On January 30 and 31, 2024, the second edition of the Sustainable Health Summit, organized by the Quebec Public Health Association, took place simultaneously in Quebec City and Montreal. The aim of this text is to describe the event and take an ethical look, highlighting the Summit’s strengths and points to consider for a possible third edition.

At a time when Quebec’s public health system is facing various challenges in a post-pandemic context, it is time to find solutions to lighten the load on the system and on the people working in it. In order to further reflection and identify solutions to promote sustainable health, the first Sustainable Health Summit was organized by the Association de la santé publique du Québec (ASPQ). It took place from January 25 to 27, 2023, at the Musée de la civilisation (...) de Québec. This text consists of a report on the event, followed by an ethical analysis to highlight the strengths of the Summit and possible points of improvement for a second edition. (shrink)

Bien que les violences conjugales soient un véritable problème de santé publique, force est de constater qu’elles restent souvent indifférenciées. Les auteurs discutent dans cette contribution des enjeux de la violence causée par des vulnérabilités spécifiques, inhérentes souvent à la conjugalité mais se répercutant sur la parentalité et l’enfant, et qui nécessitent l’intervention de la justice. Ils se basent sur le dispositif « Protection médiation prévention » ( pmp ) pour illustrer que la justice peut présenter un (...) vecteur thérapeutique utile à appeler à la (juste) place de chaque membre de la famille dès l’annonce d’un conflit en amont de la violence et l’installation de troubles psychologiques pérennes, notamment pour l’enfant. La confrontation avec la justice peut être l’occasion de sensibiliser aux souffrances engendrées par les violences et créer une amorce thérapeutique. Pour cela, les professionnels doivent pouvoir discriminer ce qui relève du registre du conflit et de la violence tout comme de la dysparentalité et de la conjugopathie. Ces réflexions et expériences de terrain ont débouché sur une recherche-action à l’université de Caen qui vise à proposer des interventions spécifiques et différenciées dans des situations de conflits et/ou de violence dans le cadre de l’assistance éducative. (shrink)

Quelles sont les principales problématiques en émergence dans l’éthique de la santé publique ces 10 prochaines années? Se hasarder à prédire l’avenir nécessite toujours une certaine dose d’autodérision, mais les fondements des enjeux sur une échéance aussi proche sont en grande partie déjà présents. Ils peuvent être décrits à différents niveaux d’observation. Le premier de ces niveaux est technique : la santé publique recouvre toute une série d’interventions, dont la mise en œuvre rencontre des obstacles qui, pour certains, (...) ont une résonance éthique. Le deuxième niveau est philosophique et politique : la dimension collective des interventions de santé publique mobilise les débats généraux concernant la liberté individuelle d’une part, et la justice distributive d’autre part. Le troisième niveau est systémique : la santé de la population peut en effet être considérée comme une ressource faisant l’objet de tensions politiques dont la visibilité est pour le moment variable. Certes, l’idée que la santé du peuple est une richesse pour la nation remonte au Siècle des lumières (1). Néanmoins, prise dans les débat centrés sur l’individu et la collectivité, l’éthique de la santé publique peine davantage à concevoir parmi ses objets les tensions à l’œuvre entre différentes collectivités, certaines seulement comptant parmi leurs tâches la protection des biens communs dont fait partie la santé publique. (shrink)

L'impôt sous son angle colonial en Afrique était perçu comme un instrument de pression, d'oppression et d'appauvrissement du citoyen contribuable par l'impôt dit, de capitation. Ce lourd passé historique pèse encore sur les systèmes fiscaux d'Afrique et d'ailleurs, systèmes au sein desquels les citoyens se sentent encore victimes parce que spoliés de leurs biens par les puissances publiques. Dans cet ouvrage, Docteur Célestin Amané DAGO propose un changement de paradigme du système de la fiscalité à travers la philosophie politique normative (...) et l'éthique économique appliquée du philosophe américain John Rawls, en introduisant une part de volontariat dans l'accomplissement de l'obligation fiscale, afin de changer le rapport du contribuable à l'Etat. L'ouvrage vu sous cet angle, est un appel aux pouvoirs publics pour inscrire le contribuable au coeur du système fiscal afin que, le paiement de l'impôt soit un acte spontané et volontaire. L'acte volontaire, s'entend comme la réponse à la justice et à l'équité fiscales dans la redistribution sociale des richesses nationales. Au commencement était la philosophie en tant que mère de toutes les sciences et, naturellement M. Amané Célestin DAGO, embrassa cette discipline prestigieuse à l'Université de BOUAKE ; mais, cet eudémoniste toujours souriant et généreux, est un monomane de l'application des savoirs, un citoyen rivé au credo selon lequel le bonheur de la cité ne viendra que d'un gouvernement de philosophes. Voilà le principe d'intelligibilité de toutes ses activités théoriques et pratiques. Etonné par la ruée automatique des politiciens négro-africains vers la démocratie comme régime politique idéal, parce que le maître blanc en domination l'a dit, Monsieur DAGO prépara et soutint un mémoire de maîtrise en philosophie politique et sociale sur le thème suivant : Du procès de la démocratie dans la République de PLATON ; à la suite de quoi, un mémoire de DEA de philosophie intégrale intitulé : La République comme médiation de la justice chez PLATON ; puis, voulant être différent du philosophe THALES de Milet, il prépara son second DEA en philosophie politique normative, qui a eu pour thème : La justice et la répartition fiscale dans la philosophie de JOHN RAWLS. Il est admis au Cycle Supérieur de l'Ecole Nationale d'Administration (ENA) où il obtient le Diplôme option Impôts, promotion 2004-2005. Depuis novembre 2011, Monsieur DAGO a été nommé Receveur des Impôts Divers par Arrêté du Ministre en charge de l'Economie et des Finances. Malgré ses nombreuses charges administratives, Monsieur DAGO a su réaliser sa passion en soutenant une thèse unique de Doctorat de philosophie politique normative, option éthique économique appliquée. Cette thèse a été sanctionnée par la mention très honorable à l'unanimité du jury. Ajoutons que Monsieur DAGO est l'actuel Président de la Mutuelle de Développement de HIRE (MUDH), mission de développement qui l'a contraint à écrire le livre blanc de la sous-préfecture de HIRE intitulé : Besoin de développement et Exploitation minière à HIRE. Aujourd'hui, Dr DAGO est Administrateur Principal des Sces Financiers à la Direction Générale des Impôts de Côte d'ivoire. (shrink)

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep (...) this “essential industry” producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry’s implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities. (shrink)

« Jouer le jeu académique » est l’aboutissement de deux années de billets hebdomadaires sur le blogue BrynStorming de Bryn Williams-Jones, professeur de bioéthique à l’École de santé publique de l’Université de Montréal. -/- En tant qu’éthicien intéressé depuis longtemps par les questions de justice, Williams-Jones a été motivé par le besoin de répondre aux injustices rencontrées dans le monde universitaire. De nombreux étudiants ou chercheurs échouent dans leurs études ou dans leur progression de carrière non pas parce (...) qu’ils n’ont pas les capacités intellectuelles ou le dynamisme nécessaires, mais simplement parce qu’ils ne savent pas ce que l’on attend d’eux ou comment se présenter au mieux dans un environnement compétitif. En d’autres termes, ils ne connaissent pas « les règles du jeu, » et ce n’est pas juste, car les règles sont rarement explicites. -/- Dans ce livre, qui s’articule autour de cinq grands sections – le parcours académique; l’identité professionnelle; la vie universitaire; la productivité et la créativité; les responsabilités multiples et la santé mentale – Williams-Jones fait part de ses 30 années d’expérience dans le monde universitaire pour rendre explicites les normes et les règles souvent implicites de la vie universitaire, afin que tous ceux qui le souhaitent puissent jouer le jeu de manière équitable. (shrink)

Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public health (...) challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic. (shrink)

This article traces the development and growth of health justice partnerships (HJPs) in three countries: the United States, Australia and the United Kingdom.

