Ethical perspectives on regional, rural, and remote healthcare often, understandably and importantly, focus on inequities in access to services. In this commentary, we take the opportunity to examine the implications of normalizing metrocentric views, values, knowledge, and orientations, evidenced by the recent (2022) New South Wales inquiry into health outcomes and access to hospital and health services in regional, rural and remote New South Wales, for contemporary rural governance and justice debates. To do this, we draw on the feminist inspired (...) approach to rural health ethics involving analysis of power relationships developed by Simpson and McDonald and related ideas from critical health sociology. In presenting this analysis, we extend contemporary thought about spatial health inequities and structural violence. (shrink)

This paper explores the difference it makes to incorporate the multi-focal conception of violence that has emerged in peace studies over recent decades into the discourse of non-violent direct action (Galtung 1969, 1990; Uvin 2003; Springs 2015b). I argue that non-violent action can and should incorporate and deploy the distinctions between direct, cultural, and structural forms of violence. On one hand, these analytical distinctions can facilitate forms of self-reflexive critical analysis that guard against certain violent conceptual and practical implications of (...) non-violence, however inadvertent those may be. At the same time, these lenses help reconceptualise non-violent action in ways that open up an array of strategies and tools not previously prevalent among activists committed to non-violence. Non-violent action may itself be either complicit in, or might be enabled to illuminate and cut against, forms of violence that infuse social, political, and economic structures (i.e. structural violence). Appeals to non-violence and the actions with which they interweave may be complicit in, or might be enabled to illuminate and cut against, religious, ideological, aesthetic, and even scientific understandings and conceptual frames that underpin and support structural violence (i.e. cultural violence). In each case, non- violence must be critically examined with all these possibilities in mind. I first define and contextualize a multidimensional account of violence in terms of direct, structural, and cultural violence. I then consider two examples of how it challenges thinking about non-violence. (shrink)

Journal of Social Philosophy, EarlyView.

The application of human right frameworks is an increasingly important part of efforts to accelerate progress in global mental health. Much of this has been driven by several influential legal and policy instruments, most notably the United Nations’ Convention on the Rights of Persons with Disabilities, as well as the World Health Organization’s QualityRights Tool Kit and Mental Health Action Plan. Despite these significant developments, however, much more needs to be done to prevent human rights violations. This chapter focuses on (...) a critical component of this broader challenge, which is the question of how best to regulate and reduce the use of coercive measures. The recent literature on coercion in psychiatry – which addresses involuntary commitment, seclusion, restraint, and forced medication – represents a useful resource that can help guide tractable solutions in global mental health. These issues are evaluated from the perspective of global health governance, and several general recommendations are made in order to improve monitoring and enforcement, provide guidance for domestic legislative reform, and strengthen health systems. (shrink)

In this article, I report on a Bulgarian female migrant caregiver's “life-story,” especially focusing on her relationship with an old Italian woman, on the care practices performed in her favor in Italy, and on her daughter and parents still living in Bulgaria. I chose to do it by means of an anthropological approach based on experience as field of mediation between personal dimensions and historical and social processes and therefore centered on the body conceived as historical product, the influence of (...) political and social forces on shaping human lives, and finally interest in the specific link between bodies and work. From this analysis, based on language and narratives, I think useful cultural aspects may emerge about “gender” and care practices, regarding the two women linked by an assistance relationship, and the activities/strategies used by the Bulgarian caregiver to fulfill her family obligations. (shrink)

Given that mitigating climate change is a large-scale global issue, what obligations do individuals have to lower their personal carbon emissions? I survey recent suggestions by Walter Sinnott-Armstrong and Dale Jamieson and offer models for thinking about their respective approaches. I then present a third model based on the notion of structural violence. While the three models are not mutually incompatible, each one suggests a different focus for mitigating climate change. In the end, I agree with Sinnott-Armstrong that people have (...) limited moral obligations to directly lower personal emissions, but I offer different reasons for this conclusion, namely that the structural arrangements of our lives place a limit on how much individuals can restrict their own emissions. Thus, individuals should focus their efforts on changing the systems instead (e.g., the design of cities, laws and regulation, etc.), which will lead to lower emissions on a larger scale. (shrink)

