What is the difference between a philosophy and an ideology? Would simply observing some aspect of human experience count as ideology? No. But suppose we try to explain and interpret what we have seen. Now, we enter the neighborhood of what gets called ideology. What else does it take to sort out what should be called ideological? And why would a worldview sometimes turn into an echo chamber, a cocoon of confirmation bias that fosters false consciousness?

In clinical trials involving experimental subjects who are also patients, what is supposed to become of the imperative to focus on the patient’s best interest? A second set of policy questions concerns patients who want to die. Are there limits to the imperative to let patients choose for themselves? Is commodification a threat to autonomy? When, if ever, do costs and benefits become decisively important? Can we know what to count as a cost-effective preparation for the next pandemic? When we put procedures in place to protect against abuse, is there any way to prevent such measures from becoming bureaucratic obstacles to accomplishing anything at all?

This essay provides a comprehensive and critical introduction to ideology. It traces the origins and development of various conceptions of ideology, articulating both what they have in common and their differences. Among the distinctions that we develop are the contrasts between pejorative and nonpejorative conceptions, functionalist and causal conceptions, and conceptions that limit ideologies to supporting existing oppressive orders and those that allow for ideologies that challenge such orders. We also explain the role that ideologies can play in either preventing or facilitating social movements to overturn or improve existing institutions. The concluding section of this essay provides a list of important topics for future research on ideology and emphasizes that, in each case, an interdisciplinary approach is needed to understand them fully.

There is a growing movement within contemporary medical ethics to blur the boundaries between clinical medicine and clinical research. Some writers now argue that the research-practice distinction is outdated and the importance of distinguishing between research and medicine is no longer as pressing as it once was or seemed to be. Instead, we are now urged to view the health-care system as a dynamic “learning health-care system” in which research components are embedded within standard clinical care. This essay defends the ethical significance of the research-practice distinction while acknowledging the reality and usefulness of integrated health care. A key claim that this essay advances is that the principle of clinical equipoise, which has largely been rejected by research ethicists, can be reinterpreted and repurposed to help distinguish medical practices that call for more demanding forms of informed consent from those that do not.

Ideology can be understood as a type of cultural system, a set of interrelated meanings that are symbolically mediated through semiotic devices such as metaphors. Ideologies underlie social orders as well as help people make sense of their environment and decide on courses of action. While much has been said about ideology, little has been written on the sources of ideological change beyond pointing to ideological entrepreneurship. Even less has been written on the relationship between violent and disruptive social movements and ideology beyond pointing to the ideological motivations for the movements. We contend that extreme protests are often triggered by an ideological crisis, that is, an intolerable disconnection between the ideology adopted by some group and the current circumstances or, alternatively, an inability of their ideology to make sense of their current situation. Moreover, extreme protests are a form of ideological work, as they are often sources of ideological inspiration, development, and change.

As more jurisdictions permit a medically assisted death (MAiD)—and none of the jurisdictions that introduced MAiD has seen any serious attempts at reversing it—the focus of debate has turned to the question of what is a morally defensible access threshold for MAiD. This permits us to rethink the moral reasons for the legalization or decriminalization of assisted dying. Unlike what is assumed in many legislative frameworks, unbearable suffering caused by terminal illness is not what oftentimes motivates decisionally capable people to request MAiD. This matters when access thresholds are considered. The argument advanced in this essay is that because MAiD is less destructive to people’s relationships and less harmful than medically unsupervised suicide, access to medical assistance in dying should be open to anyone who is legally capacitated and who persistently requests such assistance.

Public health emergencies sometimes require the restriction of civil liberties through social distancing: lockdowns, quarantines, the closure of public spaces and institutions, and so on. Social distancing measures can decrease mortality and morbidity, but they also cause social and economic harm. Policymakers have to make trade-offs between “lives and livelihoods,” while introducing only minimally necessary restrictions on civil liberties. Traditionally, cost-benefit analysis has played a central role in formulating these trade-offs. Recently, however, some philosophers have argued that the trade-offs should instead be made on the basis of contractualist moral theory. In this essay, I argue against the use of contractualism for this purpose.

