Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for autonomy. We identify some of the challenges (...) emerging from this literature: in particular, how to reconcile universal human vulnerability with a context-sensitive analysis of specific kinds and sources of vulnerability; and how to reconcile obligations to protect vulnerable persons with obligations to respect autonomy. We then briefly survey some of the theoretical resources available within the philosophical literature to address these challenges, and to assist in understanding the conceptual connections between vulnerability and related concepts such as harm, exploitation, needs, and autonomy. We also sketch out a taxonomy of sources and kinds of vulnerability. Finally, we consider the implications for policy evaluation of making vulnerability an explicit and central focus of bioethics. Our investigation is in the form of a broad survey motivating a research agenda rather than a detailed analysis. (shrink)

Sweatshop labor is often cited as an example of the worst and most pervasive form of exploitation today, yet understanding what is meant by the charge has proven surprisingly difficult for philosophers. I develop an account of what I call “Needs Exploitation,” grounded in a specification of the duty of beneficence. In the case of sweatshop labor, I argue that employers face a duty to extend to employees a wage sufficient to meet their basic needs. This duty is limited by (...) the degree of the employees’ dependence on the employer for basic needs and a reasonability standard where the employer may remain within a range of well-being between deficiency and luxury. (shrink)

Human need and related concepts such as basic needs have long been part of the implicit conceptual foundation for social work theory, practice, and research. However, while the published literature in social work has long stressed social justice, and has incorporated discussion of human rights, human need has long been both a neglected and contested concept. In recent years, the explicit use of human needs theory has begun to have a significant influence on the literature in social work.

BackgroundVulnerability is a key concept in traditional and contemporary bioethics. In the philosophical literature, vulnerability is understood not only to be an ontological condition of humanity, but also to be a consequence of contingent factors. Within bioethics debates, vulnerable populations are defined in relation to compromised capacity to consent, increased susceptibility to harm, and/or exploitation. Although vulnerability has historically been associated with older adults, to date, no comprehensive or systematic work exists on the meaning of their vulnerability. To fill this (...) gap, we analysed the literature on aged care for the meaning, foundations, and uses of vulnerability as an ethical concept.MethodsUsing PRISMA guidelines, we conducted a systematic review of argument-based ethics literature in four major databases: PubMed, Embase®, Web of Science™, and Philosopher’s Index. These covered biomedical, philosophy, bioethical, and anthropological literature. Titles, abstracts, and full texts of identified papers were screened for relevance. The snowball technique and citation tracking were used to identify relevant publications. Data analysis and synthesis followed the preparatory steps of the coding process detailed in the QUAGOL methodology.ResultsThirty-eight publications met our criteria and were included. Publication dates ranged from 1984 to 2020, with 17 publications appearing between 2015 and 2020. Publications originated from all five major continents, as indicated by the affiliation of the first author. Our analyses revealed that the concept of vulnerability could be distinguished in terms of basic human and situational vulnerability. Six dimensions of older adults’ vulnerability were identified: physical; psychological; relational/interpersonal; moral; sociocultural, political, and economic; and existential/spiritual. This analysis suggested three ways to relate to older adults’ vulnerability: understanding older adults’ vulnerability, taking care of vulnerable older adults, and intervening through socio-political-economic measures.ConclusionsThe way in which vulnerability was conceptualised in the included publications overlaps with distinctions used within contemporary bioethics literature. Dimensions of aged care vulnerability map onto defining features of humans, giving weight to the claim that vulnerability represents an inherent characteristic of humans. Vulnerability is mostly a value-laden concept, endowed with positive and negative connotations. Most publications focused on and promoted aged care, strengthening the idea that care is a defining practice of being human. (shrink)

In attempts to compare different distributions with regards to need, so-called “measures of need-based distributive justice” have emerged in recent years. Each of the proposed measures relies on a single dimension of need that is taken into account. This is shown to be problematic since humans experience different kinds of need that appear to be incommensurable. A strategy to deal with this problem is introduced by using multidimensional measures.

This book offers an original account of a distinctly republican theory of social and global justice. The book starts by exploring the nature and value of Hegelian recognition theory. It shows the importance of that theory for grounding a normative account of free and autonomous agency. It is this normative account of free agency which provides the groundwork for a republican conception of social and global justice, based on the core-ideas of freedom as non-domination and autonomy as non-alienation. As the (...) author argues, republicans should endorse a sufficientarian account of social justice, which focuses on the nature of social relationships and their effects on people's ability to act freely and realize their fundamental interests. On the global level, the book argues for the cosmopolitan extension of the republican principles of non-domination and non-alienation within a multi-level democratic system. In so doing, the book addresses a major gap in the existing literature, presenting an original theory of justice, which combines Hegelian recognition theory and republican ideas of freedom, and applying this hybrid theory to the global domain. Fabian Schuppert creates a grand synthesis uniting neo-republican insights on freedom with Hegelian recognition theory. The result is an account of agency that arises from the idea of non-domination whose aim it is to safeguard individual freedom. When combined with Hegelian recognition theory a social focus also emerges. This amalgam comments on many of the major disputes concerning global justice from a cosmopolitan perspective. Because of the broad scope and the many contemporary discussions engaged this book will be of keen interest to scholars as well as a welcome addition to the classroom. (shrink)

