Politics, Philosophy & Economics, Volume 21, Issue 2, Page 165-189, May 2022. It is generally acknowledged that a certain amount of state intervention in health and health care is needed to address the significant market failures in these sectors; however, it is also thought that the primary rationale for state involvement in health must lie elsewhere, for example in an egalitarian commitment to equalizing access to health care for all citizens. This paper argues that a complete theory of (...) justice in health can be derived from a commitment to correcting market failure, or in other words promoting Pareto-efficiency, in the domain of health. This approach can address familiar problems around access to care, as well as problems related to resource allocation and rationing, the control of health care costs, and the foundations of public health. Egalitarian theories of justice in health cannot make sense of the depth and pervasiveness of state involvement in health and health care; only a theory rooted in the need to correct market failure can. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well (...) as economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

Genes are functional cell segments of DNA within an organism, as well as basic physical units of biological inheritance, which have consequences for human dignity and public interest. Genes and genetic material (DNA strands of nucleotides, genetically altered plants and animals e.g., see Appendix B) are patentable. In the US and around the globe, governments grant genetic patents for new, non-obvious, and useful gene inventions. A wide range of interest groups such as religious leaders, scientists, biotech pharmaceuticals, medical practitioners, health (...) care providers, venture capitalists, medical patients and persons have interests in defining what is subject to patents. Yet, it is at least questionable that genetic inventions, and the ownership of discoveries of gene mutations leading to possible diseases, should be subject to influence by interest groups. Although some genes (cDNA) are currently legally patentable, the question in this examination is whether gene patents should be legally and morally justified. In this work I examine whether gene patents should legally and morally be justified, given the principles of biomedical ethics such as human Beneficence /Autonomy and Justice. I argue that gene patenting is not justifiable, and I consider what can be done to create a system that delivers access to genetic information in the current genetic Intellectual Patent system. This interdisciplinary work is more complex than whether bio-science researchers and corporate entities should hold gene patents, or differentiating the legal question of whether genes are an invention or a discovery in the human genome. Mere responses to these questions would not ultimately solve the genetic justice problem. The justification for genetic appropriation is more complexity, since it is grounded in axiological claims about human dignity and public interest set in an ever changing biomedical/biogenetic technology. To address this complexity, I will draw upon the ideas of “the capability approach” to genetic justice found in the work of Nussbaum and Sen. This work is an interdisciplinary examination of the proper appropriation of natural genetic material and its impact on human dignity. It is argued that genetic material and information should be accessible to all, via heath care, for example. We must look to new ways to achieve genetic justice that promote human flourishing as a public good. (shrink)

The normally staid topics of judicial ethics and the standards for judicial recusal have become the focus of political debates, editorials and letter writing campaigns. Most of the recent focus falls on conservative justices of the US Supreme Court and in particular on their anticipated participation in what is expected to be an important ruling on the constitutionality of the heath care reforms championed by President Obama and the Democratic Party. But the issue is not simply about partisan (...) politics. It's also about the structure of the US federal judiciary and the need to think about the impact of two-career couples on the judicial recusal rules. (shrink)

The relationship of religion and health is often misunderstood owing to a tendency to concentrate on the medical model and to ignore the wider context of heath care. A conceptual--as opposed to a historical--examination of this context reveals nine central religious ideas or categories which provide an ethical foundation and heritage for medical practice and health care delivery. These include doctrines of creation; dominion or stewardship; freedom and responsibility; human dignity or sanctity of life; love or compassion; (...) covenant; justice; vocation; and finitude. A discussion of the complementarity of religion and medicine is necessary and should proceed from these shared values and common concerns. (shrink)

I'm going to focus my comments on a relatively small part of Joe Heath's book, the section on the household division of labour. Although it's a small piece of a much larger picture, I've chosen this area for two reasons: First, it connects with my own interests in issues of family justice. Second, I think for me it highlights a potentially larger problem concerning the relationship between justice and efficiency. When Heath puts the contrast between those (...) who place rights before efficiency in terms of a contrast between the US and Canadian health care systems, I find that I'm in agreement with the argument for efficiency. But when I think about the contrast in terms of the question of the gendered division of domestic labour, I'm less certain that I want to accord efficiency the kind of status it has according to Heath. (I must confess that I've always thought of Canada as the just society, rather than the efficient society. If it turns out.. (shrink)