In our study of U.S. counterterrorism programs, we found that anthropology needs a mode of analysis that considers security as a form distinct from insecurity, in order to capture the very heterogeneity of security objects, logics and forms of action. This article first presents a genealogy for the anthropology of security, and identifies four main approaches: violence and State terror; military, militarization, and militarism; para-state securitization; and what we submit as “security analytics.” Security analytics moves away from studying security formations, (...) and how much violence or insecurity they yield, to identifying security forms of action, whether or not they are part of the nation-state. As a framework for anthropological inquiry, it is oriented toward capturing how these forms of action work and what types of security they produce. We then illustrate this approach through our fieldwork on counterterrorism in the domains of law enforcement, biomedical research and federal-state counter extremism. In each of our cases, we use security analytics to arrive at a diagnosis of the form of action. The set of conceptual distinctions that we propose as an aid to approaching empirical situations and the study of security is, on another level, a proposal for an approach to anthropology today. We do not expect that the distinctions that aid us will suffice for every situation. Rather, we submit that this work presents a set of specific insights about contemporary U.S. security, and an example of a new approach to anthropological problems. (shrink)

Randomized experiments, as developed by Esther Duflo and Abhijit Banerjee at the Abdul Latif Jameel Poverty Action Lab, offer a novel, evidence-based approach to fighting poverty. This approach is original, in that it imports the methodology of clinical trials for application in development economics. This paper examines the analogy between J-PAL’s field experiments in development economics and randomized controlled trials in medicine. RCTs and randomized field experiments are commonly treated as identical, but such treatment neglects some of the major distinguishing (...) features that make each experiment specifically apt for use in its respective field. The central claim of this paper is that the analogy between medicine and development economics is incomplete because the central dimensions of RCTs are not simply different but altogether lacking in J-PAL’s approach. This weakens both the political and the theoretical power of such experiments in development economics. (shrink)

In order to enhance the “structural competency” of medicine—the capability of clinicians to address social and institutional determinants of their patients’ health—physicians need a theoretical lens to see how social conditions influence health and how they might address them. We consider one such theoretical lens, fundamental cause theory, and propose how it might contribute to a more structurally competent medical profession. We first describe fundamental cause theory and how it makes the social causes of disease and health visible. We then (...) outline the sorts of “fundamental interventions” that physicians might make in order to address the fundamental causes. (shrink)

The substantive center of Christian ethics is Jesus’s ministry of the kingdom or reign of God, and its preferential inclusion of the poor, the outcast, and the sinner. What defines a gospel-based bioethics is a hopeful, practical commitment to improve the health of those who are most vulnerable to illness and early death because they lack basic needs. This commitment is distinctive of Christian bioethics, if not “unique” in the sense that no other bioethical approaches or traditions share it. To (...) succeed in reducing disparities in access to health care requires cooperative social action with members of multiple moral and political communities, meaning that there is no strict boundary between secular and Christian bioethics at the practical, political level, the level of applied Christian social ethics. (shrink)

With attention to the experiences, agency, and rights of tuberculosis patients, this symposium on TB and ethics brings together a range of different voices from the social sciences and humanities. To develop fresh insights and new approaches to TB care and prevention, it is important to incorporate diverse perspectives from outside the strictly biomedical model. In the articles presented in this issue of the Journal of Bioethical Inquiry, clinical experience is married with historical and cultural context, ethical concerns are brought (...) to bear on global health, and structural analyses shed light upon the lived experience of people living with TB. The relational and reciprocal dimensions of care feature strongly in these discussions, which serve as a poignant reminder that behind each of the yearly deaths from TB is a deeply personal story. No single discipline holds a monopoly on how to care for each of these people, but strong cases are made for support from mental health and social workers in addressing the kaleidoscope of needs in TB prevention. As the World Health Organization moves towards the goal of eliminating TB globally by 2050, attending to the needs of TB patients serves global interests to lower disease burden and to develop better integrated communities worldwide. (shrink)

This essay recognizes that the interactions that define medical care are problematic and that narrative is invoked to overcome these strains. Being grounded in science, medicine, too, might be influenced by a particular world-view that arose in the natural philosophy of the Scientific Revolution. If narrative responds to this sort of medicine, it may retain traces of this mindset. A feminist approach responds to this viewpoint and may used beneficially to analyze both the story of medicine and the stories within (...) medicine. Tensions discussed from this perspective are those between sickness and health and those between patient and provider; also questioned are suitable form(s) of narrative and whose narratives are valued. Suggestions for broadening narrative to address these issues include letting the body speak for itself, overcoming the power differential in the patient/provider interaction and using standpoints to foster a more equal and just medical system. (shrink)

