_Disaster Psychiatry: Intervening When Nightmares Come True_ captures the state of disaster psychiatry in the aftermath of the terrorist attacks of September 11, 2001. This emergent psychiatric specialty, which is increasingly separated from trauma and grief psychiatry on one hand and military psychiatry on the other, provides psychotherapeutic assistance to victims during, and in the weeks and months following, major disasters. As such, disaster psychiatrists must operate in the widely varying locales in which natural and man-made disasters (...) occur, and they must establish their role among the chaotic array of organizations involved in direct disaster response. Editors Anand Pandya and Craig Katz have captured the challenge and promise of disaster psychiatry through first-person narratives. We hear from psychiatrists who have encountered disasters at various stages of their career and in widely varying social, political, and personal contexts. Accounts of psychiatric involvement with adults and children during and after 9/11 have understandable pride of place in this collection. But they are balanced by richly informative narratives about other domestic and international disasters. Fraught with the drama attendant to the events they describe, these essays delineate the dizzying array of challenges that confront the disaster psychiatrist. They range from the intense emotional responses that are part of the aftermath of any disaster, to the need to legitimize a psychiatric presence within diverse cultural and medical contexts, to the subtle task of providing therapeutic boundaries at a time when all rules seem to be suspended. Special attention is given to the daunting task of working with children whose parents' are disaster victims. What emerges from these testimonies is compelling documentation of skilled and compassionate psychiatrists at the outer limits of their specialty, pursuing their calling into uncharted realms of therapeutic engagement. (shrink)

Millions of people in our world are in need of assistance: from the global poor, to refugees, from the victims of natural disasters, to those of violent crimes. What are our responsibilities towards them? Christian Barry and Gerhard Øverland’s answer is plausible and straightforward: we have enforceable duties to assist others in need whenever we can do so ‘at relatively moderate cost to ourselves, and others’. Barry and Øverland defend this answer on the ground that it best fits our (...) intuitions in a variety of hypothetical rescue scenarios. I argue that, although Barry and Øverland’s view is intuitively appealing, appeal to intuitive cases is insufficient to vindicate it satisfactorily. Intuitive cases alone do not allow us to establish: (i) what costs count as moderate and (ii) whether assistance-based responsibilities are, in fact, enforceable. These considerations suggest that Barry and Øverland’s defence of their preferred answer to the assistance question may be incomplete. (shrink)

Le rôle de l’Etat face aux catastrophes naturelles est examiné en fonction des critères d’ efficacité et de liberté. Les bureaucraties d’assistance face aux désastres ont des points communs, mais aussi d’importantes différences, avec celles de la santé publique. Certains programmes gouvernementaux faits pour assister les victimes de catastrophes naturelles ont des effets pervers en créant plus de souffrance, et d’autres entretiennent activement les comportements irresponsables. Le rôle de l’Etat en tant que coordinateur des efforts d’assistance est justifié, (...) mais il se trouve qu’il n’est pas logiquement nécessaire.The role of the state in responding to natural disasters is examined with an eye to questions of both efficacy and liberty. Disaster relief bureaucracies have some similarities to, but important differences from, welfare relief bureaucracies. Some government programs designed to assist the victims of natural disasters have perverse effects of creating more suffering, and others actively foster irresponsible behavior. The role of the state in coordinating relief efforts is justified, but turns out not to be logically necessary. (shrink)

An increasing number of non-governmental organisations provide humanitarian assistance, including healthcare. Some faith-based NGOs combine proselytising work with humanitarian aid. This can result in ethical dilemmas that are rarely discussed in the literature. The article explores several ethical issues, using four generic activities of faith-based NGOs: It is discriminatory to deny aid to a needy community because it provides less opportunity for proselytising work. Allocating aid to a community with fewer health needs but potential for proselytising work is unjust, (...) since it neither maximises welfare nor assists the most needy . Faith-based-NGOs may state that proselytising work combined with humanitarian assistance improves spiritual wellbeing and overall benefit. However, proselytising work creates religious doubts, which could transiently decrease wellbeing. Proselytising work is unlikely to be a perceived need of the population and, if carried out without consent, breaches the principle of autonomy. Such work also exploits the vulnerability of disaster victims. Governments that decline the assistance of a faith-based NGO involved in proselytising work may deprive the needy of aid. Three strategies are proposed: Increase knowledge to empower communities, individuals and governments; information on NGOs could be provided through an accessible register that discloses objectives, funding sources and intended spiritual activities. Clearly demarcate between humanitarian aid from proselytising work, by setting explicit guidelines for humanitarian assistance. Strengthen self-regulation by modifying the Code of Conduct of the Red Cross to state criteria for selecting communities for assistance and procedures for proselytising work. (shrink)

This paper examines the concept of ‘tsunami-tendenko,’ a guideline suggesting that individuals prioritise their own safety over aiding others during large-scale disasters. Kodama defends tsunami-tendenko against accusations of egoism by arguing that the principle can be justified ethically on consequentialist (or more precisely, utilitarian) grounds. Kodama asserts that attempting to assist others during such disasters heightens the risk of ‘tomo-daore,’ where both the rescuer and the victim may perish. He claims that having people focus solely on saving themselves can (...) maximise the overall number of lives saved. However, we challenge Kodama’s assertion that utilitarianism inherently favours tsunami-tendenko over mutual assistance during disasters. Instead, this paper proposes an alternative ethical foundation for tsunami-tendenko grounded in the ‘antiextinction principle,’ which prioritises minimising the potential for catastrophic outcomes. When considering the ethics of responding to disaster, it is important to distinguish between maximising the number of lives saved (utilitarianism) and minimising the risk of tomo-daore (antiextinction principle). This distinction may be overlooked if the distribution of probabilities is not considered. We conclude that the antiextinction principle aligns more naturally with tsunami-tendenko, emphasising the avoidance of catastrophic outcomes—a concern not always addressed by utilitarianism. Therefore, tsunami-tendenko should be regarded as a societal guideline aimed at preserving community sustainability by averting total destruction. (shrink)