We summarize key messages from the World Bank report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. A central lesson of the Report is that in decision-making on the path to UHC, procedural fairness matters alongside substantive fairness. Decision systems should be assessed using a complete conception of procedural fairness that embodies core commitments to impartial and equal consideration of interests and perspectives. These commitments demand that comprehensive information is gathered and disclosed and that justifications for policies are (...) publicly debated; that participation in decision-making is enabled; and that these characteristics of the decision system are institutionalised rather than up to the good will of decision-makers. Procedural fairness can improve equity in outcomes, raise legitimacy and trust, and can help make reforms last. While improving procedural fairness can be costly and there are barriers to achieving it, the range of instruments that countries at varying levels of income and institutional capacity have used with some success shows that, in many contexts, advances in procedural fairness in health financing are possible and worthwhile. (shrink)

Studies into the ethical aspects of consumption tend to focus on a limited class of actions that are explicitly understood as “ethical consumption”. The SARS-CoV-2 pandemic provided a context in which other ethical issues and questions of whom we should care for first, and how, suddenly and dramatically gained salience. This article draws on the care literature to explore the reconfiguration of consumption decisions and dilemmas during this period. Building on twenty-eight in-depth interviews, it considers the temporal and (...) spatial dimensions of care and consumption and examines various ethical and ideological considerations that arose, particularly regarding the allocation of care in the face of competing demands. Subsequently, the article problematises mainstream accounts of ethical consumption, arguing for considering a plurality of ethics present within decisions about consumption. It concludes with a call to incorporate a more capacious understanding of care in broader discussions of ethics in consumption. (shrink)

Critical response to John Rawls's The Law of Peopleshas been surprisingly harsh) Most of the complaints centre on Rawls's claim that there are no obligations of distributive justice among nations. Many of Rawls's critics evidently had been hoping for a global application of the difference principle, so that wealthier nations would be bound to assign lexical priority to the development of the poorest nations, or perhaps the primary goods endowment of the poorest citizens of any nation. Their subsequent disappointment (...) reveals that, while the reception of Rawls's political philosophy has been very broad, it has not been especially deep. Rawls has very good reason for denying that there are obligations of distributive justice in an international context. (shrink)

Literature on consumer ethics tends to focus on issues within the public sphere, such as the environment, and treats other drivers of consumption decisions, such as family, as non-moral concerns. Consequently, an attitude–behaviour gap is viewed as a straightforward failure by consumers to act ethically. We argue that this is based upon a view of consumer behaviour as linear and unproblematic, and an approach to moral reasoning, arising from a stereotypically masculine understanding of morality, which foregrounds abstract principles. By demonstrating (...) the importance of context to consumption decisions and articulating the impact of caring relationships, we highlight how such decisions are both complex and situated. This is particularly evident for decisions involving the needs of others, as occurs in family life. We argue that the incorporation of care ethics provides both theoretical insights and a more complete account of consumer ethics. This is explored empirically through an investigation of the ethical dilemmas arising from consumption decisions made by mothers of young children. Such decisions juxtapose an ethical consumption orientation with care for one’s child. Therefore, what has been previously considered a failure to act ethically may in fact be the outcome of complex decision making, which involves competing ethical considerations. We discuss the implications of our findings for theory and practice and how this approach to consumer ethics could be applied more widely. (shrink)

One of the arguments that is often advanced in defence of the public health care system in Canada appeals to the idea that medical care should not be treated as a “commodity.” The recent Romanow Report on the Future of Health Care in Canada, for instance, says that, “Canadians view medicare as a moral enterprise, not a business venture.”1 Public provision is then urged on the grounds that this is the only mode of delivery compatible with this (...) constraint. This argument has received surprisingly little scrutiny, despite the important role that it plays in structuring the recommendations of the report, not to mention the broader public debate. This is unfortunate, since not only is it, in my view, a bad argument, but it is one that actually obscures the rationale for the current public system. It encourages the widely shared misperception that health care is a pure public good in our society (financed through taxation, then provided “for free” to all citizens). Provincial governments in Canada do not, for the most part, deliver health care services directly to the population. What they provide instead is health insurance. They rely primarily upon the private sector to deliver care. Thus the Canadian health care system more closely resembles what is often described as a quasi-market, or a “public market.” The justification for the role of the public sector in health care can be traced back to market failure in the insurance sector, and not in the market for health care services. (shrink)

This book analyses tensions that arise between the principles of social justice and the need for cooperation to advance collective goals.