On doit à l’économiste américain d’origine allemande, Richard A. Musgrave, la formulation des critères d’Équité Horizontale (ÉH) et d’Équité Verticale (ÉV). Étant donnée une base fiscale, l’ÉH veut que les égaux soient traités également, alors que l’ÉV exige que les inégaux soient traités inégalement (par exemple que les plus riches payent proportionnellement plus d’impôts). Musgrave opère en 1959 une redescription créative de considérations d’équité qui ont une longue histoire de Hobbes à Buchanan, en passant notamment par la fameuse maxime de (...) Adam Smith. La reconstruction généalogique montre que l’ÉV et l’ÉH relèvent de la justice distributive au sens aristotélicien du terme. Un critère purement formel, l’équité en matière d’impôt signifie l’égalité proportionnelle dans la répartition des charges communes à tous les individus membres d’une communauté politique. À défaut d’un consensus théorique sur la manière de conceptualiser les contribuables, l’ÉH conserve tout de même une valeur de principe régulateur dans le cadre non idéal de débats de réforme fiscale.Codes JEL : H20, B11, B12, B20, B40, D63. (shrink)

Anouck Alary | : La transformation du sang placentaire en une précieuse source de cellules souches a donné naissance à partir des années 1990 à une industrie globale de conservation de sang de cordon ombilical faisant désormais concurrence à un large réseau de banques publiques de sang de cordon. Cet article explore les soubassements socioculturels liés à l’émergence de cette industrie et tente d’élucider les enjeux éthiques et politiques qu’elle pose. Si les banques publiques de sang de cordon sont porteuses (...) des valeurs d’altruisme et de solidarité nationale traditionnellement liées au modèle redistributif d’échange de sang et d’organes né après la Seconde Guerre mondiale, les banques privées renvoient, elles, à des formes de solidarité bien différentes. C’est effectivement sous couvert de la solidarité familiale et de la responsabilité morale des mères de protéger leurs enfants qu’elles définissent la conservation privée comme une forme d’ « assurance biologique » contre les risques à la santé de l’enfant. En permettant aux mères d’investir leurs tissus corporels à la fois dans le futur incertain de leurs enfants et dans des thérapies cellulaires expérimentales, ces banques promeuvent un nouveau modèle de participation du/de la patient.e à la coconstitution de futures innovations thérapeutiques. Nous inscrivons ce modèle de participation dans les reconfigurations contemporaines du biopolitique que le sociologue britannique Nikolas Rose voit s’incarner dans l’émergence d’une nouvelle forme de biocitoyenneté. L’article critique finalement ces services personnalisés en soulignant qu’ils ont le potentiel d’opérer de nouvelles formes de coercition sur les mères, dans un contexte sociopolitique caractérisé par une responsabilisation accrue des individus au regard de la « bonne gestion » de leurs risques à la santé. Ces services sont aussi jugés problématiques sur le plan éthique, au vu de leur incohérence avec un principe de justice distributive défendant l’accès égal pour chaque citoyen.ne à des soins de santé de base. | : Since the 1990s, the transformation of cord blood into a precious source of stem cells has given rise to a global cord blood bank industry, which is now competing with a large network of public cord blood banks. This article explores the sociocultural context surrounding the emergence of this industry and aims at elucidating the ethical and political concerns that this industry raises. Whereas public cord blood banks are purveyors of values such as altruism and national solidarity traditionally linked to the redistributive model of human blood and organ donation that emerged after World War Two, private banks engage very different forms of solidarity. It is indeed under the guise of family solidarity and mothers’ moral responsibility to do their best to protect their children that they come to define private preservation as a form of “biological insurance” against potential risks to their children’s health. By allowing mothers to invest their bodily tissues simultaneously in their children’s uncertain future and in experimental cell therapies, these banks promote a new model of patient participation in the development of future therapeutic innovations. This article analyzes this model as embedded in the contemporary reconfiguration of biopolitics that sociologist Nikolas Rose envisions as constituting a new form of biocitizenship. The paper finally casts a critical eye on these personalized services, in particular because of the new forms of social coercion on mothers that are brought about in a social and political context characterized by an increasing moral accountability of individuals with regard to the “good management” of their own health risks. These services also appear ethically problematic in relation to political demands of distributive justice—e.g., the ideal of equal access to basic health care for every citizen. (shrink)

Achieving equity in international research is one of the pressing concerns of the twenty-first century. In this era of progressive globalization, there are many opportunities for the deliberate or accidental export of unethical research practices from high-income regions to low- and middle-income countries and emerging economies. The export of unethical practices, termed “ethics dumping,” may occur through all forms of research and can affect individuals, communities, countries, animals, and the environment. Ethics dumping may be the result of purposeful exploitation but (...) often arises from lack of awareness of good ethical and governance practice. This chapter describes the work of the TRUST project toward counteracting the practice of ethics dumping through the development of tools for the improvement of research governance structures. Multi-stakeholder consultation informs all of TRUST’s developments. Most importantly, this gives voice to marginalized vulnerable groups and indigenous people, who have been equal and active partners throughout the project. At the heart of the TRUST project is an ambitious aim to develop a Global Code of Conduct for Research in Resource-Poor Settings. Uniquely, the Code provides guidance across all research disciplines in clear, short statements, focusing on research collaborations that entail considerable imbalances of power, resources and knowledge and using a new framework based on the values of fairness, respect, care, and honesty. The code was recently adopted by the European Commission as a reference document for Horizon 2020 and Horizon Europe. (shrink)

With the world grappling with continued spread of monkeypox internationally, vaccines play a crucial role in mitigating the harms from infection and preventing spread. However, countries with the greatest need - particularly historically endemic countries with the highest monkeypox case-fatality rates - are not able to acquire scarce vaccines. This is unjust, and requires rectification through equitable allocation of vaccines globally. We propose applying the Fair Priority Model for such allocation, which emphasizes three key principles: 1) preventing harm; 2) prioritizing (...) the disadvantaged; and 3) treating people with equal moral concern. Post-exposure prophylaxis (PEPV) has the most potential to mitigate harm, and so ensuring countries have sufficient supply for PEPV should be the first priority. And historically endemic countries, which face disadvantages that compound potential harms from monkeypox, should be the first recipients of such vaccines. Once sufficient supply is allocated for countries to apply PEPV, global allocation could move on to pre-exposure prophylaxis (PrEP), again prioritizing historically endemic countries first before distribution to the rest of the global community, based on projected number of cases and vulnerability to harm. (shrink)

Prioritization in public health has long been contentious, which necessitates ethical discussions. Despite efforts to develop frameworks that address these considerations, universally accepted models remain elusive, leaving decision-makers to manage independently. This study explores the previously underexplored topic of ethical principles guiding prioritization within different domains of health promotion and prevention at a local level. Interviews with decision-makers (n = 21) from Danish municipalities were analyzed thematically to uncover ethical dimensions of local prioritization of public health services. The study showed (...) that when confronted with resource constraints, decision-makers tended to prioritize preventive services for patients, often at the expense of broader health promotional initiatives. This decision appears rooted in ethical principles of assisting individuals who are deemed to be in the most immediate need. Analyzed against principles of justice and the broader literature on prioritization, the results reflect a prioritization common in the hospital sector: the principle of need. This contrasts with broader societal discussions of public health that are often based on principles of maximization of health benefits and equity. The study highlights the importance of weighing diverse ethical principles when prioritizing among and within initiatives and of considering the purpose of different domains of prevention and health promotion. (shrink)

Tuberculosis, caused by bacteria, usually affects the lung. Being airborne, TB has been one of the world’s deadliest communicable diseases. In spite of being curable and preventable, the disease has always been a continuous threat to human population. Moreover, there are cases of multidrug resistant, extremely drug resistant as well as HIV associated forms. Recognizing this grave threat, the World Health Organization urged every country to have a national program for tuberculosis prevention and control. After incidences of involuntary detentions of (...) people with suspected TB in some places, WHO also recommended that national TB prevention programs should incorporate ethical considerations in them. Specifically, it prescribed that human rights and social justice issues should be given due considerations. Studies suggest that India, following the international recommendations, has rolled down a national program to prevent and control TB cases in the country. However, neither is there much consideration of ethics in it, nor there is any pronounced effort to include social justice issues. The present paper investigates how the inclusion of elements from social justice theory can actually help India’s TB program to address the issue of equitable protection. Specifically, it shows how insights from JP Ruger’s ‘Health Capability Paradigm’ can help India’s TB strategies to render equitable protection by addressing health inequities. (shrink)

