When is it fair that some people are less healthy than others due to their own individual choices and preferences? In this paper, I explore two alternative answers. The first is a luck-egalitarian account that holds people responsible for choices that society could have reasonably expected them to avoid. I argue that this account is indeterminate and go on to sketch an alternative proposal based on Rawls’s idea of a “social division of responsibility.” This latter approach connects the (...) notion of responsibility for health to the social conditions under which health-related behaviour is developed. (shrink)

This paper seeks to define and delimit the scope of the social responsibilities of health professionals in reference to the concept of a social contract. While drawing on both historical data and current empirical information, this paper will primarily proceed analytically and examine the theoretical feasibility of deriving social responsibilities from the phenomenon of professionalism via the concept of a social contract.

It is natural to think that there is a tight connection between whether someone is responsible for some outcome and whether it is appropriate to hold her accountable for that outcome. And this natural thought naturally extends to health: if someone is responsible for her health, then, all else being equal, she is accountable for it. Given this, some have thought that responsibility for health has an important role to play in distributing the benefits and burdens (...) of healthcare. But there is a reason for caution. That health is influenced by social, economic, and environmental factors is a matter of consensus. And some have argued that in light of these social determinants of health, individuals are not typically responsible for their health, rendering inappropriate policies that employ a responsibility‐for‐health criterion. This debate implicates a number of overlapping concepts and questions that are often difficult to pull apart. And I worry that those who maintain that social determinants undermine responsibility for health have latched on to the wrong target. The social determinants of health are relevant to such policies, but, I argue, not by globally undermining responsibility. Rather, social determinants are sometimes responsibility‐undermining, sometimes responsibility‐preserving, and often relevant to whether we should hold individuals accountable for their health regardless of their responsibility. This calls for a more nuanced appraisal of the ways in which the social determinants of health are relevant to such policies. And here I attempt to provide one. (shrink)

The COVID-19 pandemic requires emergency policies to be put in place in order to avoid a global health catastrophe. At the same time, there has been an increasing preoccupation that argues urgent policies for public health neglect social justice. By looking at Portugal’s successful confinement case during the early stages of the pandemic, I argue that ethically driven social justice policies are not just compatible but also an instrumentally important element in addressing this pandemic in an (...) effective way. The Portuguese case study suggests that enhancing social justice towards socio-economically vulnerable groups correlates with the prevention of the spread of COVID-19; these benefits to public health can be explained by the fact that those policies create social distancing and less exposure to the COVID-19 virus and other contagious diseases and also remove disincentives to the use of healthcare services. (shrink)

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from (...) former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. (shrink)

In a democratic society, the social rules are imposed by all upon each. As “recipients” of the rules, we tend to think that they should be designed to engender the best attainable distribution of goods and ills or quality of life. We are inclined to assess social institutions by how they affect their participants. But there is another, oft-neglected perspective which the topic of health equity raises with special clarity: As imposers of the rules, we are inclined (...) to think that harms we inflict through the rules have greater moral weight than like harms we merely fail to prevent or to mitigate. What matters morally is not merely how we affect people, but how we treat them through the rules we impose. While current (consequentialist and Rawlsian) theorizing is dominated by the first perspective and thus supports purely recipient-oriented moral conceptions, an adequate approach to social justice requires a balancing of both. Such balancing results in a relational conception of justice, which distinguishes various ways in which an institutional scheme may causally affect the quality of life of its participants.This essay argues that the strength of our moral reason to prevent or mitigate particular medical conditions depends not only on what one might call distributional factors, such as how badly off the people affected by these conditions are in absolute and relative terms, how costly prevention or treatment would be, and how much patients would benefit from given treatment. Rather, it depends also on relational factors, that is, on how we are related to the medical conditions they suffer. It then discusses some implications of this view for understanding responsibilities for international health outcomes. (shrink)

The food industry faces many significant risks from public criticism of corporate social responsibility (CSR) issues in the supply chain. This paper draws upon previous research and emerging industry trends to develop a comprehensive framework of supply chain CSR in the industry. The framework details unique CSR applications in the food supply chain including animal welfare, biotechnology, environment, fair trade, health and safety, and labor and human rights. General supply chain CSR issues such as community and procurement (...) are also considered. Ultimately, the framework serves as a comprehensive tool to support food industry practitioners and researchers in the assessment of strategic and operational supply chain CSR practices. (shrink)

Reflections about the role of human choice in determining personal health occur in the writings of practitioners and laymen throughout history. The Greek and Roman writers emphasized the effect of life's activities. During the Middle Ages and Renaisance, disease continued to be seen as a consequence of disorder of the bodily humors, which were under the individual's control. The rise of the paternalistic national regimes in Europe produced the view that society had the responsibility to maintain health. (...) Jacksonian egalitarianism led to a reaction against the agressive therapies of established professional experts, a view furthered by the Thomsonian belief that people should wrest control of their health away from orthodox physicians. Among the twentieth century reactions was the movement to urge people to have doctors evaluate laypersons' health. By the 1970s a movement emerged emphasizing again personal responsibility, which, in turn, produced a concern that this was merely "victim-blaming". Views on the role of lay people in determining personal health are heavily influenced by prevailing social, political, and moral climates. Keywords: "responsibility for health: social, personal, or professional?", "causes of illness", "self-reliant health care", historical influences, responsibility for health, "victim-blaming" CiteULike Connotea Del.icio.us What's this? (shrink)

Health policy sometimes hinges on claims about the responsibility borne by people or corporations for health outcomes. We don't want these claims to be arbitrary, so we construe them as discoveries of plain fact. But we're mistaken. They are interwoven with our values and social institutions. Recognizing that they are allows us to debate them more honestly and thoroughly.