Kevin Sauvé has recently argued in this journal that David Gauthier's conception of ‘morals by agreement’ is inimical to the development of long-term productive investment and sustainable levels of resource exploitation. According to Sauvé, this is because society is confronted with an intergenerational interaction problem whose strategic equilibrium is suboptimal. However, unlike the ‘contemporaneous Prisoner's Dilemma’ that Gauthier analyzes, the intergenerational version cannot be solved by an appeal to constrained maximization. As a result, Sauvé claims, Gauthier cannot effectively address the (...) question of intergenerational justice.The portion of Sauvé's argument that concerns me is the following:Gauthier solves the contemporaneous Prisoner's Dilemma by ensuring that each person will cooperate only if all others cooperate, and indeed his conception of morality is aimed at ensuring that all individuals incur the costs as well as the benefits of social cooperation. But the contemporaneous solution cannot be applied to the Intergenerational Dilemma: if each generation will save for the next only if the previous generations have also saved, none will ever save. (shrink)

This article examines the tensions in the identities of men who belong to the Promise Keepers movement by uncovering the social conditions that lead men to rethink gender and racial ideologies. Using participant observation and in-depth interviews, the author draws on gender and social movement scholarship to reveal how contradictory gender and racial ideologies shape PKs' identities. Furthermore, the PKs' impact on gender and race relations is also contradictory. PK fosters men's growth on an interactional level, allowing men to embrace (...) a more expressive and caring masculinity that includes cross-racial bonding. Simultaneously, however, PK ignores, and indirectly reinforces, the structural conditions that underpin gender and racial privilege among white men. (shrink)

The prelims comprise: Utilitarianism Rawls Libertarianism Post‐Rawlsian Egalitarianism The Bounds of Justice Beyond Justice as Distribution Conclusion Acknowledgments References.

In this paper, I would like to discuss two recent attempts to incorporate groupdifferentiated rights and entitlements into a broadly liberal conception of distributive justice. The first is John Roemer’s “pragmatic theory of responsibility,” and the second is Will Kymlicka’s defense of minority rights in “multinational” states.1 Both arguments try to show that egalitarianism, far from requiring a “color-blind” system of institutions and laws that is insensitive to ethnic, linguistic or subcultural differences, may in fact mandate special types of (...) rights, entitlements, or compensatory arrangements for members of minority groups. These proposals are attractive because they attempt to ground these special rights without reference to controversial philosophical doctrines, but merely through appeal to the widely accepted political norm of equality. Furthermore, if either of these arguments were to succeed, it would allow liberals to avoid many of the difficulties that have often led proponents of “the politics of difference” or the “politics of recognition” to adopt an oppositional stance toward more traditional forms of liberalism.2.. (shrink)

"Although the task of formulating an appropriate policy response to the problem of anthropogenic climate change is one that raises a number of very difficult normative issues, environmental ethicists have not played an influential role in government deliberations. This is primarily due to their rejection of many of the assumptions that structure the debates over policy. This book offers a philosophical defense of these assumptions, in order to overcome the major conceptual barriers to the participation of philosophers in these debates. (...) There are five important barriers: First, the policy debate presupposes a stance of liberal neutrality, as a result of which it does not privilege any particular set of environmental values over other concerns. Second, it assumes ongoing economic growth, along with a commitment to what is sometimes called a weak sustainability framework when analyzing the value of the bequest being made to future generations. Third, it treats climate change as fundamentally a collective action problem, not an issue of distributive justice. Fourth, there is the acceptance of cost-benefit analysis, or more precisely, the view that a carbon pricing regime should be guided by our best estimate of the social cost of carbon. And finally, there is the view that when this calculation is undertaken, it is permissible to discount costs and benefits, depending on how far removed they are from the present. This book attempts to make explicit and defend these presuppositions, and in so doing offer philosophical foundations for the debate over climate change policy"--. (shrink)

It is not clear whether the social contract is supposed to merely supplement the unequal gains that individuals are able to make through the exercise of their natural endowments with a set of equal gains secured through social cooperation, or whether the social contract must also compensate individuals for the effects of these natural inequalities, so that they literally become all equal. The issue concerns, in effect, whether natural inequality falls within the scope of egalitarian justice. I think it (...) is fair to say that the majority of egalitarians assume that the principle of equality imposes an obligation to redress natural inequality. Yet there is no consensus on this issue. David Gauthier has made the rejection of the principle of redress a central component of his project. It has often escaped notice that John Rawls also rejects the principle of redress. Thus it is not just anti-egalitarians who reject the principle of redress. There is a current of egalitarian thought – which we might call, for lack of a better term, narrow-scope.. (shrink)