Food Sovereignty is a vibrant discourse in academic and activist circles, yet despite the many shared characteristics between issues surrounding food and public health, the two are often analysed in separate frameworks and the insights from Food Sovereignty are not sufficiently brought to bear on the problems in the public health discourse. In this paper, I will introduce the concept of 'self-organised community viability' as a way to link food and health, and to argue that what I call the 'Health (...) Security' paradigm requires a 'Health Sovereignty' response modelled on Food Sovereignty. (shrink)

This article critically examines current responses to multi-drug resistant tuberculosis and argues that bioethics needs to be willing to engage in a more radical critique of the problem than is currently offered. In particular, we need to focus not simply on market-driven models of innovation and anti-microbial solutions to emergent and re-emergent infections such as TB. The global community also needs to address poverty and the structural factors that entrench inequalities—thus moving beyond the orthodox medical/public health frame of reference.

This chapter concerns the normativity of the concepts of paternalism and libertarian paternalism. The first concept is central in evaluating public health policy, but its meaning is controversial. The second concept is equally controversial and has received much attention recently. It may or may not shape the future evaluation of public health policy. In order to facilitate honest and fruitful debate, I consider three approaches to these concepts, in terms of their normativity. Concepts, I claim, may be considered nonnormative, normatively (...) charged, or normative in that they involve more complex relationships between values or duties. While the last approach is often best, other approaches may be appropriate depending on the context and purpose of discussion. The chapter’s conceptual investigation is illustrated by application to two public health policies: a tax on the consumption of fat and the encouragement of health-promoting food displays in restaurants and supermarkets. (shrink)

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

Universal access to antiretroviral treatment (ART) in Chad was officially declared in December 2006. This presidential initiative was and is still funded 100% by the country’s budget and external donors’ financial support. Many factors have triggered the spread of AIDS. Some of these factors include the existence of norms and beliefs that create or increase exposure, the low-level education that precludes access to health information, social unrest, and population migration to areas of high economic opportunities and gender-based discrimination. Social forces (...) that influence the distribution of dimensions of well-being and shape risks for infection also determine the persistence of access barriers to ART. The universal access policy is quite revolutionary but should be informed by the systemic barriers to access so as to promote equity. It is not enough to distribute ARVs and provide health services when health systems are poorly organized and managed. Comprehensive access to ART raises many organizational, ethical and policy problems that need to be solved to achieve equity in access. This paper argues that the persistence of access barriers is due to weak health systems and a poor public health leadership. AIDS has challenged health systems in a manner that is essentially different from other health problems. (shrink)

This paper examines the particular relevance of feminist critiques of epistemic authority in contexts of institutionalized violence. Reading feminist criticism of “experts” together with theorists of institutionalized violence, Stone-Mediatore argues that typical expert modes of thinking are incapable of rigorous knowledge of institutionalized violence because such knowledge requires a distinctive kind of thinking-within-discomfort for which conventionally trained experts are ill-suited. The author demonstrates the limitations of “expert” modes of thinking with reference to writings on the Iraq war by Michael Ignatieff (...) and Fouad Ajami. Finally, the author turns to a newly active group of epistemic agents—anti-war relatives of soldiers--to examine the role that undervalued epistemic traits can play in knowledge of war and other forms of structural violence. (shrink)

In the first part of this article we survey the concept of human rights from a philosophical perspective and especially in relation to the “right to healthcare”. It is argued that regardless of meta-ethical debates on the nature of rights, the ethos and language of moral deliberation associated with human rights is indispensable to any ethics that places the victim and the sufferer in its centre. In the second part we discuss the rise of the “right to privacy”, particularly in (...) the USA, as an attempt to make the element of personal free will dominate over the element of basic human interest within the structure of rights and when different rights seem to conflict. We conclude by discussing the relationship of human rights with moral values beyond the realm of rights, mainly human dignity, free will, human rationality and response to basic human needs. (shrink)