Burnout has been recognized as a serious health problem. In Portugal, before COVID-19 Pandemic, there were strong indicators of high prevalence of burnout in physicians and nurses. However, the Portuguese Health Care Service was able to efficiently respond to the increased demands. This study intends to understand how psychosocial variables might have been protective factors for burnout in physicians and nurses in Portugal. Specifically, we considered several psychosocial variables that have been found to be protective factors for burnout in previous (...) research and we compared their predictive and unique impact in the prediction of burnout. These variables are perceptions of justice (distributive, procedural, justice from colleagues, justice from patients, and their families), professional identification, meaningful work and empathy. We also included workload, as a risk factor, and controlled other variables that can be confounds for burnout, such as socio-demographic variables, ideological variables (religiosity, political orientation), and specific variables related with COVID-19 pandemic. The sample of the present study is composed by 229 physicians (aged between 23 and 70 years old,M= 36.54;SD= 10.72; 48% male and 52% female) and 268 nurses (aged between 22 and 69 years old,M= 34.96;SD= 9.52; 27% male and 73% female). An online survey was created using Qualtrics and participants were recruited via Facebook and LinkedIn. The data were collected during 29 days (between the 45th and the 74th days after the first diagnosed case of COVID-19 in Portugal). The results showed that workload was a significant risk factor, except for disengagement in physicians. The most consistent protectors across samples were procedural justice (for both dimensions of burnout, both in physicians and nurses) and professional identification (for disengagement, both in physicians and nurses; for exhaustion only in physicians). This study suggests that decreasing workload and promoting procedural justice and professional identification are key factors that might be simultaneously and independently addressed in interventions for reducing the risk of burnout or preventing it from occurring in the first place. (shrink)

Le Forum économique mondial a qualifié la démence de l'une des plus grandes crises sanitaires mondiales du XXIe siècle. Dans cet article, je soutiens que les soins non rémunérés prodigués par la famille ou les proches des personnes atteintes de démence devraient être une question de santé publique. Shaji et Reddy l’ont proposé en 2012 dans le contexte des soins aux personnes atteintes de démence en Inde. Ils reconnaissent explicitement l’influence de l’article de Talley et Crews de 2007 sur (...) la prestation de soins en tant que nouveau problème de santé publique. Cependant, ils limitent leur proposition aux soins prodigués aux personnes atteintes de la maladie d’Alzheimer et de démences apparentées (MADA), ce que je considère comme une première étape importante dans l’élaboration d’un argumentaire visant à inscrire plus fermement les soins dans un programme de santé publique. Pour étayer mon propos, j’établis tout d’abord que la prestation de soins est un déterminant social de la santé. Ensuite, je réfute les objections à l’ajout de la prestation de soins aux personnes atteintes de la MADA à un programme de santé publique, car cela entraînerait une dérive de la mission de la santé publique. Je soutiens ensuite qu’une compréhension large de la santé publique peut inclure ce type de prestation de soins et est préférable car elle met en évidence une question d’équité en matière de santé, la nature sexuée de la prestation de soins. Enfin, je soutiens qu'une définition de la santé publique incluant les déterminants sociaux de la santé et la prestation de soins est mieux adaptée pour faire face aux conséquences sanitaires de l’évolution actuelle des schémas démographiques. Mon argumentation renforce les écrits sur la migration qui appellent à l’élargissement du champ d’application de la santé publique. (shrink)