The problems of global health are truly terrible. Millions suffer and die from diseases like tuberculosis, HIV/AIDS, and malaria. One way of addressing these problems is via a Global Health Impact labeling campaign. If even a small percentage of consumers promote global health by purchasing Global Health Impact products, the incentive to use this label will be substantial. One might wonder, however, whether consumers are morally obligation to purchase any these goods or whether doing so is (...) even morally permissible. This paper suggests that if the proposal is implemented, purchasing Global Health Impact labelled goods is at least morally permissible, if not morally required. Its argument should, moreover, be of much more general interest to those considering different kinds of ethical consumption. (shrink)

The concept of responsibility for health is a significant feature of health discourse and public health policy, but application of the concept is poorly understood. This paper offers an analysis of the concept in two ways. Following an examination of the use of the word ‘responsibility’ in the nursing and wider health literature using three examples, the concept of ‘responsibility for health’ as fulfilling a social function is discussed with reference to (...) policy documents from the UK. The philosophical literature on moral responsibility is introduced, and in considering two versions, reactive attitudes and accountability, it is argued that in application both can be regarded, though with different emphasis, as being constituted in three parts: a responsible agent; having obligations ; and being susceptible to being held responsible if he fails to meet them. The three‐stage model is consistent with the examples of the word responsibility in use, but application to the social function model causes a number of problems for healthcare practice, especially for the reactive attitudes account. Apart from considerable problems in stating what exactly the obligations are and how they can be justified; and how blame might justly be apportioned and by whom, the very ideas of obligation and blame are in conflict within healthcare systems and professional nursing practice which have foundations deeply embedded in the notion of the supremacy of personal autonomy. It is concluded that current application of the concept of responsibility for health is conceptually incoherent, and if it is to retain its place in health policy and discourse, urgent remedy is required. (shrink)

The publication of the Report of the International Bioethics Committee of Unesco on Social responsibility and health provides an opportunity to reshape the conceptual framework of the right to health care and its practical implications. The traditional distinctions between negative and positive, civil-political and economic-social, legal and moral rights are to be questioned and probably overcome if the goal is to pursue ‘the highest attainable standard of health’ as a fundamental human right, that should (...) as such be guaranteed to every human being. What we are called upon to, is the commitment not to exclude now and forever anyone from having access to the ‘excellence’ of scientific and medical progress. Therefore, the addressees of this ‘responsibility’ cannot be just the governments and the states within the limits of their ‘jurisdiction’. The challenge is to tackle at the same time the social and global determinants of health. (shrink)

Fast food companies like Siam Burger that participate in health awareness campaigns create a conflict of interest between the social responsibility of promoting health and the business interest of increasing sales through marketing strategies like advertising. Alternative options of raising health awareness without mitigating the involvement of fast food companies either by denying advertisements or having a third party foundation should be explored.

Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using (...) a hypothetical scenario. We conducted two 2-h Fairness Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed that personal choice played an important role in participants’ thinking about health. Underlying the concept of personal choice was considerations of freedom and societal debt. In participants’ minds, personal and social responsibilities co-existed and they were unwilling to determine health care priority based on personal responsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons’ views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited. (shrink)

The conventional approach to international development by civil society—that is, the installation of “Western” programs and institutions by “Western” groups in “underdeveloped” regions—has remained largely unchanged since global poverty reduction, whether for political or social justice motivations, gained prominence in public discourse after World War II. Yet poverty rates, literacy, life expectancy, and unemployment in one of the poorest regions of the world, sub-Saharan Africa, has remained the same if not worsened since the 1970s . And, still, the great (...) Development Project continues: Problems in under-resourced areas are identified by well-meaning people from well-resourced areas, proposals to solve those problems are crafted by project managers and submitted to government and nongovernmental agencies, and successful projects are implemented by other well-meaning people who, for the most part, honestly want to make a difference. This is the system in which Priya seems to .. (shrink)

Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system is a TBI-specific extension of the PROMIS and Neuro-QoL measurement systems that includes 20 item banks across physical, emotional, social, and cognitive domains. Previous research has evaluated the responsiveness of the TBI-QOL measures in community-dwelling individuals and found clinically important change over a 6-month (...) assessment interval in a sample of individuals who were on average 5 years post-injury. In the present study, we report on the responsiveness of the TBI-QOL Cognition–General Concerns and Executive Function item bank scores and the Cognitive Health Composite scores in a recently injured sample over a 1-year study period. Data from 128 participants with complicated mild, moderate, or severe TBI within the previous 6 months were evaluated. The majority of the sample was male, white, and non-Hispanic. The participants were 18–92 years of age and were first evaluated from 0 to 5 months post-injury. Eighty participants completed the 1-year follow-up assessment. Results show acceptable standard response mean values for all measures and minimal detectable change values ranging from 8.2 to 8.8 T-score points for Cognition–General Concerns and Executive Functioning measures. Anchor rating analysis revealed that changes in scores on the Executive Function item bank and the Cognitive Health Composite were meaningfully associated with participant-reported changes in the areas of attention, multitasking, and memory. Evaluation of change score differences by a variety of clinical indicators demonstrated a small but significant difference in the three TBI-QOL change scores by TBI injury severity grouping. These results support the responsiveness of the TBI-QOL cognition measures in newly injured individuals and provides information on the minimal important differences for the TBI-QOL cognition measures, which can be used for score interpretation by clinicians and researchers seeking patient-reported outcome measures of self-reported cognitive QOL after TBI. (shrink)

Growing public concern and uncertainties surrounding emerging technologies suggest the need for socially-responsible behavior of companies in the development and implementation of oversight systems for them. In this paper, we argue that corporate social responsibility (CSR) is an important aspect of nanotechnology oversight given the role of trust in shaping public attitudes about nanotechnology and the lack of data about the health and environmental risks of nanoproducts. We argue that CSR is strengthened by the adoption of stakeholder-driven (...) models and attention to moral principles in policies and programs. In this context, we examine drivers of CSR, contextual and leadership factors that influence CSR, and strategies for CSR. To illustrate these concepts, we discuss existing cases of CSR-like behavior in nanotechnology companies, and then provide examples of how companies producing nanomedicines can exhibit morally-driven CSR behavior. (shrink)

: Background: In responsible research and innovation (RRI), innovation is seen as a way in which humankind finds solutions for societal issues. However, studies on commercial innovation show that firms respond in a different manner and at a different speed to the same societal issue. This study investigates what role organizational motives play in the product innovation processes of firms when aiming for socially responsible outcomes. Methods: This multiple-case study investigates the motives of food firms for healthier product innovation by (...) interviewing firms about the organizational motives behind product reformulation and innovation. Results: This study highlights the importance of having both instrumental and moral motives in the innovation process when aiming for socially responsible outcomes, and how both these motives interact and contribute to responsible innovation in industry. Furthermore, the study results question the nature of relational motives as a separate category from the other two categories of motives, as suggested by corporate social responsibility (CSR) scholars. Conclusions: If commercial innovation needs to contribute to solutions for societal issues, the importance of moral motives has to be stressed without annihilating the instrumental objectives of firms. Both motives contribute to the success factors of responsible product innovation in industry. (shrink)

The Article focuses on the concept of social solidarity, as it is used in the Report of the International Bioethics Committee On Social Responsibility and Health. It is argued that solidarity plays a major role in supporting the whole framework of social responsibility, as presented by the IBC. Moreover, solidarity is not limited to members of particular groups, but potentially extended to all human beings on the basis of their inherent dignity; this sense of (...) human solidarity is a necessary presupposition for a genuinely universalistic morality of justice and human rights. (shrink)

Changes in modern societies originate the perception that ethical behaviour is essential in organization’s practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility. Recently the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health has addressed this concept of social responsibility in the context of health care delivery suggesting a new paradigm (...) in hospital governance. The objective of this paper is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness. The scope of this responsible behaviour requires hospitals to fulfil its social and market objectives, in accordance to the law and general ethical standards. Social responsibility includes aspects like abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care. In conclusion, adequate corporate governance and corporate strategy are the gold standard of social responsibility. In a competitive market hospital governance will be optimised if the organization culture is reframed to meet stakeholders’ demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility. (shrink)

This book discuss the meaning and implications of the social and ethical implications of the notion of social responsibility in healthcare in six major world religions — Buddhism, Christianity, Confucianism, Hinduism, Islam, & Judaism. This collection of papers is based on a four-day workshop where bioethics experts from various religious traditions gathered. They discussed the ways in which their respective traditions could, or could not, uphold the tenets of Article 14 of UNESCO's Universal Declaration of bioethics and (...) Human Rights. The different papers presented in this book are based on this interchange of ideas at the workshop. The book explores the potential points of convergence among the various perspectives presented, as well as a discussion on the ways in which their moral differences may be managed. The managing of these moral differences through international socio-ethical mechanisms, contributes significantly to the UNESCO Universal Declaration of Bioethics and Human Rights’ goal of simultaneously respecting religio-cultural pluralism while upholding a commitment to human rights. (shrink)

Today there is a growing wave of demands being placed upon the pharmaceutical industry to contribute to improved access to medicines for poor patients in the developing countries. 1 This article aims to contribute to the development of a systematic approach and broad consensus about shared benchmarks for good corporate practices in this area. A consensus corridor on what constitutes an appropriate portfolio of corporate responsibilities for access to medicines -especially under conditions of 'failing states' and 'market failure' 2 – (...) is not only in the interest of the world's poor, but also of corporations that want to contribute to the solution of one of the most significant social problems of our time. (shrink)