This essay identifies and explores three dominant intellectual traditions that critique and theorize about ideology: Marxist, prudentialist, and social scientific. For these traditions, the word ‘ideology’ names interest-serving rationalizations, pseudoscientific totalitarian zealotry, or political outlooks. The blending of these three specialized meanings has generated a colloquial sense of ideology that is philosophically untenable and damaging to political discourse. According to this colloquial sense, all thinking is ideological and we are all ideologues. In response, I instead offer in this essay an adverbial account of ideology. In this account, “ideology” names a kind of epistemic vice. Admitting that this is something we all may do sometimes, I describe how we think when we think ideologically. Finally, I conclude with some suggestions about how education might help us avoid the epistemic vice of ideological thinking.

Some ideologies, such as liberalism, conservatism, and socialism, are complex symbolic structures. Mastering them requires specialization, and because we are all amateurs in almost all symbolically rich domains, most people are not ideologically sophisticated. Instead, they reason about politics in a maturationally natural way, via friend-foe representations and inferences based on those representations (for example, friends of foes are foes). However, even complex ideologies are much simpler than the political, economic, and social systems that they are supposed to represent. Hence, all ideologies are inaccurate to varying degrees. More subtly, all are incomplete in various ways; in particular, they fail to anticipate some crucial events (for example, global warming), which leads to unanticipated value trade-offs and strategic conundrums. Ideologists sometimes adapt to incompleteness via recombinant innovation, producing hybrid ideologies (for example, ecosocialism). In turn, this tends to produce inconsistencies between new and old parts of an ideology. Thus, inaccuracy, incompleteness, and inconsistency are not pathologies of political belief systems. They are the inevitable result of ideologists grappling with a reality that is far more complex than their symbolic constructions can be. Therefore, evaluations of ideologies that identify errors, incompleteness, or inconsistency at a single point in time are often unenlightening. Following Imre Lakatos, evaluations should focus on how a sequence of ideologies—an ideological tradition—evolves.

The public health crisis caused by the COVID-19 pandemic led to a rapid surge in activity in biomedical and social science. The pandemic created a need for new scientific knowledge specifically related to the new, emerging infectious agent and it quickly showed huge gaps in knowledge in relation to social and policy responses to pandemics. Governments all over the world accepted the COVID-19 pandemic as a significant public health crisis and went into crisis mode in order to end the crisis and mitigate its impacts. One area in which rapid policy changes occurred was in relation to research ethics. Research ethics systems and guidelines were changed in many countries. The COVID-19 crisis also led to a flurry of philosophical and bioethical work arguing that traditional research ethics rules and principles should be suspended, rethought, or abolished. This essay will analyze whether a public health crisis justifies changing research ethics principles and policies and, if so, what the scope of justified changes is.

Judith Shklar once remarked that the mere presence of ideology is not objectionable but that pretended immunity to ideology is. I scrutinize this suggestion and Shklar’s subsequent view that social theorists should acknowledge that their ideological impulses influence both their methods of study and the questions they pursue. I begin by focusing on the different ways that Shklar characterizes ideology before turning to her critique of legalism. I then chart various ways that Shklar’s call for ideologically self-aware political theorizing feeds into her later work. I conclude by examining what ideological self-consciousness implies for our understanding of the purpose and limits of political theory.

The past five years have seen a dramatic increase in scholars working to supplement or challenge accounts of structural injustice. Almost without exception, scholars in this area assume that the move from personal responsibility to political or public responsibility will represent a net gain in justice, at least in modern liberal regimes. In this essay, I challenge this assumption and introduce the concept of “structural hobbling” as a parallel cause of injustice, but one whose origins derive from neutral state activities rather than from intentional bad faith or diffuse private action (as in structural injustice). Using health-care regulations as a lens, I offer two narratives of individuals navigating health-care regulations that demonstrate how seemingly neutral regulatory decisions create regressive hobbling effects. Structural hobbling challenges structural-injustice theorists to take more seriously the complex and often subtle ways in which apparently benevolent state activity can create downstream injustice, while adding complexity to existing narratives around public responsibility and what it demands.