Photo ID 279661800 © Sidewaypics|Dreamstime.com ABSTRACT Decolonization is complex, vast, and the subject of an ongoing academic debate. While the many efforts to decolonize or dismantle the vestiges of colonialism that remain are laudable, they can also reinforce what they seek to end. For decolonization to be impactful, it must be done with epistemic and cultural humility, requiring decolonial scholars, project leaders, and well-meaning people to be more sensitive to those impacted by colonization and not regularly included in the discourse. (...) INTRODUCTION Decolonization is complex. To successfully achieve decolonization, projects should incorporate the voices of those subjugated or silenced. Including such voices requires sincerely exploring who has been affected by colonialism or neocolonialism and how, as well as cultural sensitivity. In its basic use, decolonization refers to countries under colonial rule gaining independence or freedom from forms of subjugation. Additionally, scholars use the term to refer to efforts to dismantle neocolonialism and vestiges of colonialism. The process includes de-silencing subjugated voices.[1] I use decolonization in the latter way to refer to countries with technical independence. While arguably colonization ended formally with independence from colonizing powers, neocolonialism is the indirect, informal, and sometimes subtle control of the people, their economy, and political life despite formal independence from colonizing authorities. I conceptualize neocolonialism as a system that involves direct and involuntary control of another’s political, economic, or social life, impacting their worldview and ways of encountering the world. Decolonization may target actions, places, or systems like health care or AI to overcome the ills of colonialism and neocolonialism. It also may target knowledge and require rethinking how people develop their knowledge base. For example, if people grew up seeing an outside colonizer as superior, they would need to change their knowledge of superiority. Decolonization may target power, for example, changing who owns and distributes COVID-19 vaccines and who distributors exclude in the distribution of vaccines. Decolonization could require looking at those disempowered in the distribution process. Additionally, decolonization may target autonomy of persons by freeing people, ensuring human and individual rights, and respecting cultural traditions. Decolonization projects that try to de-silence by including the voices of those affected by colonialism and neocolonialism must examine inclusiveness in the context of the culture of the subrogated individuals. Examples of decolonization projects include making datasets inclusive of diverse peoples and places, returning to traditional food and eating practices, making sure hospitals in developing countries are led by locals and respectful of cultural traditions, returning unethically obtained artefacts or objects. Another project would be laying the groundwork for equality in formerly colonized countries to ensure that business ownership, education, and financial success will flow fairly to those previously victimized by colonization. Summarily, there are many strategies for decolonizing. However, it is worth asking whether the strategies have risks that undermine the goal of decolonization. I. Understanding Decolonization Discourses Many fields, from AI to politics, economics, health care, aviation, and academia, discuss decolonization. The content of the discourse on decolonization depends on the region and field discussing it. Rather than just reporting on decolonization, the discussions may be calls to action. For example, decolonization discourses reflect activism for cognitive justice, such as equal consideration of Indian or African knowledge systems in global health discourses.[2] In politics and political science, some scholars frame decolonization as an anti-western, anti-colonial movement by Africans to emancipate Africa/ns from subjugation or shift the continent to postcolonialism and post-neo-colonialism. This framing walls off non-African participants and may undermine their capacity to benefit the conversation.[3] There are other political scientists who actively support decolonization and see it as a field of activism in support of anyone and countries where colonization harmed people and development.[4] The point is that two ways of conceptualizing decolonization in politics and political science are discernible. One conceptualization is less inclusive since it alienates scholars and professionals from Western, high-income, or developed countries. The other is more inclusive. In humanitarian studies, including philosophy, some decolonization articles and conversations are efforts to end the destructive force of colonization. They focus on either the form, such as ecocide, genocide, and many others, or the geographic location, such as Africa, Asia, Latin America, and Oceania.[5] Finally, the feelings one brings into this conversation can adversely impact how one engages in them and who they listen to or are willing to hear from. For example, anger, rage, bitterness, and hatred are emotions that are not uncommon in spaces of decolonization conversations. Decolonization conversations that originate from a place of negativity risk deepening the psychological state of victimhood and prevent people from disrupting constructively or critically engaging in the conversation.[6] II. Understanding Decolonization Strategies Decolonization strategies mainly aim to de-silence victims of domination or subjugation. People have proposed many strategies for decolonizing. These strategies may be informed by what the target is for decolonization. Decolonization can target power relations in global health. For example, during the COVID-19 pandemic, public health organizations noted the power imbalance in vaccine distribution. Decolonization could involve de-silencing those affected by neocolonialism to bring about a more balanced distribution of power and a more fair distribution of the vaccine. By analyzing who was adversely impacted by the distribution and who ought to wield power, those engaged in decolonizing advocated for positive change and equitable power relations. Equally, when being is the target of decolonization, the language of unlearning or relearning and mental decolonization take centre stage in the decolonization discourse. For example, the quest to decolonize colonized minds aims to demythologize African inferiority and Western superiority. Demythologizing African inferiority enables those engaged in the decolonization discourse to cultivate and foster African agency.[7] Finally, when knowledge production is the target of decolonization, scholars use inclusion and cognitive justice. For example, they try to alter the knowledge that underlies global health ethics.[8] “[D]decolonizing researchers aim to respectfully understand and integrate theory from Other(ed) perspectives, while also critically examining the underlying assumptions that inform their Western research framework.”[9] One common strategy that scholars use in decolonization is inclusion. It is worth asking, does including people who have been subrogated foster decolonization? Whether that is effective depends on whether included people are more heard or whether the strategies to include them create new forms of silencing. III. Inclusion and the Quest to Decolonize Evaluating how effective inclusion is in the quest to de-silence subjugated voices is important. First, inclusive strategies are not neutral. They are epistemically situated. This situatedness constrains meaning-making in different ways: how and what questions are asked, how social roles are constructed, organized or assigned, and who is admitted to the room where these conversations occur.[10] Inclusion strategies may reinforce (unchallenged) assumptions. For example, to address prejudices and stereotypes in global health images, Arsenii Alenichev and his colleagues[11] successfully inverted “one stereotypical global health image” by prompting a generative AI to produce “an image of a traditional Indian or African healer healing a White Child.” Although there were some problems with the image of the White child, this innovation is a significant, useful effort to de-embed or strip global health images of problematic pictures that mythologize White superiority and Black inferiority. Yet it is possible that using categories like traditional Indian or African reinforces unchallenged assumptions, raising key questions regarding how language and words create new stereotypes. It is common to define traditional as non-conventional, unorthodox, and informal. Yet studies continue to reveal that non-scientifically appraised healing approaches in India or Africa are not only effective but also real, meaningful, fundamental, and primary care-seeking behaviours in many communities in these regions.[12] Suppose inclusive strategies are not un-situated. These conversations may be had within the structures, language, and spaces built by or connected to colonialism. The spaces, language, places, and structures in which these conversations occur can limit who can participate and how they participate. Importantly, some conditions are not conducive to participation as equals. The allocated time for the discussion could also constrain how individuals express themselves. It is unclear who is ultimately heard. Furthermore, epistemic situatedness of inclusion can impact decolonization conversations when participants are beneficiaries of, products of, and trained by structures and systems they seek to dismantle. To enhance the decolonization project and its goals, a pressing task is to unveil and question how the circumstances may inhibit activism. If the vestiges of colonialism continue to structure the decolonization discourse invisibly, the vestiges may undermine decolonization. For example, a public health discussion that includes white Western doctors and Western pharmaceutical executives in Africa may have many local Africans at the table but could still effectively devalue their input based on built-in assumptions and biases that are vestiges of colonialism. Second, exclusion and inclusion are also not binary. Individuals may experience exclusion, even while included (the phenomenon called internal exclusion). In other words, inclusion can fail to be substantial or become a means of enhancing optics, “a way of (un)consciously weakening the radical claims being pursued.”[13] For example, in South Africa, many institutions have made significant efforts to diversify their faculties due to the promulgation of the Employment Equity Act 55.[14] The act requires South African institutions to implement employment equity that redresses the history of harmful discrimination in the country. The act further requires transforming departments and institutional administrations. Although many recognize and support the need to transform departments in South Africa, the rhetoric of transformation departs sharply from the lived experiences.[15] This misalignment between the plan and practice is evident in the underrepresentation of black people and females in senior management teams, professorships in many universities and health departments, and positions of power in some South African institutions. Those selected in the transformation of the departments have also complained of being overworked. The burden of extra work undermines their ability to develop agency and voice in the space they now occupy or fulfil key requirements that have implications for their career trajectory.[16] This is called the minority tax. Notably, "the minority tax… is the burden of extra responsibilities [placed] on faculty of colour to achieve diversity and inclusion and contributes to attrition and impedes academic promotion."[17] One challenge for decolonializing projects will be for decolonial scholars and those selected for decolonization objectives to have the humility to decline invitations, requests, roles, and platforms for which they are either unqualified or lack the capacity to fulfil. At its heart, decolonization strategies must empower those included rather than weaken them. Finally, inclusion can lead to a phenomenon known as elite capture.[18] Elite capture occurs when socially advantaged individuals in a group monopolize or exploit activism to their own benefit at the expense of the larger, struggling group. Elite capture weakens decolonization efforts from within, revealing that those likely to benefit from global inclusive efforts are those who fulfil globally constructed standards, those “already present in the room.” There is no better strategy to weaken decolonial movements than weakening the project from within by strategically positioning individuals who share physical properties with the victims of exclusion and silencing but intellectually, behaviourally, psychologically, and emotionally share more common ground with the colonizer. Such insiders may be unaware they are furthering neocolonial conditions rather than decolonizing. In relation to decolonization, particularly in global health, elite capture reveals that those whose voices are loudest in the room are not necessarily those more impacted by colonialism. They may benefit more from reinforcing colonialism. Opportunism weakens meaningful activism from within, preventing good initiatives and strategies from having their intended impact or taking substantive root.[19] This paper cannot do justice to elite capture, but it is worth noting its negative impacts. IV. Improving the Impact of Decolonization To end neo-colonialism, it is important to understand how it manifests and what to do at each level. Beyond the academic discourse, many tangible efforts exist to decolonize through de-silencing. Examples of these efforts include the ME2 movement that seeks to centre the concerns and experiences of sexually abused or harassed victims in the public discourse. At the funding level, many grant-awarding agencies like Wellcome Trust have dedicated huge budgets to studies that help them understand how they may have perpetrated colonialism or neocolonialism and what they can do differently going forward.[20] In South Africa, promulgating the Employment Equity Act 55 was a tangible attempt to entrench decolonization concerns in a country's regulatory framework. Yet, these decolonization efforts could fail to be substantive if they do not reflect cultural sensitivity. Two key components of cultural sensitivity are worth highlighting here: epistemic and cultural humility. Epistemic humility is an intellectual virtue described as knowing one’s limitations and the limitations of the learning methods employed. At its simplest, it is the ability to admit when one is wrong. Cultural humility includes genuine attempts to learn about and embrace other cultures. Epistemic and cultural humility are signs of academic excellence and strength. Epistemic and cultural humility seriously acknowledge how the state of our knowledge, cognitive limitations, experiences, and backgrounds, while constraining us, also invite us to listen, learn, grow, and change. The limitations-owing account of epistemic and cultural humility suggests that “a person who is aware of her cognitive limitations and owns them is much better positioned to achieve such epistemic goods as true beliefs and understanding than someone who… simply has insight into the epistemic status of her beliefs.”[21] Epistemic and cultural humility may help prevent decolonization projects that unintentionally reinforce what they seek to dismantle. Epistemic humility calls on decolonizers to defer tasks for which they are not qualified to suitably qualified persons. Beyond this, humility supports brave scholarship that imagines and reimagines how featuring the same voices, faces, and perspectives possibly introduces new forms of domination or silencing. Cultural knowledge can lead to a more intentional way of seeking out the right people or a more diverse group than those frequently featured in decolonization conversations. This would give others more opportunities to navigate these spaces and should do so in ways that are familiar to them. One ought to be more sensitive to those who would ordinarily not be included in these conversations. Unless we radically and boldly reimagine these discussions, we risk alienating those most negatively impacted by neocolonialism. CONCLUSION Decolonization conversations are complex and the subject of academic debate. The strategies employed to decolonize can harm or help the victims of neo-colonialism. Inclusion of previously silenced individuals may not be enough to overcome the vestiges of colonialism, leading to a false inclusion, where those included feel excluded or contribute in ways reflecting their own biases and circumstances. Inclusion of an elite or people who do not truly represent the subjugated can lead to elite capture. For decolonization strategies to be impactful, for example, in the context of global health, project leaders and participants must engage in conversations employing epistemic and cultural humility. In many ways, epistemic and cultural humility can help us demythologize our assumptions of any cultural superiority or cognitive authority, allowing for diverse voices, cultures, and perspectives to emerge without domination. - [1] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [2] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [3] Anye-Nkwenti Nyamnjoh 2023. Is decolonisation Africanisation? The politics of belonging in the truly African university. Social Dynamics, 1-20. [4] Rianna Oelofsen 2015. Decolonisation of the African mind and intellectual landscape. Phronimon, 16, 130-146. [5] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [6] Pedro Alexis Tabensky 2008. The Postcolonial Heart of African Philosophy. South African Journal of Philosophy, 27, 285-295. [7] Nicholas M. Creary 2012. African Intellectuals and Decolonization, Ohio, Ohio University Press. [8] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [9] Vivetha Thambinathan & Elizabeth Anne Kinsella 2021. Decolonizing Methodologies in Qualitative Research: Creating Spaces for Transformative Praxis. International Journal of Qualitative Methods, 20, 16094069211014766. [10] Abimbola Seye 2023. Knowledge from the global South is in the global South. Journal of Medical Ethics, 49, 337. [11] A. Alenichev, P. Kingori & K. P. Grietens 2023. Reflections before the storm: the AI reproduction of biased imagery in global health visuals. Lancet Glob Health. [12] Jonathan K. Burns & Andrew Tomita 2015. Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 50, 867-877. [13] Anye-Nkwenti Nyamnjoh & Cornelius Ewuoso 2023. What type of inclusion does epistemic injustice require? Journal of Medical Ethics, jme-2023-109091. [14] 1998. Employment Equity Act. In: GOVERNMENT, S. A. (ed.) 19370. [15] Dina Zoe Belluigi & Gladman Thondhlana 2019. ‘Why mouth all the pieties?’ Black and women academics’ revelations about discourses of ‘transformation’ at an historically white South African university. Higher Education, 78, 947-963. [16] Juliet Ramohai & Khomotso Marumo 2016. Women in Senior Positions in South African Higher Education: A Reflection on Voice and Agency. 231, 135-157. [17] J. Trejo 2020. The burden of service for faculty of color to achieve diversity and inclusion: the minority tax. Mol Biol Cell, 31, 2752-2754. [18] Olufemi Taiwo 2020. Being-in-the-Room Privilege: Elite Capture and Epistemic Deference. The Philosopher, 108, 7. [19] Margarita Kurbatova & Elena Kagan 2016. Opportunism of University Lecturers As a Way to Adaptate the External Control Activities Strengthening. Journal of Institutional Studies, 8, 116-136. [20] Jeremy Farrar. 2022. An update on Wellcome's anti-racist programme. An update on Wellcome's anti-racist programme [Online]. Available from: https://wellcome.org/news/update-wellcomes-anti-racism-programme [Accessed August 10, 2022 2022]. [21] Katherine Dormandy 2018. Does Epistemic Humility Threaten Religious Beliefs? Journal of Psychology and Theology, 46, 292-304. (shrink)