The primary function of the police in a critical incident is the maintenance of public safety, public security, and maintaining public order. This has been further complicated as a result of the increasing presence of the internet, digital communications and social media, all of which hold both promise and challenge. There are many aspects of crisis and disaster management, including communications, interoperability, leadership, and police responsibility. Risk identification and management are essential part of dealing with crises and disasters. There (...) is a significant threat to organizational reputation and public trust for any police or security organization that depends entirely on how that organization responds to a crisis or disaster. -/- This chapter examines Hurricane Katrina (2005) in the USA which caused large-scale damage to infrastructure and loss of life, and the response as handled by some government agencies. The management of crises and disasters is a cyclical process. It includes risk assessment, planning, preparation, mitigation and contingency, response, recovery, and finally, an evaluation. The core features, and the elements of an effective response, of a crisis or disaster, as well as the criticality of effective leadership are examined. This chapter also studies the fundamentals of Disaster Victim Identification (DVI). (shrink)

Natural disasters, technological disasters, and terrorist attacks have an extensive aftermath, often involving society’s institutions such as the legal system and the police. Victims’ perceptions of institutional trustworthiness may impact their potential for healing. This cross-sectional study investigates institutional trust, health, and social support in victims of a disaster that occurred in 1990. We conducted face-to-face interviews with 184 survivors and bereaved, with a 60% response rate 26 years after the disaster. Levels of trust in the police and (...) in the justice system were compared with general population data. We assessed the relationships between institutional trust and current psychological distress, social support, and quality of life. The levels of trust in the police and in the justice system were notably lower in survivors and bereaved than in the general population. Among the victims, low institutional trust was associated with more mental health problems, poorer social support, more barriers to seeking social support, and a lower quality of life. Lost trust in the aftermath of a disaster may perhaps never be restored and the lack of trust may act to strengthen or maintain health problems. An exclusively individualistic approach to trauma and disaster may miss out on the opportunities for promoting health and wellbeing that lies within the larger societal structures. Decision-makers should take this information into account, and acknowledge the potential long-term consequences of institutional performance in the aftermath of a disaster. (shrink)

This article argues that there is no sound basis for thinking that we have a general and strong duty to rectify disparities of wealth around the world, apart from the special case where some become wealthy by theft or fraud. The nearest thing we have to a rational morality for all has to be built on the interests of all, and they include substantial freedoms, but not substantial entitlements to others' assistance. It is also pointed out that the situation (...) of the world's poor is not that of victims of disasters, but simply of less-developed technology, which can be repaired by full and free trade relations with others. The true savior of the world's poor is the businessman, not the missionary. What we do need to do is strike down barriers to commerce, rather than requisition "aid.". (shrink)

The issue of justice after catastrophe is an enormous challenge to contemporary theories of distributive justice. In the past three decades, the controversy over distributive justice has centered on the ideal of equality. One of intensely debated issues concerns what is often called the “equality of what,” on which there are three primary views: welfarism, resourcism, and the capabilities approach. Another major point of dispute can be termed the “equality or another,” about which three positions debate: egalitarianism, prioritarianism, and sufficientarianism. (...) On these topics of distributive justice, authors are concerned with the current difference between the better-off and the worse-off or the present situation of the badly-off. By contrast, it is essential to take account of the past distribution of well-being as well as the present situation in order to explore questions of post-catastrophe justice. Without looking at the pre-disaster distribution of income, preference satisfaction, or basic capabilities among affected people, no present assessment of the damage caused by the disaster could be correct and no proposed remedy adequate. It is true that luck egalitarians assess the current distribution among people by referring to the decision that each individual made. Yet they pay scant attention to the situation in which each one stayed in the past. Therefore, we can legitimately say that most theorists of distributive justice, including luck egalitarians, have failed to give consideration to the past state of each person. -/- To fill this gap in the literature, the present article explores philosophical questions that arise when we take account of each person’s past and present situations in discussing distributive justice regarding public compensation and assistance to survivors and families of victims of natural and industrial disasters. In addressing these novel questions, I develop and refine various concepts, ideas, and arguments that have been presented in the study of distributive justice in normal settings. I tackle two tasks, the first of which is to explore the foundation and scope of luck egalitarianism. Despite the moral appeal it has in many cases, luck egalitarianism has attracted the so-called harshness objection. Some luck egalitarians attempt to avoid this objection in a pragmatic way by combining the luck egalitarian doctrine with the principle of basic needs satisfaction. However, they do not provide any systematic rationale for this combination. In contrast with such pragmatic responses, I seek to offer a principled argument for holding individuals responsible for their choices only when their basic needs are met, by invoking the ideas of respect for human voluntariness and rescue of human vulnerability. Based on this argument, I propose a form of responsibility-sensitive theory, which considers the pre-disaster distribution of well-being as a default position. The second task I take on is to refine sufficientarianism in the context of post-catastrophe justice. Luck egalitarianism with boundaries set by the basic needs principle seems to indicate the potential for sufficientarianism. But major proponents of this view conceive the welfarist assumption, a considerably high standard of well-being, and the controversial treatment of persons staying below the threshold, all of which seem problematic in the post-disaster situation. I try to construct a new version of sufficientarianism by replacing these current features with more robust ones. (shrink)

What is it that makes the involuntarily unemployed, those suffering from genetic disorders and congenital illnesses, and the victims of unforeseen natural disasters the rightful recipients of assistance?