One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new drug is rewarded in proportion to its impact on the global disease burden (not through monopoly rents). This reform would bring (...) drug prices down worldwide close to their marginal cost of production and would powerfully stimulate pharmaceutical research into currently neglected diseases concentrated among the poor. Its feasibility shows that the existing medical-patent regime (trade-related aspects of intellectual property rights—TRIPS—as supplemented by bilateral agreements) is severely unjust—and its imposition a human-rights violation on account of the avoidable mortality and morbidity it foreseeably produces. (shrink)

Recent decades of women's rights advocacy have produced numerous regional and international agreements for protecting women's security, including a UN convention that affirms the state's responsibility to protect key gender-specific rights, with no exceptions on the basis of culture or religion. At the same time, however, the focus on universal women's rights has enabled influential feminists in the United States to view women's rights in opposition to culture, and most often in opposition to other people's cultures. Not surprisingly, then, feminists (...) across the global South have criticized the universal-women's-rights agenda. This article reviews representative critical responses to universal-women's-rights advocacy. The author argues that, taken collectively, these critical responses do not reject the possibility of cross-cultural feminist advocacy but they do suggest the need for feminists in the United States and Europe to focus less on transferring rights across the obstacles of culture and more on how they can revise and expand their own understanding of women's rights in response to the struggles of other women, many of whom view women's rights as organic to their own cultures and as connected to broader social struggles. (shrink)

The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, (...) and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches. (shrink)

This edited volume provides a biosemiotic analysis of the ecological relationship between food and medicine. Drawing on the origins of semiotics in medicine, this collection proposes innovative ways of considering aliments and treatments. Considering the ever-evolving character of our understanding of meaning-making in biology, and considering the keen popular interest in issues relating to food and medicines - fueled by an increasing body of interdisciplinary knowledge - the contributions here provide diverse insights and arguments into the larger ecology of organisms’ (...) engagement with and transformation through taking in matter. Bodies interpret molecules, enzymes, and alkaloids they intentionally and unintentionally come in contact with according to their pre-existing receptors. But their receptors are also changed by the experience. Once the body has identified a particular substance, it responds by initiating semiotic sequences and negotiations that fulfill vital functions for the organism at macro-, meso-, and micro-scales. -/- Human abilities to distill and extract the living world into highly refined foods and medicines, however, have created substances far more potent than their counterparts in our historical evolution. Many of these substances also lack certain accompanying proteins, enzymes, and alkaloids that otherwise aid digestion or protect against side-effects in active extracted chemicals. Human biology has yet to catch up with human inventions such as supernormal foods and medicines that may flood receptors, overwhelming the body’s normal satiation mechanisms. This volume discusses how biosemioticians can come to terms with these networks of meaning, providing a valuable and provocative compendium for semioticians, medical researchers and practitioners, sociologists, cultural theorists, bioethicists and scholars investigating the interdisciplinary questions stemming from food and medicine. (shrink)

In December 2010, the governor of Mississippi suspended the dual life sentences of two African American sisters who had been imprisoned for sixteen years on an extraordinary condition: that Gladys Scott donate a kidney to her ailing sister Jamie Scott. The Scott Sisters’ case is a highly unusual one, yet it is a revealing site for inquiry into US biopolitics more broadly. Close attention to the conditional release and its context demands a broader frame than traditional bioethics and helps to (...) push science and technology studies analysis of race past its conventional focus on genetics. This article draws on the Scott Sisters’ case as a site for interrogating the US context of racialized mass incarceration and kin-oriented and consumerist valorization of organ donation. Tensions between racialized exclusions, the promise of consumerist freedom, and the lack of expectations of the state are foundational to a distinctly American biological citizenship. By putting the Scott Sisters’ case into conversation with broader arguments about incarceration as a site of racialization and STS literatures of organ transplantation and of biological citizenship in diverse geographical sites, this article seeks to articulate some of the racialized contours of biopolitics in the United States. (shrink)

This article argues that to advance the struggle for access to essential medicines, it is necessary to identify the global and local regimes that shape the rules that give impetus to particular policy options, while undermining others. In exploring the role of law and politics in this process, the author first outlines the globalization of a standardized, corporate-inspired, intellectual property regime. Second, the author uses the example of the HIV/aids pandemic to demonstrate how the stability of this new regime came (...) under pressure, both locally and globally. Finally, it is argued that while the global HIV/aids pandemic and the social movements that emerged in response to government inaction have effectively challenged the TRIPS regime, this complex contestation has reached an unsustainable stalemate in which development aid, corporate, and non-governmental philanthropy is simultaneously providing increased availability to drugs while precluding a more lasting solution to the crisis of access to essential medicines in developing countries. (shrink)