Despite increased efforts to ensure diversity in genomic research, the exclusion of minority groups from data analyses and publications remains a critical issue. This paper addresses the ethical implications of these exclusions and proposes accountability for reasonableness (A4R) as a framework to promote fairness and equity in research. Originally conceived by Norman Daniels and James Sabin to guide resource allocation in the context of health policy, A4R emphasizes publicity, relevance of reasons, enforcement, and revision as essential for legitimacy and trust (...) in the decision‐making process. The authors argue that A4R is also relevant to resource allocation in research and that, if adequately informed and incentivized by funding agencies, institutional review boards, and scientific journals, researchers are well‐positioned to assess data‐selection justifications. The A4R framework provides a promising foundation for fostering accountability in genomics and other fields, including artificial intelligence, where lack of diversity and pervasive biases threaten equitable benefit sharing. (shrink)

The paper examines the impact of the Nigerian education and the extent to which it contributes towards the promotion of peace and justice with specific reference to Catholic schools. The paper argues that the role of Catholic Church in providing education has immensely contributed to the growth and development of education in Nigeria. Due to the church‟s focused intervention, approximately 649 elementary schools, 384 secondary schools and 16 tertiary institutions have been established in Nigeria. Relying on documentary method of (...) data collection and descriptive analytic approach, this study explains that Catholic schools have a significant role towards achieving a peaceful and equitable society in Nigeria. The article recommends more engaged efforts by other non-state institutions towards the building of developed educational institutions that will help in promoting peace and justice in Nigeria. (shrink)

As inpatient nurses spend the majority of their work time caring for patients at the bedside, they are often firsthand witnesses to the devastating outcomes of inadequate preventive healthcare and structural injustices within current social systems. This experience should obligate inpatient nurses to be involved in meeting the social justice needs of their patients. Many nursing codes of ethics mandate some degree of involvement in the social justice needs of society, though how this is to be achieved is (...) not detailed in these general guidelines. Acknowledging an explicit obligation for inpatient nurses to address the social justice issues of their patients would facilitate better overall understanding of social justice issues and reduce preventable admissions. If implementation of such an obligation is done with care, having inpatient nurses participate in justice projects could also mitigate compassion fatigue, allow for better job satisfaction among these nurses, and provide a sense of revitalization in nurses’ role as health promoters. (shrink)

Les crises économiques, financières, politiques, sociales, morales et écologiques se succèdent et s'entremêlent à l'échelle globale, au travers d'une mondialisation qui, dans la concrétisation de l'universel, traduit un jeu dual (global-local) dans lequel l'universalisation des conditions d'accès à l'universel fait défaut. L'extrême pauvreté dans les " sociétés non libérales " et le recul des libertés en termes de " capabilités " des plus vulnérables nous interpellent tous sur la glocalisation des grands maux sociétaux qui affligent en l'occurrence les plus mal (...) lotis et requièrent ainsi de nouvelles interrogations sur la pensée de John Rawls à propos de la solidarité et de la justice dans les relations internationales. Le glocaliste Thomas Pogge, qui mesure fort bien les enjeux de la conception de la justice comme équité à l'horizon cosmopolitique, se positionne en s'opposant à Rawls sur ce sujet. Le " principe de différence global " qui manque dans les politiques publiques et les institutions de redistribution de richesses est le point nodal de la discussion dans ce livre. Avec le souci d'établir les jalons d'un " développement glocaliste " juste et équitable, Daniel Noumbissié Tchamo ouvre un débat en philosophie pratique sur la distribution des richesses et les nouvelles considérations sur le développement dans une société mondiale glocalisée. (shrink)

This paper examines John Rawls' renowned theory of justice, which outlines two principles of justice and their respective significance. It explores how Rawls' notion of equality aligns with the philosophical concept of equity, emphasizing that his call for citizen equality inherently incorporates fairness. Additionally, the paper discusses the application of Rawls' "Difference Principle" to India's reservation policy. Rawls' principles, which aim to support the worst-off in society, are reflected in India's system of reservations for marginalized groups, including backward (...) classes and differently-abled individuals, to promote equitable opportunities. However, the paper cautions that excessive reservations could limit opportunities for more privileged groups. Ultimately, it is argued that Rawls' concept of social justice has contributed to the promotion of social justice in India. (shrink)

Au Québec, le régime d’examen des plaintes dans le réseau de la santé et des services sociaux contribue à l’amélioration continue des soins en permettant aux usagers de partager leur insatisfaction auprès d’une instance indépendante pouvant émettre des recommandations aux établissements. Le régime permet ainsi de renforcer la participation active de l’usager et donc de démocratiser les soins et services. En plus de sa parenté évidente avec cet objectif d’autonomisation, la bioéthique est omniprésente dans le travail des instances responsables (...) de l’application du régime, soit les commissariats aux plaintes. Cet article met en lumière l’usage implicite de concepts issus de la bioéthique dans le travail quotidien des commissariats aux plaintes. Nous y abordons l’autonomie, sous l’angle de l’autodétermination et de la confidentialité dans l’analyse de la recevabilité des plaintes. Nous y abordons également la justice, sous l’angle de l’équité dans l’allocation des ressources et de la justice épistémique dans le traitement des plaintes. Ensuite, nous abordons les similitudes entre les méthodologies de la bioéthique et du régime d’examen des plaintes, nommément les grilles d’analyse en éthique clinique et la narrativité. Finalement, nous abordons l’importance de l’impartialité, de l’indépendance et de la transparence dans le travail des commissariats aux plaintes. Nous concluons en offrant des pistes de réflexion en vue d’une mise à jour des connaissances empiriques concernant la concrétisation des objectifs de renforcement de la participation de l’usager dans ses soins et de démocratisation des soins et services. (shrink)

Although seventeenth‐century societies fell far short of contemporary standards of justice, early modern philosophers thought deeply about what social justice consists in. At a theoretical level, they aimed to articulate distributive principles. At a practical level, they asked what qualities we need to possess in order to make just judgments. In the first part of this article, I discuss two interpretations of the conception of equity on which justice was held to rest. On either interpretation, I suggest, (...) treating people equitably was held to be compatible with treating them in ways that we would consider radically unjust. This raises the practical question: What qualities was an equitable or just judge thought to need? The middle section of the article sketches a reply, drawing on a genre of early modern works about how to reason. As this section reveals, early modern thinkers were alive to the many ways in which we can fall short of justice and possessed many techniques for self‐improvement. Greater justice was not beyond the bounds of their imaginations; so, what prevented them from defending it? In the final section of the article, I propose a partial answer, as relevant to us as to our early modern forebears. (shrink)