This case illustrates the dilemma facing a medium-sized family business, EMME Logistics and Security Agency that wanted to do more for the victims of the 2013 Typhoon Haiyan. About a third of the company’s personnel had family in the hardest hit areas and were anxious to go to find out if their relatives had survived the wreckage caused by the strongest typhoon ever to hit landfall in the Phillipines. Committing the company’s resources to the relief operation would behampered by a (...) damaged infrastructure and the breakdown of civil order. There would also be significant costs associated with disrupting normal business operations and diverting resources. How much humanitarian assistance should businesses shoulder in response to such events? How should businesses better plan for such disasters? (shrink)

Victims of disaster suffer, not only at the very moment of the disaster, but also years after the disaster has taken place, they are still in an emotional journey. While many moral perspectives focus on the moment of the disaster itself, a lot of work is to be done years after the disaster. How do people go through their suffering and how can we take care of them? Research on human suffering after a major catastrophe, (...) using an ethics of care perspective, is scarce. People suffering from disasters are often called to be in distress and their emotional difficulties ‘medicalised’. This brings them often into a situation of long term use of medication, and one can wonder if medication is of help to them in the long run. In our paper, we will explore another moral perspective, focusing on the importance of the victims’ narrative and their lived experiences. We will use Paul Ricoeur’s phenomenological reflections from ‘Suffering is not the same as pain’ for conceptualizing human suffering and how to apply it to victims of disaster. Ricoeur suggests that suffering is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Above all, the perspective of care and listening could offer an opportunity to reconcile people from their loss and suffering. (shrink)

Liberal egalitarians face unappreciated challenges in explaining why the state should assist citizens in disaster recovery and why the state should ever assist in rebuilding in high-risk areas. Addressing these challenges and justifying state-funded disaster recovery assistance requires invoking the most politically salient aspect of disasters: their tendency to increase social inequality. A liberal egalitarian principle of equal opportunity justifies assistance in recovery, at least for disadvantaged citizens. But further argument is required to show why the (...) state should ever subsidize rebuilding as opposed to relocation, if citizens can have access to equally good opportunities in a low-risk area. I argue that displacement has costs which matter under equal opportunity – but this rationale for disaster recovery extends to other causes of displacement, such as gentrification. (shrink)

Social forestry, in contrast to traditional forestry, is intended to meet biological/environmental, procedural and equity goals. Social forestry projects may not fulfill this multiplicity of goals either because priority is given to a single goal or because various factors including the structure and norms of implementing institutions and the distribution of local power overwhelm procedural and distributive intentions. Thus, despite participatory and equitable project designs, social forestry projects may result in the distribution of benefits to the rich and costs to (...) the poor and products that either have little local value or lose their value over time. Factors leading to these outcomes are explored and countervailing measures considered. (shrink)

In this paper I examine which is the most appropriate moral theory for dealing with disaster bioethics contexts. It is pointed out that, contrary to what is usually believed, moral theories of right action cannot actually guide us in such difficult situations. Instead, it is claimed that a virtue ethics theory of an Aristotelian version, which gives emphasis not only on the virtuous person but also on the relevant developmental process of becoming virtuous, can provide us with the right (...) theoretical framework for coping with the problems which the victims of such disastrous situations face. (shrink)

The present paper argues that the standardised treatment of disaster research and practice perpetuates the production of systematic epistemic injustices against victims of disasters. On the one hand, disaster victims are often prevented from contributing with their opinions and knowledge to the processes of disaster mitigation and disaster conceptualisation. On the other hand, disaster victims tend to lack the hermeneutical resources to make sense of their experiences intelligibly, due to the existence of significant hermeneutical gaps (...) in the hegemonic terminology on the matter. I argue that both forms of epistemic injustice, the testimonial and the hermeneutical, are sustained by an epistemic privilege between the Global North and the Global South in matters of disasters. The second group comprises what I categorise generally as ‘disaster victims’. I identify two forms of structural prejudice that operate against disaster victims: one is the ‘non-expert’ prejudice, and the other is the colonial prejudice. Finally, because of the intercultural nature of disaster environments, I discuss the field of ‘multicultural competencies’ as a useful form of unveiling and counteracting the epistemic injustices contained in both disaster theory and practice. (shrink)

Disaster has a triple violence: the literal event; inequality in rescue efforts; deprivation and coercion prior to physical disaster. Globally, the poor are the most vulnerable in disaster, but there are different degrees of poverty. Although Chile suffered a far more severe earthquake than Haiti, in 2010, the developed infrastructure of Chile allowed for greater resilience. The extreme poverty of Haiti impeded the implementation of humanitarian assistance pledged in the billions. In New Orleans, the exiled poor (...) left behind usable real estate that represented an opportunity for disaster capitalists. The exploitation of the poor in this case is less classic exploitation than depredation. The prevention of depredation will require study, laws prohibiting disaster capitalism, and further emphasis on disaster preparation. (shrink)