This theoretical paper argues for prioritarianism as an ethical underpinning for digital health in contexts of extreme disadvantage. In support of this claim, the paper develops three prioritarian principles for making ethical decisions for digital health programme design, grounded in the normative position that the greater the need, the stronger the moral claim. The principles are positioned as an alternative view to the prevailing utilitarian approach to digital health, which the paper argues is not sufficient to address the needs of (...) the worst off. As researchers of digital health, we must ensure that the most globally marginalised are not overlooked by overtly technocentric implementation practices. Consequently, the paper concludes by advocating for use of the three principles to support stronger critical reflection on the ethics involved in the design and implementation of digital health programmes. (shrink)

Recent decades have seen a significant increase in physicians participating in international short-term missions to regions with limited or no access to health care by virtue of natural disaster or lack of resources. Recent publications in the ethics literature have explored the potential of these missions for unintentional harm to the intended beneficiaries. Less has been discussed about how to respond when harm actually occurs. The authors review the ethical issues raised by short-term medical and humanitarian missions and the literature (...) on responding to unintended error to provide guidelines for avoiding harm to the intended beneficiaries of missions and an appropriate response when harm occurs. Two cases demonstrating an analysis and response to unintended harm are presented. (shrink)

Peace and conflict studies education has grown significantly in the last 30 years, mainly in Higher Education. This article critically analyzes the ways in which this field might be subject to poststructural critique, and posits Bourdieusian second-order reflexivity as a means of responding to these critiques. We propose here that theory-building within PACS education is often limited by the dominance of Galtung and Freire, and that, while the foundational ideas of positive and negative peace, structural and cultural violence, conscientization, reflexivity (...) and critical pedagogy are still relevant today, they nevertheless need to be combined in new ways with each other, and with Bourdieu’s notions of habitus and field, to adequately respond to poststructural critique. Thus, we call here for greater field-based reflexivity in twenty-first century PACS. (shrink)

The general scholarship on armed conflict in Manipur, India, ignores the experiences of women as agents. Feminist scholarship counters this tendency, revealing women's everyday responses to the violence that constrains them. However, this scholarship often fails to be intersectional, and it lauds every instance of women's agency without evaluating it in terms of its ability to build peace. Employing Kimberlé Crenshaw's underused distinction between structural and political intersectionality and Saba Mahmood's concept of agency, I analyze my field research conducted with (...) women's peacebuilding groups in Manipur in 2014 and 2015. Using structural intersectionality, I first describe the qualitatively different experiences of women peacebuilders living at different social locations. Using political intersectionality as a normative tool, I then show that ethnic and religious hierarchies often disrupt women's attempts to build peace. Interethnic peacebuilding groups that rely on gender-based solidarity tend to privilege the experiences of the women coming from the majority ethnic group. Other peacebuilding groups, bound by ethnicity, often distrust and resent women who come from different ethnic enclaves. I argue that women's peacebuilding agency must aim at an inclusive justpeace if it is to succeed. We should evaluate agency, rather than glorifying all instances of women's responses to violence. (shrink)

Lisa A. Eckenwiler, Long-term care, globalization, and justice, Baltimore: The Johns Hopkins University Press, 2012, reviewed by Lynette Reid.

The essays in this issue of JMP are devoted to critical engagement of my book, The Anticipatory Corpse. The essays, for the most part, accept the main thrust of my critique of medicine. The main thrust of the criticism is whether the scope of the critique is too totalizing, and whether the proposed remedy is sufficient. I greatly appreciate these interventions because they allow me this occasion to respond and clarify, and to even further extend the argument of my book. (...) In this response essay, I maintain that the regnant social imaginary of medicine is the regnant social imaginary of our time. It is grounded in a specific ontotheology: where ontology is a power ontology; where material is malleable to the open-ended organization of power and dependent only on working out the efficient mechanisms of its enactment; where ethically it is oriented only to the immanent telos of utility maximization in the short run, and ultimately to some posthuman future in the long run. This ontotheology originates in the anticipatory corpse and is ordered toward some god-like posthuman being. The entire ontotheology finds enactment through the political economy of neoliberalism. This social imaginary constantly works to insulate itself from other social imaginaries through the use of its institutional power, through marginalization, circumscription, or absorption. The modern social imaginary of neoliberal societies marginalizes and politically isolates other social imaginaries, or transforms them into something acceptable to the neoliberal imaginary. Yet, these other social imaginaries could influence the larger social imaginary in novel ways, sometimes through withdrawal and sometimes through challenges. These other practices—again, usually practices ordered according to different ontological and teleological purposes—might serve as a source of renewal and transformation, but only if the practitioners of these other social imaginaries understand the ontotheological powers that they are up against. (shrink)