Scientific data‐sharing and open science initiatives are increasingly important mechanisms for advancing the impact of genomic research. These mechanisms are being implemented as growing attention is paid to the need to improve the inclusion of research participants from marginalized and underrepresented groups. Together, these efforts aim to promote equitable advancements in genomic medicine. However, if not guided by community‐informed protections, these efforts may harm the very participants and communities they aim to benefit. This essay examines potential benefits and harms of (...) open science and explores how to advance a more just vision of open science in genomics. Drawing on relational ethics frameworks, we argue that researchers should consider their obligations to participants as well as the broader communities that are impacted by their research. We propose eight strategies to provide a foundation of practical steps for researchers to reduce the possibility of harms stemming from open science and to work toward genomic justice. (shrink)

La prévention du vieillissement est au cœur des politiques publiques de la santé. De nombreux dispositifs sont ainsi proposés aux différentes échelles de l’action publique afin de promouvoir le vieillissement réussi ou le vieillissement actif ou encore le bien vieillir. Dans les plans et programmes, trois piliers semblent se dégager au cœur des mesures préventives pour la santé des personnes âgées : la nutrition, l’activité sociale et la pratique des activités physiques et sportives (APS).Notre intérêt se porte sur (...) la politique de prévention de la vieillesse de manière générale ainsi que sur l’usage des APS comme outil privilégié de celle-ci et du maintien en bonne santé des personnes âgées. Ces deux axes permettent de questionner les temporalités de manière plurielle et de faire ressortir leurs articulations et leurs éventuels désajustements.Poser la question de la temporalité invite à questionner le temps long des transformations économiques, sociales ou scientifiques et les temps moyens ou courts des incitations des organisations internationales et des plans et programmes nationaux. De surcroît, en tant que politique préventive, la prévention du vieillissement a un rapport singulier à la temporalité en termes d’anticipation des risques. L’action publique doit ainsi articuler urgence et anticipation, se déployer dans le court terme en intégrant une projection d’un futur plus ou moins lointain. Enfin, les temporalités jouent aussi au niveau du public cible et des effets escomptés. Les plans reposent sur des transformations des conduites qui ont une portée temporelle très différente de celle des réformes et se confrontent aux parcours de vie des acteurs concernés inscrits dans un temps plus long et dans un temps subjectif. (shrink)

Cet article porte sur l’introduction du principe de précaution en matière de gestion du jeu. Il repose sur les réflexions suggérées par deux recherches effectuées au cours des dernières années par le Laboratoire d’éthique publique. Ainsi, il tente de répondre aux questions posées par ces deux recherches précédentes : comment gérer de façon responsable? Au nom de quel principe agir? Où tracer la limite de ce qu’il devrait être ou non permis de faire dans la commercialisation et l’exploitation des jeux (...) de hasard et d’argent? Les auteurs tentent donc de démontrer que l’adoption par l’État du principe de précaution lui permettrait de faire preuve de plus de rigueur dans la gestion d’une industrie qui pose de sérieux problèmes de santé publique. (shrink)

A number of articles and empirical studies over the past decade, most by Paul Robinson and co-authors, have suggested a relationship between the extent of the criminal law's reputation for being just in its distribution of criminal liability and punishment in the eyes of the community – its "moral credibility" – and its ability to gain that community's deference and compliance through a variety of mechanisms that enhance its crime-control effectiveness. This has led to proposals to have criminal liability and (...) punishment rules reflect lay intuitions of justice – "empirical desert" – as a means of enhancing the system's moral credibility. In a recent article, Christopher Slobogin and Lauren Brinkley-Rubinstein (SBR) report seven sets of studies that they argue undermine these claims of empirical desert and moral credibility and instead support SBR's proposed distributive principle of "individual prevention," a view that focuses on an offender's future dangerousness rather than on his perceived desert. -/- The idea that there is a relationship between the criminal law's reputation for justness and its crime-control effectiveness did not originate with Robinson and his co-authors. Rather, it has been a common theme among a wide range of punishment theory scholars for many decades. A particularly important conclusion of recent Robinson studies, however, is their confirmation that this relationship is a continuous one: even small nudges in moral credibility can produce corresponding changes in the community's deference to the criminal law. This is important because it shows that even piecemeal changes or changes at the margin – as in reforming even one unjust doctrine or procedure – can have real implications for crime-control. SBR's studies, rather than contradicting the crime-control power of empirical desert, in fact confirm it. Further, SBR's studies do not provide support for their proposed "individual prevention" distributive principle, contrary to what they claim. -/- While SBR try to associate their principle with the popular "limiting retributivism" adopted by the American Law Institute in its 2007 amendment of the Model Penal Code, in fact it is, in many respects, just the reverse of that principle. With limiting retributivism, the Model Code's new provision sets desert as dominant, never allowing punishment to conflict with it. SBR would have "punishment" essentially always set according to future dangerousness; it is to be constrained by desert only when the extent of the resulting injustices or failures of justice is so egregious as to significantly delegitimize the government and its law. This ignores the fact that even minor departures from justice may have an important cumulative effect on the system as a whole. What SBR propose – essentially substituting preventive detention for criminal justice – promotes the worst of the failed policies of the 1960s, where detention decisions were made at the back-end by "experts," and conflicts with the trend of the past several decades of encouraging more community involvement in criminal punishment, not less. (shrink)

Through a theoretical examination of the preventive turn in criminal law and justice which has gained momentum in Anglo-American criminal justice systems since the late-twentieth century, The Preventive Turn in Criminal Law demonstrates how recent transformations in criminal law and justiceare intrinsically related to and embedded in the way liberal society and liberal law have been imagined, developed, and conditioned by its social, political, and historical context. Henrique Carvalho identifies a tension between the idea of punishment as an (...) expression of individual justice, andprevention as a manifestation of the need for security and the promotion of welfare. Tracing this tension back to an intrinsic ambivalence within the modern conception of individual liberty, which is both repressed and preserved by liberal conceptions of responsibility and punishment, Carvalhoproves that as long as this ambivalence remains unexamined, liberal law has the potential to both promote and undermine individual justice.Engaging with the dominant contemporary literature on criminal law, prevention, risk, security, and criminalisation, this volume deploys a theoretical perspective developed through a critical analysis of both classical and contemporary works of social and political theory. The book reveals that thepervasiveness of prevention in 21st century criminal justice systems represents not only the consequence of new and unprecedented features of contemporary politics and society, but also the manifestation of essential aspects of the liberal legal and political tradition. (shrink)

In accordance with environmental injustice, sometimes called environmental racism, minority communities are disproportionately subjected to a higher level of environmental risk than other segments of society. Growing concern over unequal environmental risk and mounting evidence of both racial and economic injustices have led to a grass-roots civil rights campaign called the environmental justice movement. The environmental ethics aspects of environmental injustice challenge narrow utilitarian views and promote Kantian rights and obligations. Nevertheless, an environmentaljustice value exists in all ethical world (...) views, although it involves a concept of equitable distribution of environmental protection that has been lacking in environmental ethics discussion. (shrink)

In the article “Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics,” Sean Valles provides an important reminder of the consequences of mass incarceration in the United States and identifies potential roles for bioethicists in addressing this system. My limited view—that of a physician who conducts court‐ordered investigations and monitoring of health services behind bars—is that the ongoing failure of most academic and professional organizations to be more effective in this much‐ignored area stems from the lack of (...) leaders and staff who have been directly impacted by mass incarceration. As conditions behind bars worsen, and a new war on drugs recoils the spring of mass incarceration, there is a pressing need to train, recruit, and promote people who know the realities of the criminal (and immigration) justice system and its impact on health and well‐being. This step can bring a more powerful engagement of bioethics regarding housing, employment, and health care and policing, as well as the numerous and harmful elements of jails, prisons, and detention settings. I provide examples of partners I learn from in this arena, as well as some discrete and technical areas for possible investigation. (shrink)

This research questions the prevention and health promotion practices developed for young people, in France, and re-examines the nature of competences enlisted in the classical model of empowerment in health education. Moving away from the epidemiological postulate of evidence based medicine (EBM), it explores another approach of these educational practices. The research uses the perspective of narrative mediation; it tries also to identify issues about a better knowledge of oneself, making more comprehensive the issues of young students’ health.