Agrifood scholars have long called for changes to the dominant food system, with the goal of making food systems more sustainable and just. This paper focuses on the ways in which recent and future food system shocks provide an opportunity for sustainable transitions in the food system. However, this requires strategic engagement on the part of alternative agrifood initiatives—agrifood niches—otherwise food systems are likely to return to business as usual. Drawing on the multi-level perspective (MLP) within the sustainability transitions framework, (...) core themes that emerge from social science studies of disasters in agrifood systems are identified. These are summarized as resources, polices, and practices that can assist niches in transforming agrifood regimes in response to disasters. The results highlight that while niches are generally independent of governments, niches would be better positioned to engage in post disaster agrifood change if they have some pre-existing connections with local or regional governments. (shrink)

Is there a principled way to understand what liberal democratic states owe, as a matter of justice, to the victims of disasters? This article shows what is normatively special and distinctive about disasters and argues for the view that there are substantial duties of justice for liberal democratic states. The article rejects both a libertarian and a utilitarian approach to this question and, based on broadly Rawlsian principles, argues for a ‘political definition’ of disasters that is concerned with the restoration (...) of citizens' dignity and their capacities for effective citizenship. (shrink)

As I write, I hear that Dr. Jack Kevorluan has delivered another victim to the emergency room of his local Michigan hospital. Why do physicians and terminally ill patients feel we need to change the law with respect to assisted suicide when a rogue pathologist, who has been stripped of his medical license, is allowed to pursue his appetite for providing his clients with inhalation treatments of carbon monoxide gas? If no court will convict this outlaw, what makes the (...) physicians and patients who brought Compassion in Dying v. State of Washington and Quill v. Vacco fear that any court would ever convict a licensed physician of assisting in a suicide when he/she writes one of her established patients a prescription for a short-acting barbiturate? Moreover, it is not even clear that laws against assisted suicide in most jurisdictions were ever intended to apply to the actions of licensed physicians. Nonetheless, the plaintiffs in the Second and Ninth Circuit Courts of Appeals were clearly seeking some kind of redress, some kind of protection from potential legal claims they feared might be made against them. (shrink)

This article focuses on some «disaster ethics» considerations on disaster preparedness and its related responsibilities. After recalling that concerns about preparedness and vulnerability have come to the fore in the domains of «disaster risk reduction» over the last decades, the article will endorse the view that the demarcation between natural disasters and human-induced disasters has becoming blurred and even questionable in many cases. Then, it will be argued that the ethical assessment of disasters needs to consider the (...) entire disaster cycle and that ethical duties extend to the phase of disaster preparedness and require a framework of prospective and shared responsibilities. Accordingly, a number of ethical duties concerning disaster preparedness will be commented upon. Finally, the article will discuss a specific socio-epistemic dynamics of blame assignment that unbalances the appraisal of both vulnerability conditions and moral responsibilities of certain worst-off disaster victims. (shrink)

The aim of the present study was to gain a first-person perspective on the experiences of technology-assisted child sexual abuse (TA-CSA), and a deeper understanding of the way it may affect its victims. Seven young women (aged 17–24) with experience of TA-CSA before the age of 18 participated in individual in-depth interviews. The interviews were teller-focused with the aim of capturing the interviewee’s own story about how they made sense of their experiences over time, and what impact the victimization had (...) on them in the short and long terms. Thematic analysis of the interviews revealed a broad range of abusive experiences that had profoundly impacted the individuals’ lives, health and self-concepts. Three dominant themes emerged from the analysis –From thrilling to abusive,Negative effect on health and wellbeing, andA new self after the abuse.From thrilling to abusivecaptures the wide range of experiences described, starting from the child’s own sexual curiosity to descriptions of having been manipulated or threatened into engaging in sexual activity, as well as the sometimes long and complex process of understanding the severity of one’s experiences.Negative effect on health and wellbeingdescribes the victimization’s comprehensive impact on the life and health of the participants, how they blamed themselves for what had happened, and the struggle of having to live with the constant fear of pictures from the abuse resurfacing.A new self after the abusedepicts how the victimization impacted the way participants viewed and thought about themselves in relation to others, and distorted their views of their bodies. The findings are discussed in relation to previous research on both offline CSA and TA-CSA, as well as theoretical and practical implications. (shrink)

When natural disasters strike, a network of individuals, aid agencies, and corporations join together in a humanitarian effort to provide relief and recovery to those in need. Corporations, in particular, have played an increasing role in disaster assistance by providing financial support, goods, services, and logistic coordination (Muller and Whiteman 2009). Previous research has addressed corporate responses to disaster by investigating the factors that impact the likelihood of giving. Instead of focusing on the likelihood of corporate action, (...) or inaction, we address how different types of compassion are employed by corporations when they engage in disaster relief. We investigate how the use of language signals either strategic or altruistic compassion. (shrink)