Important medical advances over the last several decades have vastly improved the technical capacity to control human pain. Millions of patients suffering from cancer, HIV/AIDS, and other conditions have been able to find relief from incapacitating chronic and acute pain. However, despite these developments, pain remains severely under treated worldwide, particularly in developing countries. The tragic consequence is that for millions of people around the globe, excruciating pain is an inescapable reality of life.

A friend once told me I was wasting my time writing about cross-cultural perspectives on the beginnings of life. “Your work is interesting for its curiosity value,” he said, “but fundamentally worthless. What happens in other cultures is totally irrelevant to what is happening here.” Those were discouraging words, but as I followed the American debates about the beginnings and ends of life, it seemed he was right. Anthropologists have written a great deal about birth and death rites in other (...) societies and about non-western notions of personhood, but to date our findings have had little impact on American policy, ethics, or law. The recognized experts on contentious topics such as abortion and euthanasia tend to come from the fields of philosophy, bioethics, theology, law, and biology, but rarely from the social sciences. I was a bit surprised, therefore, to be invited to address the Thomas A. Pitts Memorial Lectureship on “Defining the Beginning and the End of Human Life.”. (shrink)

In this paper I utilize anthropological insights to illuminate how health professionals and patients navigate and negotiate what for them is social about tuberculosis in order to improve treatment outcomes and support patients as human beings. I draw on ethnographic research about the implementation of the DOTS approach in Georgia’s National Tuberculosis Program in the wake of the Soviet healthcare system. Georgia is a particularly unique context for exploring these issues given the country’s rich history of medical professionalism and the (...) insistence that the practice of medicine is a moral commitment to society. I argue for critical attention to the ways in which treatment recipients and providers navigate what, for them, is “social” about therapeutic practices and their significance for avoiding biological and social reductionism. (shrink)

Although suffering in Schopenhauer’s works may be explained by how the will to life is objectified in the world, a more precise inquiry leads us to elucidate the significance of this experience in his writings. This article claims in the first place that suffering in this author’s works is triggered by multiple sources and takes various forms. In fact, and this is the article’s second claim, these sources coincide with some later scholars’ characterizations of modern suffering. The main aim is (...) to show the value of Schopenhauer’s works in understanding modern malaise. This article is divided into 4 parts: in the first part, some considerations about suffering and modernity are indicated; in the second part, the place of suffering in Schopenhauer’s works is explored; in the third part, some of suffering’s sources are analysed; finally, a number of dimensions that may be of great value in better understanding modern malaise are noted. (shrink)

Abstract.In a previous issue of Zygon (Carvalho 2007), I explored the role of scientists—especially those engaging the science‐religion dialogue—within the arena of global equity health, world poverty, and human rights. I contended that experimental biologists, who might have reduced agency because of their professional workload or lack of individual resources, can still unite into collective forces with other scientists as well as human rights organizations, medical doctors, and political and civic leaders to foster progressive change in our world. In this (...) article, I present some recent findings from research on three emerging viruses—HIV, dengue, and rotavirus—to explore the factors that lead to the geographical expansion of these viruses and the increase in frequency of the infectious diseases they cause. I show how these viruses are generating problems for geopolitical stability, human rights, and equity health care for developing nations that are already experiencing a growing poverty crisis. I suggest some avenues of future research for the scientific community for the movement toward resolution of these problems and indicate where the science‐religion field can be of additional aid. (shrink)

