Physicians place significant weight on the distinction between acts and omissions. Most believe that autonomous refusals for procedures, such as blood transfusions and resuscitation, ought to be respected, but they feel no similar obligation to accede to requests for treatment that will, in the physician’s opinion, harm the patient (e.g., assisted death). Thus, there is an asymmetry. In this paper, we challenge the strength of this distinction by arguing that the ordering of values should be the same in both cases. The reason for respecting refusals is that, in such cases, autonomy outweighs well-being. We argue that the same should be true in request cases, which means that requests should not be denied only due to the treatment being too harmful in the physician’s opinion. Our strategy is to consider and reject a number of arguments for the asymmetrical view, including an appeal to the doing–allowing distinction and positive and negative rights. The duty to respect refusals is still greater than the duty to grant requests on our view, but, by arguing that the ordering of values is the same in both cases, we show that there is less of a distinction in healthcare between requests and refusals than many currently believe.

While our knowledge of the entanglements of cities and religions is growing, the ‘other’ of religion and its impact on the city has not received the same level of attention in research so far. This article explores how this lacuna could start to be filled. Its focus is on the history of modern cremation that unfolded with strong secularist leanings during the long nineteenth century. I will look into the history of the first European crematories that were built in Milan and Gotha, the construction of the first cremation furnaces and the infrastructures necessary to make them work. My hypothesis is that what I call ‘worldview technologies’ and related infrastructures changed the faces of cities and were in turn influenced by these cities’ histories and self-images.

Australia’s approach to its biosecurity and borders has always been two-pronged – quarantine first, vaccination second. This article asks what this combination looked like in practice by exploring two neglected smallpox vaccination campaigns directed towards Indigenous peoples in the early twentieth century. We argue these were important campaigns because they were the first two pre-emptive, rather than reactionary, vaccination programs directed towards First Nations people. Second, both episodes occurred in Australia’s northern coastline, where the porous maritime geography and proximity to Southeast Asia posed a point of vulnerability for Australian health officials. While smallpox was never endemic, (though epidemic), in Australia, it was endemic at various times and places across Southeast Asia. This shifting spectre of smallpox along the northern coastline was made even more acute for state and federal health officials because of the existing polyethnic relationships, communities, and economies. By vaccinating Indigenous peoples in this smallpox geography, they were envisioned and embedded into a ‘hygienic’ border for the protection of white Australia, entwining the two-prongs as one approach. In this article, we place public health into a recent scholarship that has ‘turned the map upside down’ to re-spatialise Australia’s history and geography to the north and its global connections, while demonstrating how particular coastlines and their connections were drawn into a national imaginary through a health lens.

Limited Aggregation is the view that when there are competing moral claims that demand our attention, we should sometimes satisfy the largest aggregate of claims, depending on the strength of the claims in question. In recent years, philosophers such as Patrick Tomlin and Alastair Norcross have argued that Limited Aggregation violates a number of rational choice principles such as Transitivity, Separability, and Contraction Consistency. Current versions of Limited Aggregation are what may be called Comparative Approaches because they involve assessing the relative strengths of various claims. In this paper, we offer a non-comparative version of Limited Aggregation, what we call the Threshold Approach. It states that there is a non-relative threshold that separates various claims. We demonstrate that the Threshold Approach does not violate rational choice principles such as Transitivity, Separability, and Contraction Consistency, and we show that potential concerns regarding such a view are surmountable.

For the past two decades anti-abortionists in the Global North have been aggressively instrumentalising disability in order to undermine women’s social autonomy, asserting, falsely, there is an insuperable conflict between disability rights and reproductive rights. The utilisation of disability in struggles over abortion access is not new, it has a history dating back to the interwar era. Indeed, decades before anti-abortionists’ campaign, feminists invoked disability to expand access to safe abortion. This paper examines the feminist eugenics in the first organisation dedicated to liberalising restrictive abortion laws, the Abortion Law Reform Association (ALRA), established in England in 1936. ALRA played a vital role in the passage of the Abortion Act 1967 (or the Act) that greatly expanded the grounds for legal abortion, a hugely important gain for women in Britain and beyond seeking legal, safe abortions. In addition, the Act permitted eugenic abortion, which also had transnational effects: within a decade, jurisdictions in numerous Commonwealth countries passed abortion laws that incorporated the Act’s eugenics clause, sometimes verbatim. This essay analyses ALRA’s role in codifying eugenics in the Abortion Act 1967 and argues that from the outset, ALRA was simultaneously a feminist and eugenist association. Initially, ALRA prioritized their feminist commitment to ‘voluntary motherhood’ in their campaign whereas starting in the 1940s, they subordinated feminism to negative eugenics, a shift that was simultaneously strategic and a reflection of genuine concern to prevent the birth of children with disabilities.

Variable-Value axiologies avoid Parfit’s Repugnant Conclusion while satisfying some weak instances of the Mere Addition principle. We apply calibration methods to two leading members of the family of Variable-Value views conditional upon: first, a very weak instance of Mere Addition and, second, some plausible empirical assumptions about the size and welfare of the intertemporal world population. We find that such facts calibrate these two Variable-Value views to be nearly totalist, and therefore imply conclusions that should seem repugnant to anyone who opposes Total Utilitarianism only due to the Repugnant Conclusion.

The late nineteenth and early twentieth century saw dramatic new developments in climatic medicine, particularly the institutionalisation of thinking about tropical hygiene. There were also more limited efforts to understand how hygiene theories should be applied in a polar environment. Studying the British National Antarctic Expedition (1901–1904), led by Robert Falcon Scott, helps us understand how these practices had both similarities and differences from applications of hygiene in other contexts. The expedition offers unique insights into debates about hygiene, environment, and health because of the important, and well documented, role that medics, naval officers and scientists played in organising logistical arrangements for the journey to Antarctica. In analysing the writings of expedition members and organisers, this paper examines the ways that the universal tools of hygiene theories were applied and developed in a polar environment. Many of the most acute threats seemed to come not from the outside environment but from the explorers’ supplies and equipment. There was general agreement on many issues. Yet the expedition’s organisers, medics and leadership had numerous arguments about the best way to preserve or restore health. These disagreements were the product of both competing medical theories about the cause of disease and the importance of embodied (and somewhat subjective) observations in establishing the safety of foods, atmospheres and environments in this period.

Debates about cultural participation of persons with disabilities within legal and socio-legal scholarship and within disability studies tend to remain disconnected. This article brings legal analysis and other academic disciplines into a critical dialogue. It sheds light on how the right to cultural participation is understood from the bottom up, building on a study carried out across Europe. Participants in this study perceived opportunities to participate in, and to contribute to, arts and culture in ways that are consistent with the human rights approach to disability as expressed in the UN Convention on the Rights of Persons with Disabilities, and as central to the concept of inclusive equality. Cultural participation was also understood as intrinsic to the humanity of all people, as vital to inclusion in mainstream life, as capable of communicating experiences or identities not otherwise represented, and as potentially transformative of art-forms and ultimately, of society.