In The Case for Animal Rights, Tom Regan argues that, in addition to the negative duty not to harm nonhuman animals, moral agents have a positive duty to assist nonhuman animals who are victims of injustice. This claim is not unproblematic because, in many cases, assisting a victim of injustice requires that we harm some other nonhuman animal(s). For instance, in order to feed victims of injustice who are obligate carnivores, we must kill some other animal(s). It seems, then, (...) that sometimes the duty to assist nonhuman animals who are victims of injustice conflicts with the prima facie duty not to harm nonhuman animals. In defense of Regan’s theory against this apparent inconsistency, I introduce an additional principle, the “guardianship principle,” which can be used to illustrate how we can be justified, under certain conditions, in overriding our prima facie duty not to harm nonhuman animals in order to fulfill our duty to assist nonhuman animals who are victims of injustice. (shrink)

This article examines the bodily donations made by Greeks, Turks and Cypriots to the victims of two devastating earthquakes in Turkey and Greece (1999), as well as to a Greek and a Turkish Cypriot boy, both suffering from leukemia (2000). Considering the age old discourse of amity and enmity shared by the citizens of the three nation states, I ask what made them see these hardly rare events as exceptionally important, and rush to offer each other their blood and body (...) organs. Politicians and journalists of the time presented these corporeal responses as "civil society's demand for brotherly rapprochement," thus underscoring the anthropological insight that contemporary identity politics is increasingly "medicalized". Taking into consideration both the medical regimes of truth that made these donations possible, and the painful political experiences lived and remembered by Greeks, Turks and Cypriots to this day, I argue that the conciliation these donors performed revealed the suspense of their faith in the reconciliatory future rather than their acceptance of restorative notions such as brotherhood and rapprochement. Stated otherwise, these donors, being familiar with the euphemistic and the conditional hence pending nature of such political conciliations, dared the Derridian impossible: without endangering the principle of sharing, they opened their bodies to alterity, to their foe's bodies, and hence entertained the possibility of non-predetermined, thus unexpected even incongruous events of memory. . (shrink)

Victim compensation now plays a central role in dealing with harm. It can be brought into play by various devices: private or social insurance, the courts or special funds created for specific disasters. With each device, compensation raises complex evaluation issues: is it appropriate to use financial compensation to repair harm? Who should pay and on what basis should the compensation be awarded? What is the nature of the damage? How to evaluate it and how to value the amount (...) of compensation determined? These questions are the subject of intense work of evaluation by both those who create or implement the compensation devices and by those who use them. This article looks more specifically at this work of evaluation by people who have endured a collective disaster and who have had to deal with the devices designed to compensate them. (shrink)

En más de 100 conflictos bélicos que se han producido en los últimos diez años, más del 80 por ciento de las víctimas son civiles. Se ha producido un desarrollo acelerado en las investigaciones concernientes a las consecuencias psico-sociales de la guerra en la población civil, la cual es el blanco principal de las víctimas en la guerra contemporánea. Este trabajo constituye una revisión bibliográfica sobre la guerra como desastre, acerca de los conceptos “modernos” de “guerra total”, desastre y las (...) consecuencias psicológicas de la guerra en la población civil, la utilización de los niños como soldados lo cual acarrea desórdenes mentales marcados y se aborda el problema de la violencia sexual como arma de guerra. Las mujeres, las jóvenes, e incluso niñas, son a menudo sometidas, violadas, secuestradas y forzadas a la esclavitud sexual o cualquier tipo de abuso sexual; son vejadas, humilladas y dañadas en lo más profundo de sus sentimientos psicológicos, y valores morales, lo que también trasciende al grupo social, comunidad, clase social o etnia a la que pertenecen. El deterioro o la destrucción de la infraestructura económica, social y política de las naciones en conflicto impide la atención de las necesidades básicas de la población. El trastorno por estrés postraumático es la entidad nosológica más frecuente en las víctimas de la guerra, pero existen otros trastornos mentales que hay que tener en cuenta In over 100 war conflicts that have occurred in the last 10 years, m ore than 80 percent of the victims were civilians. The scope of recent studies has been increasingly focused on psychological and social effects among civilians who are the target and main victims of contemporary wars. This article is an explanation of why war is considered a disaster, a revision of modern terms for war, disaster and the psychological effects of war on civilians, the training of children as soldiers, and the resulting mental disorders. It touches upon sexual violence problem as a war weapon. Women, adolescents and young children are often violated and forced into sexual slavery or any other type of sexual abuse, causing humiliation and psychological, ethical and moral damage, which can affect social groups, communities, social classes, or races. The deterioration or destruction of the economic, social and political infrastructure of the countries in conflict hinders the satisfaction of the citizens' basic needs. The most common psychological effect among war victims is posttraumatic stress, but there are also other mental disorders which must be taken into consideration. (shrink)

One can in all innocence help people who are not victims of injustice. In this essay I argue that women can attempt to provide better opportunities for women in just this spirit, in the way that the members of a trade union will join to assist one another. The observance of this distinction will make it easier for us calmly to assess whether women are on the whole unjustly treated by comparison with men. The word “sexism” is a campaign word (...) that should not be allowed to do our thinking for us. It was coined to invite a comparison with racism. But is there a signifiant analogy here? At the very least, we need to expose the myth of misogyny. There is enough injustice in the world without our having to invent it. (shrink)

The terrorist attacks of 2001 were a reminder that individual and collective safety cannot be taken for granted. Since then, physicians, alongside public health professionals and other healthcare professionals as well as nonhealthcare personnel, have been developing plans to enhance the protection of public health and the provision of medical care in response to various threats, including acts of terrorism or bioterrorism. Included in those plans are strategies to attend to large numbers of victims and help prevent greater harm to (...) even larger populations. (shrink)