This paper provides a case study of an unique initiative in corporate (SME) social responsibility which is too often overlooked in the academic study of “socialresponsibility of business in society” This case focuses on three specific points, 1) the role of an SME in social responsibility, 2) the role of a non-business trained entrepreneur and 3) the adaptation of social responsibility to a new and different socio-economic culture. This case presents the hypothesis that “a (...) good socially responsible initiative provides an excellent insurance policy for the health of a business venture in a new culture internationally. (shrink)

Many health care organizations made public commitments to become antiracist in the wake of George Floyd's murder. These actions raise questions about the appropriateness of health care's engagement in racial justice and social justice movements generally. We argue that health care organizations can be usefully thought of as having two roles: a functional role to care for the sick and a meta‐role as an organizational citizen. Fulfilling the role of citizen may require participating in the pursuit (...) of social justice, including efforts to achieve racial equity. The demands of these two roles will need to be balanced, but the role of organizational citizen has been largely ignored and merits serious attention. (shrink)

This paper presents the critical role of corporate responsibility in the sustainability of health care programs in lower income communities mostly located in the rural areas. The Leaders for Health Program (LHP)—a tri-partite partnership between the Philippine Department of Health, the Health Unit of the Ateneo de Manila University Graduate School of Business, and Pfizer Philippines, Inc.—is an innovative approach focusing on health promotion and education as the cornerstone for community development. LHP adopts a (...) systemic and comprehensive approach that takes into consideration all the major stakeholders in health, especially in rural communities. This paper aims to support the viability of education as the main catalyst for community empowerment and self-sufficiency. (shrink)

Pollution results from humankind’s failure to be good stewards of creation. Guided by Catholic environmental bioethics, Catholic health care organizations have reduced their contribution to this pollution, but they also encounter its human cost. Catholic hospitals treat countless patients sickened by pollution, which most strongly impacts the poor and disenfranchised—those whom the Church expresses a preferential responsibility to care for, in part via the charity care that Catholic health care provides. The poor encounter another cost of pollution: (...) the financial cost of seeking health care, particularly in the US. The authors argue that Catholic health care institutions should take the moral harm of pollution seriously by reducing the financial burden on those sickened by pollution. As an example, they highlight the situation of those sickened by lead exposure in the US and outline how Catholic health care institutions could consider lessening the financial burden of treating this sickness. (shrink)

Traditional medical practices and relationships are changing given the widespread adoption of AI-driven technologies across the various domains of health and healthcare. In many cases, these new technologies are not specific to the field of healthcare. Still, they are existent, ubiquitous, and commercially available systems upskilled to integrate these novel care practices. Given the widespread adoption, coupled with the dramatic changes in practices, new ethical and social issues emerge due to how these systems nudge users into making decisions (...) and changing behaviours. This article discusses how these AI-driven systems pose particular ethical challenges with regards to nudging. To confront these issues, the value sensitive design approach is adopted as a principled methodology that designers can adopt to design these systems to avoid harming and contribute to the social good. The AI for Social Good factors are adopted as the norms constraining maleficence. In contrast, higher-order values specific to AI, such as those from the EU High-Level Expert Group on AI and the United Nations Sustainable Development Goals, are adopted as the values to be promoted as much as possible in design. The use case of Amazon Alexa's Healthcare Skills is used to illustrate this design approach. It provides an exemplar of how designers and engineers can begin to orientate their design programs of these technologies towards the social good. (shrink)

Approximately one in two hundred persons in the Marshall Islands have active tuberculosis. We examine the historical antecedents of this situation in order to assign ethical responsibility for the present situation. Examining the antecedents in terms of Galtung’s dialectic of personal versus structural violence, we can identify instances in the history of the Marshall Islands when individual subjects made decisions with large-scale ecologic, social, and health consequences. The roles of medical experimenters, military commanders, captains of the weapons (...) industry in particular, and industrial capitalism in general are examined. In that, together with Lewontin, we also identify industrial capitalism as the cause of tuberculosis, we note that the distinction between personal versus structural violence is difficult to maintain. By identifying the cause of the tuberculosis in the Marshall Islands, we also identify what needs be done to treat and prevent it. (shrink)

Combatting chronic, lifestyle-related disease has become a healthcare priority in the developed world. The role personal responsibility should play in healthcare provision has growing pertinence given the growing significance of individual lifestyle choices for health. Media reporting focussing on the ‘bad behaviour’ of individuals suffering lifestyle-related disease, and policies aimed at encouraging ‘responsibilisation’ in healthcare highlight the importance of understanding the scope of responsibility ascriptions in this context. Research into the social determinants of health and (...) psychological mechanisms of health behaviour could undermine some commonly held and tacit assumptions about the moral responsibility of agents for the sorts of lifestyles they adopt. I use Philip Petit's conception of freedom as ‘fitness to be held responsible’ to consider the significance of some of this evidence for assessing the moral responsibility of agents. I propose that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others. (shrink)

Fast food companies like Siam Burger that participate in health awareness campaigns create a conflict of interest between the social responsibility of promoting health and the business interest of increasing sales through marketing strategies like advertising. Alternative options of raising health awareness without mitigating the involvement of fast food companies either by denying advertisements or having a third party foundation should be explored.

