The argument of this article is that what I term generic globalization has created unprecedented opportunities for advances in human rights universally, but that the dominant actually existing historical form of globalization ? capitalist globalization ? undermines these opportunities. Substantively, I argue that taking the globalization of human rights seriously means eliminating the ideological distinction that exists between civil and political rights on the one hand, and economic and social rights on the other. Doing this systematically undermines the three central (...) claims of capitalist globalization ? namely, that globalizing corporations are the most efficient and equitable form of production, distribution and exchange; that the transnational capitalist class organizes communities and the global order in the best interests of everyone; and that the culture-ideology of consumerism will satisfy our real needs. (shrink)

Our approach to global bioethics will depend, among other things, on how we answer the questions whether global bioethics is possible and whether it, if it is possible, is desirable. Our approach to global bioethics will also vary depending on whether we believe that the required bioethical deliberation should take as its principal point of departure that which we have in common or that which we have in common and that on which we differ. The aim of this article is (...) to elaborate a theoretical underpinning for a bioethics that acknowledges the diversity of traditions and experiences without leading to relativism. The theoretical underpinning will be elaborated through an exploration of the concepts of sameness, otherness, self and other, and through a discussion of the conditions for understanding and critical reflection. Furthermore, the article discusses whether the principle of respect for the other as both the same and different can function as the normative core of this global bioethics. The article also discusses the New Jersey Death Definition Law and the Japanese Transplantation Law. These laws are helpful in order to highlight possible implications of the principle of respect for the other as both the same and different. Both of these laws open the door to more than one concept of death within one and the same legal system. Both of them relate preference for a particular concept of death to religious and/or cultural beliefs. (shrink)

Our aim in this paper is to suggest that most current theories of global justice fail to adequately recognise the importance of global public goods. Broadly speaking, this failing can be attributed at least in part to the complexity of the global context, the individualistic focus of most theories of justice, and the localised nature of the theoretical foundations of most theories of global justice. We argue ? using examples (particularly that of protecting antibiotic efficacy) ? that any truly effective (...) theory of global justice must recognise the importance of global public goods. Global public goods confer significant benefits to individuals yet can only be effectively promoted and preserved through collective action and the restriction of individual choice; something which most theories of justice are structurally unequipped to sufficiently promote. (shrink)

This paper explores a global public goods approach to the health of migrants. It suggests that this approach establishes that there are a number of health goods which must be provided to migrants not because these are theirs by right, but because these goods are primary goods which fit the threefold criteria of global public goods. There are two key advantages to this approach: first, it is non-confrontational and non-oppositional, and second, it provides self-interested arguments to provide at least some (...) health goods to migrants and thus appeals to those little moved by rights-based arguments. (shrink)

One of the major concerns of advocates of common morality is that respect for cultural diversity may result in moral relativism. On their part, proponents of culturally responsive bioethics are concerned that common morality may result in moral imperialism because of the asymmetry of power in the world. It is in this context that critics argue that global bioethics is impossible because of the difficulties to address these two theoretical concerns. In this paper, I argue that global bioethics is possible (...) if we adopt a culturally responsive and self-critical attitude towards our moral values and those of others. I use the example of women’s reproductive autonomy in indigenous African culture to show that the difference between the leading Euro-American and indigenous African construal of autonomy is that the former ascribes greater weight on individual self-determination while the latter emphasizes responsibilities towards the community. One develops dignity in virtue of their capacity for communing with others. Hence, women have rights, but as members of the community, they also have obligations including the duty to procreate. The involvement of the family in reproductive decisions does not contravene women’s dignity and human rights. In applying the principle of autonomy in this communitarian context, one has to be sensitive to these ontological and moral specificities. The aim of global bioethics should not be to reach common grounds at all costs; any common norms should be the result of a negotiated democratic dialogue between cultures and not the result of imposition by the preponderant culture. (shrink)

In a recent public engagement study on heritable human genome editing (HHGE) conducted among South Africans, participants approved of using HHGE for serious health conditions—viewing it as a means of bringing about valuable social goods—and proposed that the government should actively invest resources to ensure everyone has equal access to the technology for these purposes. This position was animated by the view that future generations have a claim to these social goods, and this entitlement justified making HHGE available in the (...) present. This claim can be ethically justified in the Ubuntu ethic (deriving from South Africa) as it (a) emphasizes the interests of the community, and (b) espouses a metaphysical conception of the community that transcends the present generation and includes past and future generations. On this basis, a compelling claim can be made on behalf of prospective persons in favor of equal access to HHGE. (shrink)