Research on fairness in machine learning (ML) has been largely focusing on individual and group fairness. With the adoption of ML-based technologies as assistive technology in complex societal transformations or crisis situations on a global scale these existing definitions fail to account for algorithmic fairness transnationally. We propose to complement existing perspectives on algorithmic fairness with a notion of transnational algorithmic fairness and take first steps towards an analytical framework. We exemplify the relevance of a transnational fairness assessment in a (...) case study on a disaster response system using images from online social media. In the presented case, ML systems are used as a support tool in categorizing and classifying images from social media after a disaster event as an almost instantly available source of information for coordinating disaster response. We present an empirical analysis assessing the transnational fairness of the application’s outputs-based on national socio-demographic development indicators as potentially discriminatory attributes. In doing so, the paper combines interdisciplinary perspectives from data analytics, ML, digital media studies and media sociology in order to address fairness beyond the technical system. The case study investigated reflects an embedded perspective of peoples’ everyday media use and social media platforms as the producers of sociality and processing data-with relevance far beyond the case of algorithmic fairness in disaster scenarios. Especially in light of the concentration of artificial intelligence (AI) development in the Global North and a perceived hegemonic constellation, we argue that transnational fairness offers a perspective on global injustices in relation to AI development and application that has the potential to substantiate discussions by identifying gaps in data and technology. These analyses ultimately will enable researchers and policy makers to derive actionable insights that could alleviate existing problems with fair use of AI technology and mitigate risks associated with future developments. (shrink)

The Philippines sits atop vast mineral deposits estimated to be worth around 47 trillion Philippine Pesos. Yet, mining in the Philippines has a mixed track record as far as its impact on human and economic development is concerned. This paper tries to draw lessons from the Marcopper Mine in Marinduque, Philippines, using a framework—what we call a “mining and human development causality chain”—to begin to think through how extractive industries can contribute to inclusive growth. Essentially, there is a chain of (...) inputs and events that—when properly executed by various stakeholders—could lead to very strong economic and human development outcomes not just for the communities directly affected by the mine but also the country as a whole. Too often, this chain is easily broken by governance. Using a critical analysis of the Marinduque mining disaster, we illustrate how breaking this chain can completely reverse mining’s potential to assist in human development. (shrink)

We say that celebrated accidents shape public perception of safety and risk in health care. Take the so-called celebrated story of the three Colorado nurses who, by administering bezathine penicillin intravenously, caused the death of a neonate. The nurses were charged with criminal negligence, with one pleading guilty to a reduced charge and another fighting the charge and eventually being exonerated. “Celebrated” accidents seem to follow a predictable script and cast participants in recognizable roles. They present heroes, survivors, and victims. (...) And, of course, they put villains, or anti-heroes, center stage – the chief protagonists of a fatal plot. (shrink)

Many philosophers have defended the view that well‐off people or nations have an obligation to assist people who suffer from famine in less developed areas of the world. However, in contrast to this outlook, some theorists have claimed that it is ethically wrong to provide this kind of assistance. In this article the non‐assistance view is discussed. It is argued that even if a neo‐Malthusian population theory is correct and if we accept a maximizing policy which allows the (...) relevant weighing of evils, there may still be an obligation to assist the victims of starvation in poor countries. (shrink)

The way people at the receiving end of humanitarian assistance perceive this intervention may provide invaluable bottom-up feedback to improve the quality of the intervention. We analyzed and mapped Haitians’ views regarding international humanitarian aid in cases of natural disaster. Two hundred fifty participants–137 women and 113 men aged 18-67–who had suffered from the consequences of the earthquake in 2010 were presented with a series of vignettes depicting a humanitarian team's action and were asked to what extent these (...) actions corresponded to what ought to be expected from an international aid mission. Four factors were considered in the vignettes whether the team worked in close association with local institutions, whether it was composed of competent people who were prepared for their mission, whether they treated people as a function of immediate needs, and whether they behaved in a respectful way. Through cluster analysis, five qualitatively different positions were found: Complete hostility to any kind of humanitarian aid ; Strong hostility to humanitarian aid in the case of disrespectful attitudes or behaviors ; Technical competence is the only factor that matters ; Both manifestation of respect for the population and technical competence matter and Undetermined. Most Haitians expect humanitarian teams to be technically competent, but even very competent aid is not considered adequate if provided in an arrogant and disrespectful manner. (shrink)

When healthcare resources become overwhelmed in medical disasters, as they inevitably will, we have to ask, in an unflinching fashion, the question: “What then?” or more precisely, “What should we do when we run out of resources?” In a mass casualty event worthy of the designation, we will indeed run out of resources, perhaps quite quickly. This article provides an ethical framework for the responsible management of medical disasters in which the “What then?” question must be asked. The framework begins (...) with a critique of existing guidance from professional associations of physicians and then argues for an alternative approach that qualifies the obligation to preserve life, takes seriously the ethical challenges of overwhelmed healthcare resources, and countenances physician-assisted suicide as a last resort. (shrink)