This book advances a novel theory of international justice that combines the orthodox liberal notion that the lives of individuals are what ultimately matter morally with the putatively antiliberal idea of an irreducibly collective right of self-governance. The individual and her rights are placed at center stage insofar as political states are judged legitimate if they adequately protect the human rights of their constituents and respect the rights of all others. Yet, the book argues that legitimate states have a (...) moral right to self-determination and that this right is inherently collective, irreducible to the individual rights of the persons who constitute them. Exploring the implications of these ideas, the book addresses issues pertaining to democracy, secession, international criminal law, armed intervention, political assassination, global distributive justice, and immigration. A number of the positions taken in the book run against the grain of current academic opinion: there is no human right to democracy; separatist groups can be morally entitled to secede from legitimate states; the fact that it is a matter of brute luck whether one is born in a wealthy state or a poorer one does not mean that economic inequalities across states must be minimized or even kept within certain limits; most existing states have no right against armed intervention; and it is morally permissible for a legitimate state to exclude all would-be immigrants. (shrink)

The nineteenth century was a period of unprecedented productivity in the world, occasioned by the widespread development and practice of contract and voluntary exchange. For the first time in history, man began to cease, like other animals, to be essentially predatory on his environment, despoiling and exhausting it, and began instead to make it progressively more productive and more able to support his own kind. Thomas Robert Malthus lived well into this productive century, but his thinking remained in the past, (...) as did that of his contemporary, David Ricardo, and his successors, the Classical Economists, including even J.S. Mill. In this essay Spencer Heath carefully refutes Ricardo’s argument in support of Malthus and stresses the importance of understanding man not in terms of his animal nature, but in terms of his uniquely human potential; that is, his evolving, creative nature. (shrink)

One of the most important themes in recent thinking about racial justice in the United States has been a shift in emphasis away from the traditional issue of racial discrimination, toward an exploration of the various forms of privilege that dominant groups enjoy. Many of the privileges that whites have been encouraged to explore, however, do not stem directly from their racial identity, but rather from the fact that they belong the majority demographic group. Describing these benefits as a (...) “privilege” is often intended to suggest that there is something objectionable or unjust about them. On closer examination, that claim turns out to be extremely controversial. This paper examines some of the major arguments that have been made by egalitarian philosophers on this question, before concluding with a few take-away lessons for issues of pedagogy and racial justice. (shrink)

The term “political” egalitarianism is used here, not to refer to equality within the political sphere, but rather in John Rawls’s sense, to refer to a conception of egalitarian distributive justice that is capable of serving as the object of an overlapping consensus in a pluralistic society.1 Thus “political” egalitarianism is political in the same way that Rawls’s “political” liberalism is political. The central task when it comes to developing such a conception of equality is to determine what constraints (...) a principle of equality must satisfy in order to qualify as “freestanding,” or to be justifiable in a way that does not presuppose the correctness of any one member of the set of reasonable yet incompatible “religious, philosophical and moral” doctrines that attract large numbers of adherents in our world.2 (Rawls uses the analogy of a “module” in order to describe the way that a properly political conception of justice “fits into and can be supported by various reasonable comprehensive doctrines that endure in the society regulated by it.”3 Political egalitarianism would be “modular” in this sense.) Rather than getting embroiled in the controversies that have arisen over Rawls’s formulation of this idea, I would like simply to accept the intuition, widespread among political philosophers, that equality is the sort of principle that – if given a proper formulation – could satisfy the requirements of a political conception of justice. After all, regardless of what peoples’ projects, values, or conceptions of the good life may be, it should be possible to design a set of arrangements that would provide equal opportunity to pursue these goals, or that would treat each conception of the good with equal respect, etc. From this perspective, the principle of equality resembles the principle of Pareto-efficiency, or certain formulations of the principle of liberty – it is one that everyone should be able to endorse, insofar as it does not privilege, or presuppose the correctness of, any particular set of projects, values.. (shrink)

There are four basic models for health care systems: the private market insurance model, the national single-payer model, the national health service model, and the social insurance model. The social justice debate over health care usually focuses on the comparative efficiency and quality of competitive private market insurance and the universal coverage and equity of national health care systems. It is a mistake, however, to think that a universal right to health care services requires a (...) single-payer, government-run, national health care system. The social insurance model of Germany, France, Japan, and many other countries, deserves more attention, as it incorporates the strengths of both market models and national health care models. (shrink)