ABSTRACTThe responsibility of the food and beverage industry for noncommunicable diseases is a controversial topic. Public health scholars identify the food and beverage industry as one of the main contributors to the rise of these diseases. We argue that aside from moral duties like not doing harm and respecting consumer autonomy, the food industry also has a responsibility for addressing the structural injustices involved in food-related health problems. Drawing on the work of Iris Marion Young, this (...) article first shows how food-related public health problems can be understood as structural injustices. Second, it makes clear how the industry is sustaining these health injustices, and that due to this connection, corporate actors share responsibility for addressing food-related health problems. Finally, three criteria are discussed as grounds for attributing responsibility, allowing for further specification on what taking responsibility for food-related health problems can entail in corporate practice. (shrink)

_Relevance_. Organizations' social responsibility in the market is manifested through the quality of the services they provide, consumer information, care for their health, safety and the integration of environmental requirements into the activities of the organizations. Employees are one of the key stakeholders, and their approach is one way of exposing the organization's CSR issues. From the point of view of organizations' economic responsibility, it is important to strive for competitiveness of goods and services, efficient management (...) and economical use of resources (Carden and Boyd, 2011, etc.). Ethical social sphere emphasizes honest cooperation with stakeholders, taking into account public expectations and customer information. Pedersen (2010), Homburg et al. (2013), Segal (2011) discuss topical issues of social responsibility that define an organization's relationship with its stakeholders in pursuit of organizational customer loyalty and trust and socio-economic justice in the community. In the field of environment protection, the integration of environmental protection legislation into the activities of the company, reduction of pollution, improvement of operational activities, continuous monitoring, anticipation and implementation of necessary changes is important (Delmas et al. 2013, Claydon (2009), Valdes-Vasquez (2011), Fleming (2017), Allen (2016), Shin (2015), etc. A survey of CSR in the market was conducted in small and medium-sized enterprises. 175 respondents participated in the research. _R__esearch aim_. Assess the social responsibility of organizations towards consumers, the environment and the community in terms of employees. _Research methods_. Analysis of scientific literature, questionnaire survey. _Research results and conclusions_. Responsibility in the market for the quality of services provided was assessed on the basis of the following statements: at my workplace there is paid great attention to quality of service (production), effort is made to deliver on our promises to our customers, quality of services declared within the organization does not differ from reality, product quality control system exists in the workplace, consumer complaints are being investigated and the findings improve quality, and not only the legislation is used in customer relations, but generally accepted morals are rated only moderately. Responsibility in the market according to consumer information, caring about their health and safety has been assessed by employees to what extent these statements correspond to the reality: organizations provide detailed product information; I enjoy the services and products of my organization; my organization is concerned with the health of consumers when providing services, products; there has been no evidence that the services (products) provided by my workplace have been detrimental to the welfare of consumers and my organization does not manipulate consumer confidence. From the employees' point of view, the investigated organizations have a higher than average level of responsibility. The lack of responsibility is reflected in the fact that employees disagree that organizations do not manipulate consumer confidence. Promoting environmental protection is important in terms of market responsibility. Responsibility in the market is defined by these statements: the organization uses technologies that comply with organic standards; organizes environmental initiatives; uses only tools and technologies that reduce the negative impact on the environment; the organization takes care of the ecologic education of its employees, the organization takes care of all waste to be recycled, the waste is sorted, and green ideas are encouraged financially in the workplace. Having assessed the respondents' attitudes towards meeting environmental requirements, it could be indicated that the surveyed organizations have a medium level of responsibility, while employees indicate that organizations do not financially promote green ideas or contribute to the organization of environmental initiatives. Based on the results obtained there was ascertained higher than average level of social responsibility of organizations in the market, therefore, in the case under review, the activities of organizations in the context of applying social responsibility principles should be improved according to all categories defining social responsibility in the market. __. (shrink)

Se realizó la revisión bibliográfica con el objetivo de que los jóvenes profesionales de la salud conozcan acerca de la historia, origen y significado del distintivo que representa a la Medicina en todos sus campos con un carácter humanista y elevados valores éticos y morales: el emblema de Esculapio, al que se le atribuyen dotes para calmar o apaciguar. Esta imagen del bastón con la serpiente es la que ha quedado como un atributo del dios curativo y ha llegado hasta (...) la actualidad como símbolo de la Medicina. The literature review was made in order to young health professionals know about the history , origin and meaning of the emblem that represents the Medicine in all fields with humanist and high ethical values and moral character : the Aesculapius emblem, the feats attributed to him to calm or appease . This image of the snake with the cane has remained as a healing attribute of God and has come to the present as a symbol of medicine. (shrink)