An empirical analysis of the relationship between “objectively assessed need” and the formation of NGOs in Andhra Pradesh, India, suggests that the former is not a significant trigger for the latter. The formation of NGOs appears to be a response to perceptions of need that are so far removed from the local level that they fail to prioritize amongst levels and locations of poverty. In the absence of objective feedback mechanisms, the global—and therefore indiscriminate—perspective of international funding sources may help (...) explain the lack of correspondence between need and NGO location, combined with the inevitably limited and blinkered knowledge of regional disparities that can be obtained through local NGOs. This preliminary “epistemological” approach to the question of the sub-optimal formation of NGOs is buttressed by consideration of the factors that may bring perception, reality, and organizational responses into better alignment when natural disasters occur, namely the factors that make natural disasters compelling news stories, unlike chronic underdevelopment. (shrink)

In the Netherlands, euthanasia and assisted suicide are formally forbidden by criminal law, but, under certain strictly formulated conditions, physicians are excused for administering these to patients on the basis of necessity. These conditions are bound up with a long process of criteria development. Therefore, physicians still live in uncertainty. Future court decisions may change the criteria. Apart from that, physicians can always be prosecuted. The position of nurses, however, is perfectly clear; they are never allowed to administer euthanasia or (...) assisted suicide. Nevertheless, they should be involved in the decision-making process because they are an important source of information and have consultation skills. The openness of the discussion about these issues in the Netherlands may prevent an escalation of medical or nursing responsibility and falling victim to the ‘slippery slope’. (shrink)

In the trauma surrounding mass disasters, the need to identify victims accurately and as soon as possible is critical. DNA identification testing is increasingly used to identify human bodies and remains where the deceased cannot be identified by traditional means. This form of testing compares DNA taken from the body of the deceased with DNA taken from their personal items or from close biological relatives. DNA identification testing was used to identify the victims of the terrorist attack on the World (...) Trade Center in New York on September 11, 2001, and of the victims of the Tsunami that hit Asia on December 26, 2004. Shortly after the 9/11 attack, police investigators asked the victims' families for personal items belonging to the missing, and for DNA samples from family members themselves. The New York medical examiner's office coordinated the DNA identification testing program; however, some of the identification work was contracted out to private laboratories. (shrink)

Several European and North American states encourage or even require, via good Samaritan and duty to rescue laws, that persons assist others in distress. This paper offers a utilitarian and contractualist defense of this view as applied to corporations. It is argued that just as we should sometimes frown on bad Samaritans who fail to aid persons in distress, we should also frown on bad corporate Samaritans who neglect to use their considerable multinational power to undertake disaster relief or (...) to confront widespread social ills such as those currently befalling public health (obesity) and the environment (climate change). As such, the corporate duty to assist approach provides a novel justification for sustainable business practices in such cases. The paper concludes by arguing that traditional stakeholder approaches have not articulated this duty of assistance obligation, though a new utilitarian stakeholder theory by Thomas Jones and Will Felps may be coextensive. (shrink)

This article presents a corpus-assisted discourse study of the representations of China’s smog in one Chinese and three Anglo-American English-language newspapers from 2011 to 2014. The findings suggest that they converge in representing China’s smog as a kind of severe air pollution that has some consequences on residents in China and poses a problem that the government must tackle. However, the Chinese English-language newspaper prefers to represent it as a kind of weather phenomenon without serious impact on public health and (...) to construct a positive and responsible image of the Chinese central government. The Anglo-American English-language newspapers are inclined to dramatize it as a disaster with a huge health impact, and construct a negative image of the Chinese government with a view to pressurizing it to take responsibility in the context of climate change. (shrink)

Victims of oppression often disagree amongst themselves on how best to respond to their oppression. Often, these disagreements are cast as disagreements about what strategies of resistance would be most effective. In this article, I argue that victims have a wider repertoire of responses to their oppression which reflect the different underlying reasons they have to respond. I outline three distinct reasons for action—self-respect, assistance, and justice—and the respective responses to oppression—rejection, assistance, and resistance—that these reasons call for. (...) I then provide some general comments on how these distinct reasons and responses relate to one another. Appreciating a wider repertoire of reasons and responses can illuminate the nature of disagreement amongst victims, points to the unavoidability of conflict, and provides for a more nuanced understanding of resistance and its alternatives—an understanding that can aid in better responding to injustice. (shrink)

Bioethical issues are practically urgent, politically divisive, and call for resolutions. They often involve questions that are perplexing, deep, and profound. To deal with them adequately requires philosophical tools and imagination. The Lanson Lectures in Bioethics were founded upon the belief that philosophical elucidation can clarify the nature of these difficult issues, and can lead to their resolution. The present volume collects the first five lectures delivered by five preeminent moral philosophers between 2016 and 2022. In the inaugural lecture, Jonathan (...) Glover draws a distinction between two conceptions of dignity, and brings it to bear on the issues of assisted suicide, embryo research, and genetic choices. F. M. Kamm argues that doctors are morally permitted to intentionally cause death, or assist in its being intentionally caused, when either death is imminent anyway and intentionally causing it can alone stop the pain, or if the patient has already decided—not unreasonably—that death is his least bad option. Are smokers who contract lung cancer entitled to state-supported healthcare? T. M. Scanlon argues that the reasons that individuals have for wanting to have the opportunity to engage in activities involving risks need to be compared with the costs society has to bear to provide healthcare for those who suffer illness or injury as a result of these activities. Rejecting Strawson’s view that a psychiatrist can only “treat” an insane patient, Victor Tadros argues that it is often right to reason with (nonresponsible) mentally ill persons because a psychiatrist needs to see things from their perspectives, and that we should communicate to nonresponsible agents that their wrongdoing is a problem for them and for their victims. Peter Singer proposes solutions to the following questions: How to distribute scarce medical resources and vaccines ethically? Whether to relax the standard for volunteers willing to participate in vaccines research? How to compare the trade-off between saving lives and saving the economy regarding lockdowns? How to prevent pandemics in future? Each lecture is followed by a critical commentary by a moral philosophers or physician in Asia. Each commentary (except the inaugural lecture) is followed by a rejoinder. (shrink)