Using the case of the Scientific Advisory Group for Emergencies in the United Kingdom as illustration, this essay offers a framework for understanding the role of narratives and competition among narratives in mediating the relationships between scientific advisers and policymakers during the COVID-19 pandemic. Throughout the pandemic, competing judgments about scientific independence and democratic accountability, about the risks of action and inaction, and about the appropriate balance of costs and benefits to society as a whole and to subgroups of the population were filtered through the narrative perspectives of different discourse coalitions. This narrativization of the process had both positive and negative effects. On the one hand, it provided common platforms for the integration of disparate types of knowledge relevant to policymaking. On the other hand, narratives provided platforms for rival coalitions in ongoing contests that left unresolved the central normative questions of distributional fairness and democratic accountability.

This essay characterizes one way people are organized by their ideas about the ideas of others, namely, “ideational structure.” I clarify its role in social explanation, compare it to some standard social ontologies, and propose that it is an important element in an ideology.

Is it possible to do ideology critique without morality? In recent years a small group of theorists has attempted to develop such an account and, in doing so, makes claim to a certain sort of “radical realism” distinguished by the ambition to ground political judgments and prescriptions in nonmoral values, principles, or concepts. This essay presents a twofold critique of this realist ideology critique (RIC) by first offering an internal critique of the approach and then arguing that the very attempt to do political theory generally—and ideology critique more specifically—in a way that abjures morality is misguided. In doing so, I contribute both to current debates around “new” ideology critiques and to contested questions about what it means to do political theory realistically.

It is often morally important that you have a choice between two options in the sense that each option is available to you and you are not coerced into choosing one or the other. Even when you have a choice, though, the presence of time constraints and other noncoercive influences can prevent you from taking the time you need to make up your mind and really choose for yourself. How are we to understand this latter phenomenon? In this essay, I argue that while choosing for yourself seems, at first glance, to be an exercise in discovering your preferences, this is not the whole story. At least sometimes, choosing for yourself instead involves creating your preferences—and, in so doing, choosing what kind of person and valuer to be—through the exercise of what I call formative autonomy. I then explore some objections to this account and some implications for public health policy and clinical ethics. Throughout, I draw primarily on examples that involve choosing whether to continue or terminate a pregnancy and the regulations governing such choices.

Why do many postpositivists caricature contemporary social science? Why make incorrect claims, for instance about social scientists avoiding values? Why discuss features that often no longer matter, such as seeking laws or predictions? Why reject extreme forms of social science without discussing more sensible forms? Why say little or nothing about scientific methodology, which is a great strength of recent social science? To explain such oversights and caricatures, philosophical analysis will not suffice. These are not isolated intellectual errors, but systematic ones, made by numerous scholars and fostered by social practices and institutional conventions. We thus need ideological analysis, which specializes in explaining institutionalized systems of belief. Speculative explanations are offered for postpositivist caricatures, including not only psychological factors, but also external ones (for example, the arrogance of many social scientists), limitations of language (for example, the ambiguity of the term ‘methodology’), rhetorical strategies (for example, genealogical approaches), and conventions (for example, bad citation practices).

This essay considers how the fact that some morally innocent person is nevertheless a threat to others can bear on the permissibility of health policies that harm some to protect others. Two types of innocent threats are distinguished. In the case of abortion, it is argued that even if the embryo/fetus were a person, abortion could be permissible to protect a woman’s life, health, or bodily autonomy. Whether there nevertheless should be time limits on abortions and what surprising form such limits might take are also considered. In the case of pandemics, it is suggested that discussions of health policies should, but often do not, distinguish morally between innocent threats and their potential victims as well as between providing benefits to people and preventing harms to them. The essay also examines discussions of pandemics by health professionals that make use of the trolley problem, the doctrine of double effect, and related philosophical distinctions.