This paper takes as its focus the adoption by the Co‐operative Wholesale Society of what appears to be a socially responsible stance on food labelling practice and policy through the publication of a public report and a proposed code of practice.The central issue in the debate surrounding labelling is the question of ‘asymmetric information’ (when one party knows more about a product than the other). In order to function, markets need perfect information. The existence of asymmetric information gives rise to (...) ‘market failure’ which prevents the ‘free market’ from functioning according to the laissez faire model. It can be argued that regulation will overcome this problem. However, this paper counters this argument on several grounds. In the first part of the paper labelling is examined as a textual construction, and ethical dimensions are revealed through an awareness of discourse and signification, which gives rise to a view of packaging as a version of reality partially built through connotation and association.The second part of the paper examines political and regulatory concerns. Marketing and economic theories are discussed in terms of their impact upon ethical issues in food labelling. Sense is made of various arguments about the policy and practice of food regulation – particularly in the wake of the James Report calling for the establishment of a Food Standards Agency. Tactics for resisting regulation are also examined. The paper analyses the role and motivation of the CWS in taking these steps.Consideration is given to the issue of where responsibility for information giving and public health education might lie, and what phenomena act as barriers to increased public awareness and action on dietary matters. Finally the debate over food labelling is used as an example of why it is problematic (and possibly unethical) to promote the free market model as the only sensible alternative to other modes of economic organisation. (shrink)

The literature on the interplay between geographic communities and organizations has largely ignored the role of individual residents. In adopting a meso-perspective, we examine a potentially vital relationship between corporate conduct and pro-social behavior demanding sacrifice from individuals. Drawing on Weber ), we theorize that organizations in a community legitimize personal social conduct in three ways—by serving as role models, imparting norms and values, and routinizing forms of interaction. We study the relationship between corporate social responsibility (...) behavior by local firms and the social distancing of citizens in US counties during the Covid-19 pandemic, a core ethical outcome. We argue and find that the residents of communities in which firms exhibit higher levels of CSR engaged in more SD during the Covid-19 pandemic. This was true when firms were long-established, isomorphic in their CSR, and major employers and vendors. Moreover, CSR relating to the treatment of employees as well as positive and negative extremes in CSR bore especially strong relationships with SD. Implications are drawn for the study of business ethics, as modeled by CSR, as a force for ethical personal behavior and public health in communities. (shrink)

Context: Although ethics consultation is commonplace in United States hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the “best informant” within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services were found in 81% of all general hospitals in the U.S., and in (...) 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians, nurses, social workers, or chaplains. Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

Payers have shaped the healthcare system in the United States as fee-for-service has facilitated a care model that prioritizes volume over the sake of patient care. This worsens health disparities, especially in safety net facilities where ancillary social work is both necessary clinically and completely uncompensated. Using concepts from Iris Marion Young’s Responsibility for Justice, it can be concluded that payers have a moral responsibility for reimbursing social care to address historical injustices. In this article, (...) I describe the ethical hazards in paying for social care and propose a way to finance this through value-based payments. (shrink)

Corporate social responsibility (CSR) is a dramatically expanding area of activity for managers and academics. Consumer demand for responsibly produced and fair trade goods is swelling, resulting in increased demands for CSR activity and information. Assets under professional management and invested with a social responsibility focus have also grown dramatically over the last 10 years. Investors choosing social responsibility investment strategies require access to information not provided through traditional financial statements and analyses. At the (...) same time, a group of mainstream institutional investors has encouraged a movement to incorporate environmental, social, and governance information into equity analysis, and multi-stakeholder groups have supported enhanced business reporting on these issues. The majority of research in this area has been performed on European and Australian firms. We expand on this literature by exploring the CSR disclosure practices of a size- and industry-stratified sample of 50 publicly traded U.S. firms, performing a content analysis on the complete identifiable public information portfolio provided by these firms during 2004. CSR activity was disclosed by most firms in the sample, and was included in nearly half of public disclosures made during that year by the sample firms. Areas of particular emphasis are community matters, health and safety, diversity and human resources (HR) matters, and environmental programs. The primary venues of disclosure are mass media releases such as corporate websites and press releases, followed closely by disclosures contained in mandatory filings. Consistent with prior research, we identify industry effects in terms of content, emphasis, and reporting format choices. Unlike prior research, we can offer only mixed evidence on the existence of a size effect. The disclosure frequency and emphasis is significantly different for the largest one-fifth of the firms, but no identifiable trends are present within the rest of the sample. There are, however, identifiable size effects with respect to reporting format choice. Use of websites is positively related to firm size, while the use of mandatory filings is negatively related to firm size. Finally, and also consistent with prior literature, we document a generally self-laudatory tone in the content of CSR disclosures for the sample firms. (shrink)

Responsible Care is a voluntary code of conduct developed, enforced, and monitored by the Chemical Manufacturers Association. Voluntary codes could be designed and enforced by regulators, nonprofit groups, industry associations, and individual firms. They could vary in their scope, focusing on firms around the globe, in a given region, within a country, or in a given industry. This article focuses on Responsible Care’s self-regulatory services that pertain to establishing, monitoring, and enforcing industry-wide environmental, health, and safety standards. Employing insights (...) from the club theory, stakeholder theory, institutionalist theory, and the corporate social performance perspective, it examines the demand and supply sides of voluntary codes. Finally, it discusses theoretical implications and the key challenges faced by Responsible Care in the future. (shrink)