In the contemporary globalized economy, multinational companies have come to hold considerable power that may previously have rested with nation states. However, state structures remain relevant. With Brexit, the year 2016 featured an exemplary case in which the ongoing importance of nation states came to the fore. Preceding the British referendum to exit the European Union, discourses of national identity were deployed to promote a vote for the anti-globalization campaign. It is against this background that this research investigates how the (...) relationship between multinational corporations and nation states is constructed in news discourse. The underlying assumption is that news actively construct rather than merely reflects the nature of this relationship. Drawing on Social Actor Analysis and Transitivity as a theoretical framework, this study examines news coverage of the BP oil spill that occurred in the United States in 2010 but was caused by a multinational company headquartered in the United Kingdom. The main research question is ‘How does the media establish a link between multinational corporations and nation states?’. To address this central question, this study investigates how corporate responsibility is assigned, the role of the nation state is portrayed and victim status is allocated in the news. Findings show that the nature of the problem is constructed differently according to diverging national interests or priorities of the two nations represented by the media sources analyzed. The study indicates that the discourse around British nationality emphasized in the political struggle around Brexit was already mobilized extensively in the years leading up to the referendum. (shrink)

Over the past 20 years, international development assistance for health has increased, albeit for some diseases more than others. However, the triple crises of food, fuel, and finance have raised questions regarding whether aid flows will continue to increase, or even be maintained in the coming future. Health and education are often the first victims of budget cuts in times of limited funding and competing priorities as they are viewed to be in the realm of “low politics” as opposed (...) to security and military spending, which are seen as “high politics.” Cuts in overseas development aid will have a drastic impact on countries where external funding makes up a significant proportion of national health budgets. Although global health aid accounts for only 0.3% of total expenditures on health globally, in some countries like the Solomon Islands and Mozambique, for example, 82% and 66% of the national health budgets respectively come from external resources. WHO estimates that 23 countries have over 30% of their total health expenditures funded by donors. (shrink)

Victims of injustice are prominent protagonists in efforts to resist injustice. I argue that they have a duty to do so. Extant accounts of victims’ duties primarily cast these duties as self-regarding duties or duties based on collective identities and commitments. I provide an account of victims’ duties to resist injustice that is grounded in the duty to assist. I argue that victims are epistemically privileged with respect to injustice and are therefore uniquely positioned to assist fellow victims. Primarily, they (...) discharge this duty through testimony: victims alert other actors to the need for assistance and initiate and coordinate resistance efforts. I briefly provide an account of oppression that ranges from persecution to structural injustice. Through the examples of torture and ‘manterrupting’, I illustrate the duty and its limits. I outline shortcomings in victims’ epistemic privilege and explore means by which these can be overcome. I respond to objections from demandingness and fairness, arguing that victims have an essential, albeit circumscribed, role to play in defeating injustice. (shrink)

Abstract In light of the complexity of unfolding disasters, the diversity of rapidly evolving events, the enormous amount of generated information, and the huge pool of casualties, emergency responders (ERs) may be overwhelmed and in consequence poor decisions may be made. In fact, the possibility of transporting the wounded victims to one of several hospitals and the dynamic changes in healthcare resource availability make the decision process more complex. To tackle this problem, we propose a multicriteria decision support service, based (...) on the Analytic Hierarchy Process (AHP) method, that aims to avoid overcrowding and outpacing the capacity of a hospital to effectively provide the best care to victims by finding out the most appropriate hospital that meets the victims’ needs. The proposed approach searches for the most appropriate healthcare institution that can effectively deal with the victims’ needs by considering the availability of the needed resources in the hospital, the victim’s wait time to receive the healthcare, and the transfer time that represents the hospital proximity to the disaster site. The evaluation and validation results showed that the assignment of hospitals was done successfully considering the needs of each victim and without overwhelming any single hospital. (shrink)

Background: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse–patient relationships. Aim: This study aimed to understand the experience of nurses who cared for burn (...) victims of the color-dust explosion and the meaning of ethical relationships between nurse and patient. Research design: A qualitative descriptive study using a phenomenological approach. Participants and research context: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi’s method. Ethical considerations: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. Findings Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths. Conclusions: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient–nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving. (shrink)

In late 2012, Hurricane Sandy hit the East Coast of the U.S., causing much suffering and devastation. Those who could have easily helped Sandy’s victims had a duty to do so. But was this a rightfully enforceable duty of justice, or a non-enforceable duty of beneficence? The answer to this question is often thought to depend on the kind of help offered: the provision of immediate bodily services is not enforceable; the transfer of material resources is. I argue that this (...) double standard is unjustified, and defend a version of what I call “Social Samaritanism.” On this view, within political communities, the duty to help the needy—whether via bodily services or resource transfers—is always an enforceable demand of justice, except when the needy are reckless; across independent political communities, it is always a matter of beneficence. I defend this alternative double standard, and consider its implications for the case of Sandy. (shrink)