Emerging child welfare policies promoting preventive and early intervention services present a challenge to professional ethics, raising questions about how to balance respect for service users with concern for social justice. This article explains how the UK policy involves shifting the balance of power away from families towards state and professional decision making. The policy is predicated on sharing information between professionals to inform risk and need assessment and so poses a problem for the ethic of confidentiality in a (...) helping relationship. This article examines the arguments for information sharing and questions whether the predicted benefits for children outweigh the cost of eroding family privacy and changing the nature of professional relationships with service users. (shrink)

In her recent article, Prince has identified a critical challenge for those who advocate genetic enhancement to reduce social injustices. The gene–environment interaction prevents genetic enhancement from having equitable effects at the phenotypic level, even if enhancement were available to the entire population. The poor would benefit less than the rich from their improved genes because their genotypes would interact with more unfavourable socioeconomic environments. Therefore, Prince believes that genetic enhancement should not be used to combat social inequalities, since it (...) can likely aggravate them. In this article, I raise various objections to this conclusion. I argue first that genetic enhancement need not necessarily magnify social injustices. I then show that genetic enhancement can play a modest but not insignificant role in the quest for social justice in the future. Finally, I conclude by arguing for the need to consider the complex interplay between the social lottery and the natural lottery in our aspirations for justice linked to genetic technologies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Liberating Sexuality: Justice Between the Sheets by Miguel A. De La TorreSimeiqi HeLiberating Sexuality: Justice Between the Sheets Miguel A. De La Torre SAINT LOUIS: CHALICE PRESS, 2016. 232 pp. $27.99What lies at the heart of Miguel De La Torre's provocative and refreshing collection of essays Liberating Sexuality is his lifelong commitment to a justice-based society. He is deeply concerned with "how oppressive social structures, (...) [End Page 191] rooted in a two-thousand-year-old misunderstanding of Christian sexuality, prevent us from a more just social order" (vii).De La Torre rigorously engages with the biblical literature and considers it a vital ground for ethical reflection. He first returns to Genesis and successfully argues that "God blesses sex and declares it good" (4). He closely examines the story of the first man and woman and proposes the concept of "cleave to" in Genesis 2:24–25 as the guiding definition for a healthy marriage in our modern society. By revisiting and creatively retelling the stories of women in the Bible—Lot's wife, Sarah, Dinah, Rebekah, and Tamar—he restores the humanity and dignity of women and calls for our responsibility to dismantle the patriarchal structures that foster sexual abuse. He also provides alternative interpretations of the troubling biblical texts for LGBTQ communities to consider. After thoroughly surveying the biblical justification of patriarchy and the subjugation of women in the Hebrew Bible, he proposes that "the entire Bible should be read through the lens of the Gospel message, specifically passages like John 10:10" (13). Though a creative attempt to liberate the sacred text from oppression, this approach requires caution, as there may be possible anti-Semitic ramifications for reading the Hebrew Bible through a New Testament lens.One of the major contributions of De La Torre to the field of sexual ethics is the proposal of "orthoeros" through a liberative method that seriously considers liberation theology and goes beyond the inadequate approaches of both conservatives' sexual legalism and liberals' permissiveness toward sexual ethics. "Orthoeros" promotes a "familial relationship based on mutual giving and vulnerability" (21) and is made up of five biblically based principles: safe, consensual, faithful, mutually pleasing, and intimate.As an ethicist who is invested in the public discourse, De La Torre actively and boldly engages with issues of various sexual practices. He critiques Fifty Shades of Grey and envisions an ethical, Christian-based sadomasochism by employing "orthoeros" principles. He also examines the historical reasons against masturbation and argues for its constructive role in the sexuality of Christians.Deeply disturbed by the prevailing injustice that corrupts our society, De La Torre focuses much of the volume on exposing the sources and the detrimental effects of sexism, heterosexism, and racism. He reveals misogynist legislation by mapping out the "war on women," specifically the issues of equal pay, rape, reproduction rights, and global sexism. He reflects on his own "sin of heterosexuality" of being a macho man, conquering, and celebrating cojones. He also examines the Euro-American history of owning black bodies and critiques the stereotyping of Latino bodies in Hollywood.Another major contribution of De La Torre is the indecent approach to justice-based praxis—an ethics para joder—that "screws" with the prevailing power structures by utilizing a nonviolent survival strategy based on love, designed to liberate the abused and the abusers from the death-dealing social structure. [End Page 192]Liberating Sexuality, situated at the intersection between Christian ethics, biblical hermeneutics, and cultural studies, is a successful interdisciplinary endeavor. The essays gathered here remain highly engaged with the public reality and should benefit both general readers and scholars. Furthermore, this volume provides much-needed guidance on how a sexual ethics should be implemented and is, hence, a vital resource for those engaged in the practices of ministry.Simeiqi HeDrew UniversityCopyright © 2018 Society of Christian Ethics... (shrink)

Est-il moralement acceptable de transmettre aux générations futures des déchets nucléaires ou une biodiversité réduite à une peau de chagrin ? Les personnes futures sauraient-elles être titulaires de droits alors qu'elles n'existent pas ? Est-il juste de revoir à la baisse le montant des retraites pour lesquelles des pensionnés ont cotisé toute leur vie ou de transférer aux générations à venir une dette publique considérable ? Chacune de ces questions a trait à différents domaines de notre existence. Pourtant, un fil (...) rouge les relie : celui de la justice entre les générations. Brûlantes d'actualité, ces interrogations se voient bien souvent offrir pour seule réponse le dénuement relatif de nos théories. Ainsi, des concepts comme ceux de " droit acquis " en matière de pensions ou de " développement durable " ne sauraient faire office d'arguments s'ils ne s'appuient pas sur un solide arrière-fond théorique issu de la philosophie morale et politique. Car l'économie publique ou la biologie des populations ne peuvent suffire à aiguiller les citoyens et leurs représentants sur les choix qui leur incombent en matière intergénérationnelle. La philosophie a aussi son rôle à jouer, à la condition qu'elle ait la modestie d'être à l'écoute d'autres disciplines, l'exigence d'articuler clairement ses présupposés, et le courage de se frotter à la pratique [4ème de couverture ]. (shrink)

The current situation of climate change at a global level clearly requires policy changes at local levels. Global efforts to reach a consensus regarding the reduction of greenhouse gas emissions have so far been focused on developing Climate-Friendly Technologies (CFTs). The problem is that in order for these efforts to have an actual impact at a global level we need to be concerned with more than just promotion and info-dissemination on the already existing CFTs, but also with costs, implementation and (...) the international intellectual property and trade system necessary for this strategy to work. Currently, almost 80% of all patent applications belong to OECD countries like Japan, US, Germany, South Korea, Great Britain and France. The obligations climate change imposes on developing countries represent a technological shift that depends on Technology Transfer (TT) and implementation of IP laws. The current IP framework, especially patent law, copyright and trade secrets produces another kind of obligations. The main question is if the conjunction of these two sets of obligations (rules) is fair from a global justice point of view. Also, it is questionable whether this conjunction helps developing countries to produce their own CFTs. When discussing the demands of global justice one cannot skip the very important distinction Pogge makes between negative and positive obligations. In the context of global warming and the measures that the world’s states ought to take to prevent it, there seems to lie another conjunction between the positive obligation of preserving the natural environment that we all share and a negative obligation of allowing the less developed countries to help us all do so. Because one cannot impose regulations that cannot be put into practice, it is more and more obvious that a new framework of action and development needs to be drawn in the field of TT of CFTs. (shrink)

Bioethics is a field in which innovation is required to help prevent and respond to zoonotic diseases with the potential to cause epidemics and pandemics. Some of the developments necessary to fight pandemics, such as COVID-19 vaccines, require public debate on the benefits and risks of individual choice versus responsibility to society. While these debates are necessary, a more fundamental ethical innovation to rebalance human, animal, and environmental interests is also needed. One Health (OH) can be characterized as a strategy (...) that recognizes and promotes the synergy between human, animal, and environmental health. Yet, despite the recognition that these entities are interdependent, there is a pronounced inequality in the power relations between human, non-human animal, and the environmental interests which threatens the well-being of all. Until OH can ensure the moral status of animals and the environment and thereby the equal consideration of these interests, it will struggle to protect non-human interests and, as a result, human health. To create a sustainable health system requires a renewed concept of justice that is ecocentric in nature and an application of OH that is flexible and responsive to different ethical interests (e.g., person-centred care and physician responsibilities). Ultimately, to save themselves, humans must now think beyond themselves. Bioethics must assume a key role in supporting the developments required to create and maintain relationships able to sustain environmental and human health. (shrink)