Joseph Heath1 The Pareto principle states that if a proposed change in the condition of society makes at least one person better off, and does not make anyone else worse off, then that change should be regarded as an improvement. This principle forms the conceptual core of modern welfare economics, and exercises enormous influence in contemporary discussions of justice and equality. It does, however, have an Achilles’ heel. When an individual experiences envy, it means that improvements in the condition (...) of others may worsen the condition of that individual. As a result, envy has the potential to block a vast range of changes that we might intuitively be inclined to regard as Pareto improvements. (Or more precisely, envy results in too many states getting classified as Pareto-optimal, not because, intuitively, they cannot be improved upon, but because no one’s condition can be improved upon without making someone else envious.) For example, a market exchange between two people might not wind up being classified as a Pareto improvement if the benefits produced for the two parties generated envy in some otherwise uninvolved third. (shrink)

It has been said that ‘the history of Pindaric criticism is the history of the cardinal problem, unity’; but this history has yet to be fully explored. Young's pioneering study passes dismissively over the centuries preceding the publication, in 1821, of Boeckh's commentary—a landmark, indeed, but Boeckh's approach to the poet did not spring into being from nothing; it was the product of a long tradition of careful study, in which Pindar had been widely admired and diversely understood. This paper (...) attempts to document that claim; its primary purpose is therefore historical. But the study of the history of scholarship is of most value when it helps us to understand our own place in that history, disclosing and encouraging us to think critically about our tacit or ill-considered assumptions. I shall therefore conclude by pointing briefly to a possible implication of this history for some more recent work on the poet. (shrink)

Euthanasia advocates have recently begun counseling people to create advance directives calling for oral food and water to be withheld if the person reaches a certain stage of dementia. The author shows that these directives are in fact requests for euthanasia, and they leave vulnerable people subject to poor-quality care. Both surrogate decision makers and Catholic institutions have a moral obligation not to implement such directives, and surrogates, rather than withdrawing as proxies, have a moral obligation to advocate for (...) the life and proper care of the incompetent person. Finally, the author argues that society is morally culpable if it does not strongly resist euthanasia in all its forms. National Catholic Bioethics Quarterly 16.3 : 421–434. (shrink)

Support for the extreme right in Britain has been relatively low in Britain in recent years and has not shown the surge apparent in a number of other European countries. The paper uses data from the 1979 British Election survey to examine the characteristics of care and peripheral National Front supporters at the time of their last surge in support, and then goes on to consider why support has remained low in recent years. The 1979 evidence shows that support (...) for the National Front was strongly linked to racist attitudes but in other respects had a 'protest' character. It is suggested that the subsequent weakness of the extreme right in Britain may be due to its single-issue character and to the availability of more attractive alternatives for protest voters such as the Liberal Party. (shrink)

Egalitarian liberal political philosophers have been at pains to show that there is a nonnegligible “place” for liberty within the framework of an egalitarian theory of justice. Thus, many have insisted that, when redistribution is required in order to achieve greater equality, assets should be transferred in the most abstract form possible, ideally through a system of cash transfers. In this article we argue that this strategy has the potential to generate significant violations of neutrality. The problem arises from (...) the fact that individuals with certain rates of time preference often want to use social institutions as self-binding mechanisms and as a result may exhibit a preference for in-kind benefits or other institutional arrangements that are frequently misclassified as paternalistic. We argue that egalitarians who rely on cash transfers as a way of accommodating the demands of liberty do so at the expense of neutrality. (shrink)

The factions debating health care reform in the United States have gravitated toward one of two positions: that just health care is an individual responsibility or that it must be regarded as a national concern. Both arguments overlook a third possibility: that justice in health care is multilayered and requires the participation of multiple and diverse communities. _Communities of Health Care Justice_ makes a powerful ethical argument for treating communities as critical moral actors that play (...) key roles in defining and upholding just health policy. Drawing together the key community dimensions of health care, and demonstrating their neglect in most prominent theories of health care justice, Charlene Galarneau postulates the ethical norms of community justice. In the process, she proposes that while the subnational communities of health care justice are defined by shared place, including those bound by culture, religion, gender, and race that together they define justice. As she constructs her innovative theorization of health care justice, Galarneau also reveals its firm grounding in the work of real-world health policy and community advocates. _Communities of Health Care Justice_ not only strives to imagine a new framework of just health care, but also to show how elements of this framework exist in current health policy, and to outline the systemic, conceptual, and structural changes required to put these justice norms into fuller practice. (shrink)