The article presents an original needs-based partial theory of human injustice and shows its relationship to existing theories of human need and human liberation. The theory is based on an original typology of three social structural sources of human injustice, a partial theorization of the mechanisms of human injustice, and a needs-based theorization of the nature of human injustice, as experienced by individuals. The article makes a sociological contribution to normative social theory by clarifying the relationship of human injustice to (...) human needs, human rights, and human liberation. The theory contends that human injustice is produced when oppression, mechanistic dehumanization, and exploitation create systematic inequality in opportunities to address human needs, leading to wrongful need deprivation and the resulting serious harm. In one longer sentence, this needs-based partial theory of the sources, mechanisms, and nature of human injustice contends that three distinct social systemic sources—oppression, mechanistic dehumanization, and exploitation—produce unique and/or overlapping social mechanisms, which create systematic inequality in opportunities to address universal human needs in culturally specific ways, thus producing the nature of the human injustice theorized here: wrongfully unmet needs and serious harm. (shrink)

Imagine that only the state can meet the need for housing but decides not to do so. Unsurprisingly, participants in a vignette experiment deem this scenario unjust. Hence, justice ratings increase when the living situation improves. To a lesser extent, this also holds beyond the need threshold, understood as the minimum amount necessary for a decent life. Surprisingly, however, the justice evaluation function is highly convex below this point. The resulting S-shaped curve is akin to the value function in prospect (...) theory, with the need threshold providing the point of reference and inflection. A control treatment without needs-information supports this interpretation. Needs-information furthermore compresses the perceived injustice of arbitrary inequality. As in prospect theory, such reference dependency suggests biases in judgment and decision making. A consequence may be that the lot of the poorest in society does not receive the attention it would otherwise get. (shrink)

The role that need plays in dealing with problems of distributive justice is examined in a series of vignette studies. Among other things, it becomes clear that impartial observers make gradual assessments of justice that depend on the extent to which the observed individuals are endowed with a good. If it is known how high their need for that good is, the assessments are made relative to this reference point. In addition, impartial decision-makers make hypothetical distribution decisions that take into (...) account need, productivity, and accountability. The need of individuals is partially compensated even if they have contributed less to the available amount than they themselves require. However, the willingness to do so decreases if they are accountable for needing more than others or for having contributed less than others. Lastly, both impartial observers and impartial decision-makers distinguish between different types of needs, the fulfillment of which is given different levels of importance. (shrink)

Bedürfnisse sind etwas, das uns als Menschen grundlegend bestimmt. Der vorliegende Band fasst eine Reihe von Vignettenstudien zusammen, in denen untersucht wird, welche Rolle Bedürfnisse im Umgang mit Problemen der Verteilungsgerechtigkeit spielen. Während sie in Diskussionen zur Verteilungsgerechtigkeit häufig eher unterrepräsentiert sind, wird hier gezeigt, dass sie eine fundamentale Bedeutung im Denken der Menschen haben. Es wird unter anderem deutlich, dass unparteiischen Beobachter*innen graduelle Gerechtigkeitseinschätzungen von Verteilungssituationen vornehmen, die davon abhängig sind, wie umfangreich die beobachteten Parteien mit einem Gut ausgestattet (...) sind. Wenn außerdem bekannt ist, wie hoch deren Bedarf an jenem Gut ist, finden die Einschätzungen relativ zu diesem Referenzpunkt statt. Außerdem werden in der Rolle von unparteiischen Entscheider*innen hypothetische Verteilungsentscheidungen getroffen, die den Bedarf, die Leistung sowie die Verantwortung der betroffenen Parteien berücksichtigen. Hierbei wird der Bedarf einer Partei auch dann zumindest teilweise kompensiert, wenn diese weniger zu der zur Verfügung stehenden Gütermenge beigetragen hat, als sie selbst benötigt. Die Bereitschaft, den Bedarf einer Partei teilweise zu kompensieren, sinkt jedoch, wenn sie dafür verantwortlich ist, mehr als andere zu benötigen oder weniger als andere beigetragen zu haben. Und sowohl in der Rolle von unparteiischen Beobachter*innen als auch in der Rolle von unparteiischen Entscheider*innen wird zwischen unterschiedlichen Bedarfsarten unterschieden, deren Erfüllung verschiedene Wichtigkeit beigemessen wird. (shrink)

In this essay, I continue Nicholas Wolterstorff’s work of developing a rights-based theory of ethics called eirenéism, which maintains the good life only occurs when justice—as a moral state of affairs where agents enjoy the goods to which they have a right—is achieved. As a result, justice is eirenē (the Greek word for peace). In the process of developing eirenéism I explain how eirenē differs from other conceptions of peace, and I offer several interpretive arguments for how best to understand (...) eirenéism in relation to better-known competing ethical theories, like utilitarianism, virtue ethics, duty ethics, and care ethics. (shrink)