For about a decade, actors in the field of disability have been encouraged, sometimes forced, to apply an “evidence based” approach to develop their projects, i.e. to use field methods whose effectiveness has been demonstrated with a high level of evidence, whose transferability has been verified through research works, and which have been the subject of scientific publications. This requirement raises several problems: these methods, which are more often in the scope of prevention than health promotion and are too succinctly (...) described in reviews, are only applicable in very specific contexts and are difficult to adapt. The implementation of quality health promotion requires an open approach. It must be based on the results of intervention research, realistic evaluation, participatory research, and capitalization of experiences, evaluation reports, promising practices and field benchmark. This is particularly true for projects concerning people with disabilities, for which very little data from the scientific literature is available. (shrink)

The Association of American Colleges & Universities has a guiding principle that presidents, chief academic officers, deans, and faculty at its member institutions can follow to cultivate diverse, inclusive, and equitable communities at their institutions. This principle constitutes the “Making Excellence Inclusive” initiative, which is a component of the AAC&U’s Liberal Education and America’s Promise initiative. Taking the “Making Excellence Inclusive” initiative as my starting point, I challenge the way that diversity and inclusion seem to be conceived of by many (...) people at colleges and universities. I then imagine how genuinely inclusive and equitable communities can be cultivated at colleges and universities by taking social justice seriously. (shrink)

Theorists have long debated whether John Rawls’ conception of justice as fairness can be extended to nonideal (i.e. unjust) social and political conditions, and if so, what the proper way of extending it is. This paper argues that in order to properly extend justice as fairness to nonideal conditions, Rawls’ most famous innovation – the original position – must be reconceived in the form of a “nonideal original position.” I begin by providing a new analysis of the ideal/nonideal (...) theory distinction within Rawls’ theoretical framework. I then systematically construct a nonideal original position, showing that although its parties must have Rawls’ principles of ideal justice and priority relations as background aims, the parties should be entirely free to weigh those aims against whatever burdens and benefits they might face under nonideal conditions. Next, I show that the parties ought to aim to secure for themselves a special class of nonideal primary goods: all-purpose goods similar to Rawls’ original primary goods, but which in this case are all-purpose goods individuals might use to (A) promote Rawlsian ideals under nonideal conditions, (B) weigh Rawls’ principles of ideal justice and priority relations against whatever burdens and benefits they might face under nonideal conditions, and (C) effectively pursue their most favored weighting thereof. I then defend a provisional list of nonideal primary goods which include opportunities to participate effectively in equitable and inclusive grassroots reform movements guided by a series of substantive aims. Finally, I briefly speculate on how the parties to the nonideal original position might deliberate to principles of nonideal justice for distributing nonideal primary goods, suggesting that those goods should be distributed in proportion to unjust disadvantage. (shrink)

International research is an essential means of reducing health disparities between and within countries and should do so as a matter of global justice. Research funders from high-income countries have an obligation of justice to support health research in low and middle-income countries that furthers such objectives. This paper investigates how their current funding schemes are designed to incentivise health systems research in LMICs that promotes health equity. Semi-structured in-depth interviews were performed with 16 grants officers working for (...) 11 funders and organisations that support health systems research: the Alliance for Health Policy and Systems Research, Comic Relief, Doris Duke Foundation, European Commission, International Development Research Centre, Norwegian Agency for Development Cooperation, Research Council of Norway, Rockefeller Foundation, UK Department of International Development, UK Medical Research Council, and Wellcome Trust. Thematic analysis of the data demonstrates their funding schemes promote health systems research with five key features that advance health equity: being conducted with worst-off populations, focusing on research topics that advance equitable health systems, having LMIC ownership of the research agenda, strengthening LMIC research capacity, and having an impact on health disparities. The different types of incentives that encouraged proposed projects to have these features are identified and classified by their strength. It is suggested that research funders ought to create and maintain funding schemes with strong incentives for the features identified above in order to more effectively help reduce global health disparities. (shrink)

Even though considerable resources have been allocated to the study of obesity, there is no consensus on its definition, causes, or solutions. Amidst ongoing debates over understandings of obesity, Obesity Canada (OC) was established to enhance the quality of life of Canadians with obesity through the advancement of anti-discrimination, policy change, and obesity prevention and treatment. Drawing upon a transdisciplinary social justice framework, we use critical thematic analysis to examine the OC website, which is the organization’s primary knowledge mobilization (...) platform. We will address the following research question: To what extent does OC serve social justice goals that promote the best interests of larger people? We argue that the social justice potential of OC ultimately falls short and conclude with some recommendations on how the site content could be enhanced with social justice principles. (shrink)

This study aims to examine how interdisciplinary urban interventions within architectural education can effectively address social justice issues. Motivated by the growing need for inclusive and equitable urban spaces, this research explores the potential of collaborative design and participatory research methods to foster social awareness and community engagement. Focusing on student-led projects in cities such as Houston, San Diego, and Amsterdam, this study addresses social justice challenges across themes like Art Activism, Tactical Urbanism, environmental justice, and gender (...) equity. Using case study analysis, digital mapping, and poster creation as core methodologies, the research demonstrates the value of multi-scalar, interdisciplinary approaches in tackling complex urban problems. The key findings highlight that integrating these approaches into architectural education promotes critical engagement with social justice issues, equipping students with practical skills for future professional challenges. The implications suggest that expanding this framework to diverse urban contexts could enhance its impact, offering a foundation for further studies on interdisciplinary design as a tool for urban equity. (shrink)

This article explores the intersection between critical pedagogies and social justice in the context of environmental education, with a focus on transforming educational projects to promote meaningful social change. Through theoretical analysis and qualitative methodology, it highlights how critical pedagogies offer a valuable framework for addressing social and environmental inequalities. This approach fosters students' awareness of their role as agents of change in environmental protection and in creating more equitable and resilient communities. The results show that the application of (...) these principles facilitates the development of critical thinking and empowerment competencies in students, promoting active participation in environmental management. (shrink)

Efforts to promote equitable public policy with algorithms appear to be fundamentally constrained by the “impossibility of fairness” (an incompatibility between mathematical definitions of fairness). This technical limitation raises a central question about algorithmic fairness: How can computer scientists and policymakers support equitable policy reforms with algorithms? In this article, I argue that promoting justice with algorithms requires reforming the methodology of algorithmic fairness. First, I diagnose the problems of the current methodology for algorithmic fairness, which I call “formal (...) algorithmic fairness.” Because formal algorithmic fairness restricts analysis to isolated decision-making procedures, it leads to the impossibility of fairness and to models that exacerbate oppression despite appearing “fair.” Second, I draw on theories of substantive equality from law and philosophy to propose an alternative methodology, which I call “substantive algorithmic fairness.” Because substantive algorithmic fairness takes a more expansive scope of analysis, it enables an escape from the impossibility of fairness and provides a rigorous guide for alleviating injustice with algorithms. In sum, substantive algorithmic fairness presents a new direction for algorithmic fairness: away from formal mathematical models of “fair” decision-making and toward substantive evaluations of whether and how algorithms can promote justice in practice. (shrink)

The essay refers to a concern for social justice in the origins of public health, borne in part by religious commitments, and to more recent expressions of a similar concern in debates about health equity. Equity, moreover, is affected by discursive power relations (dominant/hegemonic versus local/suppressed), which are discussed in relation to current research in the African Religious Health Assets Programme on the interaction of particular 'healthworlds' (a conceptual innovation) that shape the choices and behaviour of health-seekers. Two background (...) theoretical positions guide the argument: Amartya Sen's claim that development is linked to freedom (including religious freedom); and, building on Sen's and Martha Nussbaum's human capabilities theory, an asset-based community approach to the building or reconstruction of public health systems. On this basis, it is argued that health systems and health interventions are just to the extent that they mediate between the necessary leadership or polity from 'above' ( techné ) and the experience and wisdom ( métis ) of those who are 'below', taking into account the asymmetries of power that this equation represents. Because difference and diversity are so often expressed in what we might reasonably call 'religious' terms, I specifically emphasize the continuing persistence of religion and, hence, the importance of accounting for its pertinence in social theory generally, and in relation to discourses of health and justice in the African context specifically. Acknowledging the ambiguities of religion, I nevertheless argue that an appreciative alignment between public health systems and religious or faith-based initiatives in health promotion, prevention and care is crucial to sustainable and just health systems in Africa. (shrink)