The paper seeks to make a contribution towards a better understanding of the current global political unrest. It argues that this unrest reflects ongoing tensions between hierarchical and non-hierarchical interactions. It also argues that the opposition between hierarchical and non-hierarchical interactions is not ontological but rather is rooted in the way we approach reality and is, therefore, subject to our control. The tendency to exclude the process of construction from our frame of vision is characteristic for the view of reality (...) that is dominant in our civilization. Contemporary theoretical perspectives that include, but are not limited to, systems theory, complexity theory, theory of self-organization, emergence theory and autopoiesis have much to offer in addressing and resolving this problem. The paper outlines some general organizing principles that should be part of this solution. (shrink)

By assuming the permanence of conflict, agonistic theories of politics are apparently incompatible with cosmopolitanism. Nevertheless, this paper aims to reveal the potential for a theory of cosmopolitanism in Chantal Mouffe's agonistic theory. In the first section, I present Mouffe's own critique of cosmopolitanism, pointing to its inconsistencies. The second section examines four aspects of Mouffe's agonism and explores their cosmopolitan potential. First, I argue that Mouffe's account of pluralism reveals the interconnectedness of political practices at different levels. Second, Mouffe's (...) sense of the transformation from “enemy” into “adversary” through “conversion” can be extended to cosmopolitanism. Third, the “conflictual consensus” which Mouffe attributes to adversaries is adequate for a cosmopolitanism that lacks a global consensus, but nonetheless is based on a minimal commonality of all human beings. Fourth, contestation, as conflict in the “tamed” mode, has a cosmopolitan potential to contest an.. (shrink)

This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad range of global actors up and down the chain of vaccine development who contribute to global vaccine inequities. Section 1 (Background) presents an overview of moments in which diverse global actors, each with their own priorities and aims, shaped subsequent vaccine distribution. Section 2 (Collective action failures) characterises collective action failures (...) at each phase of vaccine development that contributed to global vaccine disparities. It identifies as critical the task of establishing upstream strategies to coordinate collective action at multiple stages across a range of actors. Section 3 (A Multilateral model of global health governance) takes up this task, identifying a convergence of interests among a range of stakeholders and proposing ways to realise them. Appealing to a responsibility to protect (R2P), a doctrine developed in response to human rights atrocities during the 1990s, we show how to operationalise R2P through a principle of subsidiarity and present ethical arguments in support of this approach. (shrink)

This paper argues that cosmopolitan law has been more successfully achieved not by appeal to a supra-state authority or community, but by the development of features of existing treaty law. Specifically, it shows how the International Criminal Court's jurisdiction over serious human rights violations has been extended to the citizens and territories of non-member states – and even to otherwise immune state officials – not by challenging the sovereignty of non-member states directly, but on the basis of member states’ own (...) territorial sovereignty and the universal jurisdiction which they delegate to the Court and to the United Nations Security Council. In light of this, the authors argue that cosmopolitanism is better conceived not as invoking an independent sense of global community that supersedes and constrains state sovereignty, but as an immanent, contingent and creative development of statist criminal law itself, rooted in its principles of state sovereignty. (shrink)

The literature on patient public involvement and engagement (PPIE) in health research has grown significantly in the last decade, with a diverse range of definitions and topologies promulgated. This has led to disputes over what the central functions and purpose of PPIE in health research is, and this in turn makes it difficult to assess and evaluate PPIE in practice. This paper argues that the most important function of PPIE is the attempt to make health research more democratic. Bringing this (...) function to the fore and locating PPIE in the wider context of changes in contemporary forms of democratic engagement provides greater conceptual clarity over what PPIE in research should be trying to achieve. Conceptualizing PPIE as a form of democratization has a number of benefits. First, theories of what are appropriate, normatively justifiable and workable criteria for PPIE practices can be developed, and this can provide tools to address the legitimacy and accountability questions that have troubled the PPIE community. Second, this work can be used to form the basis of a research agenda to investigate how PPIE in health research operates, and how it can facilitate and/or improve democratic processes in health research. (shrink)