order and direct action.

Efficiency is often overlooked as an ethical value and seen as ethically relevant chiefly when it conflicts with other values, such as equality. This article argues that efficiency is a rich and philosophically interesting concept deserving of independent normative examination. Drawing on a detailed healthcare case study, we argue that making assessments of efficiency involves value-laden, deliberative judgments about how to characterize the functioning of human systems. Personal and emotional resources and ends are crucial to system functioning but are often discounted in favor of a relatively narrow set of financial inputs and institutional or procedural outputs. Judgments about efficiency tend to advantage (or disadvantage) different parties, depending on the resources and ends considered. Different constructions of efficiency can therefore promote or neglect the perspectives and interests of differently placed actors. Models of efficiency do not merely embody contestable ethical standpoints but-put to use-can unwittingly reify and reproduce them.

This essay applies an ethical analysis of the Jewish religious rite of hatafat dam brit to the ongoing debate on child genital cutting. Recent scholarship on the ethical and legal status of "de minimis" or "symbolic" involuntary genital cutting practices features disagreement over what, if anything, grounds their wrongfulness given that they are (relatively) physically superficial. Hatafat dam brit ("the drawing of covenantal blood") is even less physically intrusive than the most minor of the other practices commonly debated (e.g., "ritual nicking" of the vulva) yet still, as I will show, elicits moral concern-including from within the practicing religious community. As a type of genital cutting ritual that does not, in fact, modify the body, hatafat dam brit challenges those on both sides of the debate to clarify the basis for their moral objection or approval. I argue that debates about involuntary genital cutting of minors should focus on the ethics of these practices considered as (sexually) embodied interpersonal interactions, rather than as body modifications.

Abilify MyCite was granted regulatory approval in 2017, becoming the world's first "smart pill" that could digitally track whether patients had taken their medication. The new technology was introduced as one that had gained the support of patients and ethicists alike, and could contribute to solving the widespread and costly problem of patient nonadherence. Here, we offer an in-depth exploration of this narrative, through an examination of the origins and development of Abilify, the drug that would later become MyCite. This history illuminates how an antipsychotic can become a top-selling drug and maintain its blockbuster status for more than a decade. It also provides a detailed case study for how knowledge is constructed within the logic of biomedical capitalism, providing impetus to reexamine claims regarding how MyCite addresses patient nonadherence, engenders patient support, and is ethicist-approved.

Generalizations in medical research can be informative, but also misleading. Building on recent work in the philosophy of science and ethics of communication, I offer a novel analysis of common generalizations in clinical trials as generics in natural language. Generics, which express generalizations without terms of quantification, have attracted considerable attention from philosophers, psychologists, and linguists. My analysis draws on probabilistic and contextual features of generics to diagnose how these generalizations function and malfunction across communicative contexts in medicine. Given a high risk of misinterpretation ("slippage"), I recommend avoidance of generic claims about medical interventions in public contexts, exemplified by clinical trials and medical research more generally. Generics should only be used with vigilance in private contexts, exemplified by the physician-patient encounter. My analysis provides tools to support vigilance when communicating with generics, suggests new norms for public science communication, and raises deeper questions in the ethics of clinical communication.

Social robots are increasingly being deployed to address social isolation and loneliness, particularly among older adults. Clips on social media attest that individuals availing themselves of this option are pleased with their robot companions. Yet, some people find the use of social robots to meet fundamental human emotional needs disturbing. This article clarifies and critically evaluates this response. It sets forth a framework for loneliness, which characterizes one kind of loneliness as involving an affective experience of lacking human relations that provide certain social goods. Next, the article discusses social robots and critically reviews the literature on the ethics of using them in light of this loneliness characterization. Third, we present a normative argument connecting the philosophical critique of loneliness-as-absence with the design and deployment of social robots. Finally, we draw out the implications of our analysis for public health and for interrogating the aims of commercial companies who make social robots.

Since the invention of hormonal contraceptives, there has been disagreement between users and providers about the existence of side effects and their implications for care. The lack of consideration for cisgender women, and other people who may become pregnant, has often been explained by sexist bias in the philosophy of medicine. My goal is to contribute additional elements to this discussion. I will argue that there are structurally embedded assumptions about the responsibilities and goals of medicine that open the door to this sexism in the first place. While we tend to accept that contraception is part of medicine for pragmatic reasons, we do not exhibit the same form of pragmatism when it comes to dealing with side effects. This is an unjustified double standard that fails to recognize the goals of contraception and the fact that it relies on medical expertise to achieve them.

Cities are struggling to balance the moral imperatives of sustainable development, with equity and social justice often ignored and negatively impacted by climate change mitigation and adaptation. Yet, the nature of these impacts on social justice has not been comprehensively investigated and little ethical guidance exists on how to better promote social justice in urban climate change planning practice. This article addresses the normative question: How should urban climate change planning advance social justice? It gathers empirical literature documenting the inclusivity and equity impacts of urban climate change planning and thematically analyses that literature for dimensions of social justice drawn from philosophical and urban justice theory. Study findings demonstrate that four characteristics of climate change planning in cities-underlying neoliberal ideology, unequal treatment, green gentrification, and exclusion from decisionmaking-comprise, create, or worsen social injustices across six dimensions. These characteristics are often interconnected and inseparable. Where neoliberal ideology guides urban climate change planning, the other three characteristics frequently occur as well. The article concludes by arguing that, at a minimum, urban planners and climate planners have an obligation of justice to avoid undertaking climate change planning that exhibits any of the four characteristics and to address injustices generated where planning has such characteristics. It further suggests that planners' negative obligations likely extend beyond this because the literature review revealed gaps in existing empirical data on the equity impacts of urban climate change planning.

Ethics can be envisioned as a process where human beings move from a more passive stance in their moral lives to a more active one, in which the moral aspects of their lives become the basis of a project to best live one's life. Participatory research and methods would appear essential to ethics in this light, yet they remain rather marginally used in bioethics. In this article, I argue that participatory research methods are particularly compelling means of ethical enactments because of their ability-when carried out properly-to help promote self-actualization. Although I cannot review in detail the vast array of participatory research undertaken in management, education, communication, and so on, I pinpoint the advantages of this orientation to research, especially in light of a pragmatist and deliberative form of ethics that aims to help understand and enact human flourishing. These advantages include: (1) the co-understanding and co-reconstruction of problem situations and responses; (2) the importance attributed to meaning and intersubjectivity; (3) mutual learning (moral co-learning); (4) empowerment for effective eudemonistic change; and (5) opening the evaluation of outcomes to human flourishing. I also explain that these attributes of participatory research and methods do not preclude the use of non-participatory methods and approaches in ethics.