Good nutrition plays an important role in the optimal growth, development, health and well-being of individuals in all stages of life. Healthy eating can reduce the risk of chronic diseases, such as heart disease, stroke, diabetes and some types of cancer. However, the capitalist mindset that shapes the food environment has led to the commoditization of food. Food is not just a marketable commodity like any other commodity. Food is different from other commodities on the market in that it is (...) explicitly and intrinsically linked to our human existence. While possessing another commodity allows for social benefits, food ensures survival. Millions of people in United States of America are either malnourished or food insecure. The purpose of this paper is to present a critique of the current food system using four meanings of the common good--as a framework, rhetorical device, ethical concept and practical tool for social justice. The first section of this paper provides a general overview of the notion of the common good. The second section outlines how each of the four meanings of the common good helps us understand public practices, social policies and market values that shape the distal causal factors of nutritious food inaccessibility. We then outline policy and empowerment initiatives for nutritious food access. (shrink)

The goal of this paper is to articulate and advocate for an enhanced role for philosophers of science in the domain of science policy as well as within the science curriculum. I argue that philosophy of science as a field can learn from the successes as well as the mistakes of bioethics and begin to develop a new model that includes robust contributions to the science classroom, research collaborations with scientists, and a role for public philosophy through involvement in science (...) policy development. Through an analysis of two case studies, I illustrate how philosophers of science can make effective and productive contributions to science education as well as to interdisciplinary scientific research, and argue for the essential role of philosophers of science in the realm of science policy. (shrink)

This article aims to demonstrate how the impact of humanitarian crises on health outcomes is related to social justice issues, even when these crises are brought upon by natural disasters. Pre-existing inequalities between individuals and social groups within a community affect in important and complex ways the health disparities which result from natural disasters. Drawing on the thought-provoking work of Paul Farmer, my main hypothesis is that socio-political factors prior to natural disasters determine ‘structured health risks’ that humanitarian crises will (...) necessarily exacerbate. To adequately respond to these structured health risks, medical humanitarianism cannot abide by an apolitical approach which mainly focuses on emergency relief. A more comprehensive analysis of the socio-political aspects of the health impact of humanitarian crises indicates that a more comprehensive approach to medical humanitarianism is necessary. This has three implications. First, a coherent account of medical humanitarianism needs to assess the international dimension of structural injustice that leads to structured health disparities. Second, this comprehensive approach to medical humanitarianism supports the ‘denaturalization of natural disasters’ argument. Third, medical humanitarianism should be organized around a broader and more complex approach of overlapping sequences which bridge emergency relief, reconstruction and development through a better aligned, orchestrated and coherent international effort. (shrink)

Many legal scholars well recognize that, in some instances, support for a law or policy may be primarily because of its expressive function, i.e. the statements it makes about underlying values. In these cases, the expressive content of a law or policy may actually overshadow its central purpose. Examples of this phenomenon, according to Cass Sunstein, include, for example, regulations against hate speech in the USA. He suggests that achieving the consequence (prohibiting hateful speech against certain groups) may not be (...) the real focus (central purpose) of the law. Rather, the real focus is on the social meaning of these regulations—that bigotry is unacceptable in a liberal society. In this way, a particular law or policy can operate on many levels—while aiming to achieve a particular objective or behavior, it can also be a valuable tool for achieving other important social goals through its expressive function. This article applies this insight to the realm of public health policy, with particular attention to the case of pandemic planning, and suggests that public health policy and its overall goals may be well-served by deliberate regard for, and appropriate utilization of, the expressive function. (shrink)

This essay describes and critically evaluates a co-operative educational program to train Ugandan health care workers in bioethics. It describes one bottom-up effort, a week-long intensive workshop in bioethics provided by the authors to health care professionals in a developing country—Uganda. We will describe the background and circumstances that led to the organization of the workshop, and review its planning, design, curriculum, and outcome. We will focus especially on measures taken to make the workshop relevant for the audience of Ugandan (...) professionals, and describe lessons learned after two presentations of the workshop. Finally, we will discuss the strengths and weaknesses of such a format, and its potential value in raising bioethical expertise in developing countries. (shrink)

The lack of medical availability of effective pain medication is an enduring and expanding global health calamity. Despite important medical advances, pain remains severely under-treated worldwide, particularly in developing countries. This article contributes to the discussion of this global health crisis by considering international legal and institutional mechanisms to promote wider accessibility to critical narcotic drugs for pain relief.