The ethic of care has often been opposed to the ethic of justice as offering a different and even a contradictory approach to moral problems. This article argues that, from the perspective of the discourse ethic, both approaches are complementary in a very fundamental sense, since each one applies to one of two stages of moral reasoning that are as different as they are interconnected. It argues, in particular, that while justice is concerned with the justification and (...) elaboration of norms, care is concerned with finding a solution for specific moral situations. The article then places considerations of care at the centre of ideal discourse and subordinates the importance of rational understanding and moral justification to intuitive communication. (shrink)

Background and AimsEnd-of-life discussions can be difficult for seriously ill adolescents and young adults. Researchers aimed to determine whether completing Voicing My CHOiCES —a research-informed advance care planning guide—increased communication with family, friends, or health care providers, and to evaluate the experience of those with whom VMC was shared.MethodsFamily, friends, or HCPs who the AYAs had shared their completed VMC with were administered structured interviews to assess their perception of the ACP discussion, changes in their relationship, conversation quality, (...) and whether the discussion prompted changes in care. Open-ended responses underwent thematic analysis.ResultsOne-month post-completion, 65.1% of AYA had shared VMC completion with a family member, 22.6% with a friend, and 8.9% with an HCP. Among a sample of respondents, family and friends reported a positive change in their relationship with the AYA. Participant descriptions of the experience fell into five themes: positive experience, difficult experience, appreciated a guide to facilitate discussion, provided relief, and created worry/anxiety. Only 1 HCP noted a treatment change. Family, friends, and HCP did not think the AYA would have discussed EoL preferences without completing VMC.ConclusionsVMC has potential to enhance communication about ACP between AYA and their family and friends, though less frequently with HCPs. Participants reported a positive change in their relationship with the AYA after discussing VMC, and described experiencing the conversation as favorable, even when also emotionally difficult. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the (...) wealthy. After exploring specific discrepancies in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)

This open access book presents an ethical approach to utilizing personal medical data. It features essays that combine academic argument with practical application of ethical principles. The contributors are experts in ethics and law. They address the challenges in the re-use of medical data of the deceased on a voluntary basis. This pioneering study looks at the many factors involved when individuals and organizations wish to share information for research, policy-making, and humanitarian purposes. -/- Today, it is easy to donate (...) blood or even organs, but it is virtually impossible to donate one’s own medical data. This is seen as ethically unacceptable. Yet, data donation can greatly benefit the welfare of our societies. This collection provides timely interdisciplinary research on biomedical big data. Topics include the ethics of data donation, the legal and regulatory challenges, and the current and future collaborations. -/- Readers will learn about the ethical and regulatory challenges associated with medical data donations. They will also better understand the special nature of using deceased data for research purposes with regard to ethical principles of autonomy, beneficence, and justice. In addition, the contributors identify the key governance issues of such a scheme. The essays also look at what we can learn in terms of best practice from existing medical data schemes. (shrink)

Reviews the basic Catholic moral principles that apply to health care, then uses them to assess three major current trends in the health care industry.

Cardiopulmonary resuscitation is frequently performed on patients who, in retrospect, had a very low chance of survival. This is because all patients are ‘For cardiopulmonary resuscitation’ on admission to hospital by default, and delays occur before cardiopulmonary resuscitation can be ‘de-prescribed’. This article reviews the nature of potential harms caused by futile cardiopulmonary resuscitation, the reasons why de-prescription may be delayed, recent legal judgements relevant to timely do not attempt cardiopulmonary resuscitation decision making, and the possible detrimental effects of do (...) not attempt cardiopulmonary resuscitation discussions on end of life care. The moral and operational feasibility of a model in which informed consent must be obtained before cardiopulmonary resuscitation is attempted in some patient groups is then explored. (shrink)

After an opening chapter framing the issues of the book, the next two explore how WN, by emphasizing economic ends rather than those of classical or republican politics, reduces justice to historically evolved rules for securing lives and property and renders government subservient to economic policy. The fourth chapter notes the complexity of Smith's moral psychology, pointing out how WN emphasizes the acquisition of the very material ends which TMS discredits. Nonetheless, both works endorse "bourgeois virtue," whether characterized in (...) terms of industry and thrift or prudence. It is not surprising, as Minowitz points out in chapter 5, that Smith's view of international relations decries nationalism, mercantilism, and war, and elevates commerce, free trade, and the promise of civilizing progress. (shrink)

FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand (...) community perceptions of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)