The research project "Individual Justification and Uncertainty in Public Health Ethics" was funded by the POLONEZ BIS 3 competition, co-financed by the European Commission and the National Science Center under the Marie Skłodowska-Curie COFUND grant.

Basic informations

• Project title: Individual Justification and Uncertainty in Public Health Ethics
• Duration: September 1, 2023 - August 31, 2025
• Principal investigator: dr Jay Zameska (jay.zameska@uj.edu.pl)
• Mentor: dr hab. Tomasz Żuradzki, prof. UJ

Popularization description

Public health ethics is a relatively nascent field with many significant unresolved questions. One of the most important is how we should approach ethical questions involving risk and uncertainty. Public health genomics, screening programs, mass vaccination, and many other public health activities are all often understood in terms of risk management. Historically, consequentialist frameworks have been the most popular way to resolve ethical questions involving risk and uncertainty. However, such frameworks also have some significant shortcomings, particularly related to concerns over interpersonal aggregation. In response to such concerns, there has been a resurgence in interest in alternative approaches. Within the philosophical literature, T.M. Scanlon’s contractualism has become increasingly popular as a way to address questions of risk and uncertainty. The centerpiece of this contractualist approach is the process of individual justification, which aims to find answers to ethical questions that no individual could reasonably reject. Such a process has a strong philosophical and ethical pedigree, but it is also supported by empirical research on what motivates individual compliance with public health programs. As such, this focus on justifying public health policies to people as separate and distinct individuals represents an attractive alternative approach to ethical decision making in this area.

However, there are still fundamental questions about how this process functions in conditions of risk and uncertainty. These unresolved questions stand in the way of developing contractualism as a successful non-consequentialist framework for public health ethics. In this project, I aim to answer a couple of these fundamental questions about this process of individual justification. Specifically, I aim (1) to assess the relationship between individual justification and interpretations of risk, uncertainty, and probability, with a particular focus on what this means for the status and role of individual justification in public health ethics; and (2) to analyze the impact of heuristics and biases on individual justification, and the ethical consequences of such heuristics and biases, again with a particular focus on what this means for the status and role of individual justification in public health ethics.

Tentatively, I aim to argue that the most appropriate conception of probability in this context is epistemic, meaning that probabilities describe our beliefs about the likelihood of outcomes. To do so, I intend to argue that the “individualist restriction”—a distinctive component of contractualism that forbids the aggregation of reasons during individual justification—conflicts with the standard ‘frequentist’ interpretation of probability used in epidemiology. However, an epistemic interpretation of probability can successfully bridge the gap between epidemiological evidence and contractualist decision-making in public health ethics. As such, it represents an attractive option for developing a distinctively non-consequentialist approach to ethical decision making under risk and uncertainty. Following this, I also plan to argue that such a focus on epistemic approaches requires particular and substantial attention to the role of heuristics and biases in individual justification. Relying on an epistemic conception of probability when thinking about risk in contractalist terms means that any heuristics and biases that often affect decision making under risk (e.g. anchoring bias, availability bias, affect heuristic, etc.) are particularly relevant to the process of individual justification. I aim to assess whether and to what extent such heuristics and biases may undermine the process of individual justification, and whether the process needs to be revised in light of the extensive contemporary research on such heuristics and biases.

Answering these questions allows for a moral framework that maintains the contractualist commitment to treating individuals as separate and distinct loci of moral concern, while also allowing contractualism to offer plausible and attractive answers to ethical questions involving risk and uncertainty. The overall upshot of this project is to remove some significant barriers blocking the development of an effective non-consequentialist alternative to ethical decisionmaking under conditions of risk and uncertainty in public health.

Source of funding

This research is part of the project No. 2022/47/P/HS1/01942 within the POLONEZ BIS programme co-funded by the National Science Centre and the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 945339. 

Acronym: IJU-PHE