The purpose of this article is to argue for a position holding that epigenetic responsibility primarily should be a political and not an individual responsibility. Epigenetic is a rapidly growing research field studying regulations of gene expression that do not change the DNA sequence. Knowledge about these mechanisms is still uncertain in many respects, but main presumptions are that they are triggered by environmental factors and life style and, to a certain extent, heritable to subsequent generations, thereby reminding (...) of aspects of Lamarckism. Epigenetic research advances give rise to intriguing challenges for responsibility relations between the society and the individual. Responsibility is commonly understood in a backwards-looking manner, identifying causally responsible actors to blame for a bad outcome. If only a backwards-looking responsibility model is applied, epigenetics might give rise to arduous responsibility ascriptions to individuals for their health and the health of their future descendants. This would put heavy responsibility burdens on actors constrained by unequal social and economic structures. In contrast, a forward-looking responsibility notion takes account of structural conditions and pay attention to who is best placed to do something about conditions contributing to bad outcomes. A forward-looking responsibility notion would partly free disadvantaged individuals from responsibility, and identify actors with power and capacity to do something about structural factors constraining genuine choice. (shrink)

In a welcome broadening of the discussion surrounding responsibility in healthcare, Rebecca Brown and Julian Savulescu propose that standard philosophical accounts of responsibility are too narrow to be useful. Although these accounts of course differ with respect to the exact conditions they posit as necessary and sufficient for responsibility, they are nonetheless relatively united in their focus on a single individual at a single moment in time. Suppose a subject S performs an action a at a time (...) t that has harmful consequences for their health. Is S responsible for a and derivatively their condition? Brown and Savulescu argue that answers to this question that fail to consider both what S was or was not doing at times other than t and what people other than S were doing to encourage or discourage S from performing a cannot do justice to actions which are habitual and socially influenced—such as unhealthy patterns of eating, exercise and substance use. Given that it is precisely these kinds of patterns of behaviour that typically inflame the discussion of responsibility in healthcare, Brown and Savulescu’s insistence on the need for a diachronic and socially contextualised account of responsibility is essential— if we are to consider the issue of responsibility in healthcare at all. But should we and, if so, why? With respect to this question, Brown and Savulescu hope to sit on the fence. This is both because they recognise the complexity and balance of arguments for and against the view …. (shrink)

During the last 10 years or so, a number of corporate social responsibility (CSR) initiatives have been introduced in global supply chains, which aim to improve the conditions of workers engaged in producing goods for export. This article discusses the observations of CSR in practice in the Costa Rican-United Kingdom (UK) banana chain. The banana chain makes for an interesting case study because there are dominant corporate actors at each end who are in a position to influence the (...) conditions experienced by workers on banana plantations. At the top of the chain there are four major UK supermarket groups who control access to the retail market and as selfappointed guardians of consumer interest are demanding that producers adopt more socially responsible practices. At the other end, banana production is highly integrated and controlled by three large North American agri-businesses who have developed their own social and environmental certification programmes. Costa Rica also makes for an interesting country to locate the study as it has a tradition of state-led policies to protect worker rights. Yet, in spite of CSR commitments made by both supermarkets and producers that emphasise health and safety and the country's established Labour Law, this article shows that there are problems for workers when they are forced to meet demanding production schedules. Furthermore, it suggests that whilst supermarkets continue to drive down consumer prices and put pressure on producers to reduce costs, a downward spiral of working conditions is created regardless of the CSR policies in place. However, this article also identifies that changes to supermarket behaviour is possible when consumer trust is at stake. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Moral Responsibility in a Context of Scarcity:the Journey of a Haitian PhysicianPaul PierreAlmost all Haitian physicians have been involved in some sort of "social movement" at one point in their professional life. In a country characterized by a natural inclination to question authority, fighting the status quo of the ineffective, corrupt and disorganized [End Page 89] Haitian health system often appears to be the right thing (...) to do.In 2002, I played an active role in a large protest movement for better working conditions at the largest health facility in Port-au-Prince: the General Hospital (GH). Port-au-Prince is the capital and economic center of Haiti. It is home to close to a third of Haiti's ten million people. At that time, the situation at the GH facility was dire. All of the 400 beds at the GH were dirty. The staff was underpaid and unhappy. Drug and medical supply stock-outs were routine. Medical equipment was rarely maintained and only one of the six operating theatres in the surgery block was working. Unsupervised physicians in training (like me) were the main health care providers. Attending physicians were busy running their own private clinics, and most of them would come to the hospital solely to "recruit" the less poor patients for their clinics. As physicians-in-training, we had the responsibility of caring for the poor, but we had no means. We grew frustrated and angry witnessing our powerless patients losing legs, arms and their lives for lack of care. On many occasions, I had the parents of my patients buy the gloves that I would use to examine their sick relatives. I've seen patients fighting for the inheritance of medications left by others who had just passed away. There was no way for this hospital to fulfill its mission, and no way for its staff to deliver anything other than mediocre care. We could not accept that situation at such an early stage in our medical development, and so we refused to continue to work. We went on a strike, which completely paralyzed the delivery of care at the hospital for nearly two months. After intense negotiation, the strike ended with a signed agreement with the Minister of Health that addressed, more or less, the reasons of our movement. However, the implementation of the agreement was permanently delayed by other competing "state emergencies" including a general insurrection.At the time of our movement, I thought we were making history. After witnessing 11 "social movements" that similarly paralyzed the GH in the following decade for reasons identical to ours, I am now convinced that we were not. We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince. The social movement that we started ended up hurting the very same people that we were trying to help.Extending access to heath care to poor people seemed to me at that time to be too complicated and too expensive for an unorganized state like Haiti. I realized that local protests could, at best, influence the allocation of local resources. But so-called local resources are so limited in "resource-limited" countries. Haiti spends only $40 U.S. dollars per capita for health care. This is not enough for good care. The options we were provided were not real ones—since all of them would end in more suffering. The case of providing health care to poor people needed to be approached differently.I was born in Port-au-Prince at the same general hospital in which I would later work. I am the third of four children, and the first male child in my family. My father made me understand very clearly that my first responsibility was for my siblings. My sisters made me understand equally clearly that I had no authority over any of them. I ended up with a lot of responsibility but with very little authority. The few of us who completed school, entered university, studied abroad and "emerged" were considered, to some extent, responsible for the others—the ones who couldn't go to school, university, or abroad, the ones who had "sunk... (shrink)

