Editor’s Note, December 2021 Quill Kukla This issue of the Kennedy Institute of Ethics Journal offers essays about risk, social values, and how to act in the face of risk, especially when our risk assessments are socially freighted. It is made up of two clusters of related papers. The first cluster consists of two papers that explore the ways in which our risk assessments are shaped by moral panic around HIV, and its accompanying legacy of fear, homophobia, and stigma. These papers take up ethical and social dimensions of PrEP (the drug that prophylactically prevents people from passing on HIV) and of blood donation in the face of social and medical policies based on risk distortions. The second cluster of papers is a back-and forth exchange in response to an essay we published last year in our special issue on the pandemic: “How Government Leaders Violated Their Epistemic Duties During the SARS-CoV-2 Crisis,” by Eric Winsberg, Jason Brennan, and Chris Suprenant (Kennedy Institute of Ethics Journal 30:3, 215-242, also available at https://kiej.georgetown.edu/leaders-violated-epistemic-duties-special-issue/). This paper explored the ethics and epistemology behind governments’ decisions to impose lockdowns to contain the pandemic, and it argued for the value-laden and distorted role of risk in the models that governments relied upon and how they were used. The current issue contains a critical response to this paper, the authors’ reply, and a final reply from the critics. In “Contextualizing Risk in the Ethics of PrEP as HIV Prevention: The Lived Experiences of MSM,” Michael Montess argues that the biomedical conception of risks and benefits that has been used when assessing PrEP use is too narrow. We have focused on questions of efficacy and safety, to the exclusion of exploring the richer social, cultural, political, and interpersonal context in which PrEP use occurs. Homophobia and moral panic around HIV have framed our vision of sex on PrEP simply as ‘risky sex,’ without nuance about how PrEP use shapes relationships and impacts local culture within the MSM community. But PrEP is a complex social [End Page vii] intervention. For instance, its use may enable men to participate in group sex, poly sex, and anonymous sex, which are seen simply as ‘risky sex’ by the homophobic mainstream but which also have rich cultural meanings and roles in the gay community. But at the same time, its use may signal to a partner a plan to violate monogamy agreements, or it may help undermine a tradition of seeing sex with condoms as a way of signaling care and trustworthiness. This fascinating paper tells a whole multifaceted story about a changing and vulnerable sexual culture through the lens of a single drug. Kurt Blankschaen’s essay, “And If It Takes Lying: The Ethics of Blood Donor Non-Compliance,” asks: if unjustified policies based on risk distortion, racism, and homophobia block some people from giving blood, is it ethical to lie in order to donate, when you have good reason to believe your blood is actually safe? Donating blood is prima facie an ethical good, so can we lie to bring about that good, when what is causing the need to lie is an ill-informed and unjust policy? Blankschaen looks at donation restrictions on men who sleep with men (MSM), Haitians, and people with tattoos. He argues that in each case, the restrictions do not properly track risk, and are grounded in a moral panic around HIV, largely left over from an earlier era. His conclusion is that lying in these cases is morally permissible although not morally obligatory. The exchange concerning Winsberg, Brennan, and Suprenant’s paper is in three parts. In the original paper, written during the first few months of the pandemic in Spring 2020, Winsberg, Brennan, and Suprenant argue that governments violated their epistemic duties by imposing lockdowns without sufficient justification, given the quality of the data and models they had available to them. They look at the values that drove these decisions and risk assessments, which led to an underemphasis on the risks of lockdowns and an overinflation of the risks of COVID infection. They argue that governments...
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