The recent increased prevalence of diseases related to unhealthy lifestyles raises difficulties for healthcare insurance systems traditionally based on the principles of risk-management, solidarity, and selective altruism: since these diseases are, to some extent, predictable and avoidable, patients seem to bear some responsibility for their condition and may not deserve full access to social medical services. Here, we investigate with objective criteria to what extent it is warranted to hold patients responsible for their illness and to sanction them (...) accordingly. We ground our analysis on a series of minimal conditions for ‘practical’ and for ‘moral’ responsibility attribution. By applying these criteria consistently, we highlight that individual responsibility applies to risk-taking life choices rather than stigmatized sickness. We explain that responsibility is a matter of degree, that it varies across life-history, and can be affected by factors beyond the patients’ grasp. We point out that scientific knowledge about the effect of these factors generates responsibilities for other parties such as public health agencies and private industry. The upshot of our analysis is that health policies targeting the ‘liable’ undeserving sick are mostly unwarranted, and tend to increase unequal treatment of already vulnerable groups: the unlucky sick. (shrink)

The COVID-19 pandemic has undoubtedly become an era-defining challenge for the entire world. It has implications not only in the public health sector but also in the global economy and political landscape. The prevention strategy that has been followed in Sri Lanka is unique. Early action taken by the government and the ministry of health, being one of pre-emptive quarantining and isolation of suspected contacts even before they developed symptoms, was vital to contain the spread of the disease. (...) During the early phase, a nationwide lockdown in the form of a curfew was imposed which helped mitigate the spread of the virus. However, due to several lapses, there was a threat of community transmission; this was swiftly brought under control through ongoing government interventions. Thus, strict social/physical distancing measures enforced by the government, together with an increase in testing capacity, prevented widespread community transmission. Strictly containing the outbreaks as and when they were identified made it easier to bring the spread under control through contact tracing. In this article, we give an account of the strategy taken by Sri Lanka to mitigate the pandemic and comment on the lessons learned concerning the ethical responses to the COVID-19 crisis. (shrink)

Some people argue that the distribution of medical resources should be sensitive to agents’ responsibility for their ill-health. In contrast, others point to the social determinants of health to argue that the collective agents that control the conditions in which agents act should bear responsibility. To a large degree, this is a debate in which those who hold individuals responsible currently have the upper hand: warranted appeals to individual responsibility effectively block allocation of any (...) significant degree of responsibility to collective agents. We suggest that a different understanding of individual responsibility might lead to a fairer allocation of blame. Scaffolded agency is individual agency exercised in a context in which opportunities and affordances are structured by others. Appeals to scaffolded agency at once recognize the role of the individual and of the collective agents who have put the scaffolds in place. (shrink)

This article argues for the claim that we are morally responsible (in the qualified sense proposed in the article) for the crimes of our ancestors if our ancestors, as a collectivity, were part of a community for whose sake and in whose name crimes were committed that meet the definition of the crime of genocide. This claim of ‘‘vicarious intergenerational moral responsibility’’ is supported by two arguments. The first counters the claim that one cannot have responsibilities for events in (...) the past by arguing that this claim oversimplifies one’s relationship to one’s past and the collectivities in which people live. Such collectivities, both ethnic and religious, have identities across time; identification with these collectivities involves accepting certain moral obligations. The second argument is based on the following premise: the political, social, cultural, and educational institutions that mark all large collectivities, such as nations, provide a degree of moral reliability that is necessary for individuals to carry out their legitimate interests. We count on such institutions to exemplify the values that allow individuals to flourish in their life activities. These institutions are by their very nature intergenerational. The moral reliability of such institutions thus requires that we endeavor to acknowledge and repair the damage caused by the failure of these institutions in the past. Accordingly, their health engenders a moral obligation on our part. Vicarious intergenerational moral responsibility is a responsibility not to the past per se but to the past as it plays an active role in the present. (shrink)