Although a widely used concept in health care, person‐centred care remains somewhat ambiguous. In the field of palliative care, person‐centred care is considered a historically distinct ideal and yet there continues to be a dearth of conceptual clarity. Person‐centred care is also challenged by the pull of standardization that characterizes much of health service delivery. The conceptual ambiguity becomes especially problematic in contemporary pluralistic societies, particularly in the light of continued inequities in healthcare access and disparities in health outcomes. Our (...) aim was to explicate premises and underlying assumptions regarding person‐centred care in the context of palliative care with an attempt to bridge the apparently competing agendas of individualization versus standardization, and individuals versus populations. By positioning person‐centredness in relation to the hermeneutics of the self according to Paul Ricœur, dialectics between individualization and standardization, and between individuals and populations were constructed. The competing agendas were related in a dialectic manner in the way that population health is of importance for the individual, and standardization is of importance for the population. The analysis suggests that person‐centred care is an ethical stance, which gives prominence to both suffering and capability of the individual as a person. The dialectic analysis points towards the importance of extending person‐centred care to encompass population and societal perspectives and thereby avoiding a problematic tendency of affiliating person‐centred care with exclusively individualistic perspectives. Considerations for person‐centred palliative care on micro‐, meso‐ and macrolevels conclude the paper. (shrink)

Over the past 20 years, global ethics has come to be conceived in different ways. Two main tendencies can be distinguished. One asks from whence global ethics comes and defines ‘global ethics’ as arising from globalization. The other tendency is to ask whither global ethics must go and thus defines ‘global ethics’ as a destination, namely arriving at a comprehensive global ethic. I will note some types of discussion that may have been wrongly excluded from the scope of global ethics (...) by one or the other. In addition, I take notice of recent debates and concerns about risks that global ethics may become a neo-colonial activity. These concerns raise a further conceptual question. Should ‘global ethics’ be defined in a normative fashion, so as to exclude neo-colonial approaches that may be damaging to the credibility of global ethics? In response to these alternatives – whence vs. whither, descriptive vs. normative – I will propose a middle way. I begin by defining ‘global problems’ as those that will cause harm in the absence of cross-border cooperation. In a descriptive sense, any ethical statements about global problems should be included within the scope of global ethics. On the other hand, I will propose a more specific normative conception of the central task of global ethics: seeking reasonable and responsible agreement on global problems, agreement based on possibly diverse moral grounds. (shrink)

Humanitarian emergencies and natural disasters can overwhelm the capacity of local and national agencies to respond to the needs of affected populations. In such cases, international relief organizations are frequently involved in the provision of emergency assistance. Health care professionals play a key role in these interventions. This practice environment is significantly different from the context of health care delivery in the home countries of expatriate health care professionals. Clinicians who travel from a developed nation to a resource-poor setting where (...) a humanitarian crisis has occurred experience a shift of professional, social, cultural and regulatory environments. In this dissertation I examine the ethics of health care practice in humanitarian work. I evaluate the literature of global bioethics, global health ethics and the ethics of humanitarian assistance, and consider the contributions of various ethics frameworks and normative approaches. I also develop a set of questions to guide health care professionals as they address ethically complex issues arising in clinical practice during humanitarian crises. In the empirical component of this research program I use Interpretive Description methodology to examine the moral experience of health care professionals in humanitarian relief work, and clinician experiences of resources and constraints for addressing ethical issues in humanitarian settings. Building upon the inductively derived findings, I argue for strategies and approaches that humanitarian organizations, project teams, and health care professionals can adopt to respond to the ethics of this field of practice. I also provide a critical review of Interpretive Description methodology. The research presented in this dissertation makes an important contribution to the ethical analysis of health care practice in humanitarian work. (shrink)

Henry Shue’s model of basic rights and their correlative duties provides an excellent framework for analysing the requirements of global distributive justice, and for theorising about the minimum acceptable standards of human entitlement and wellbeing. Shue bases his model on the claim that certain ‘basic’ rights are of universal instrumental value, and are necessary for the enjoyment of any other rights, and of any ‘decent life’. Shue’s model provides a comprehensive argument about the importance of certain fundamental goods for all (...) human lives, though he does not consider health or health care in any significant detail. Adopting Shue’s model, I argue that access to health care is of sufficient importance to the enjoyment of any other rights that it qualifies as what Shue describes as a ‘basic’ right. I also argue that the basic right to health care is compatible with the basic rights model, and is required by it in order to for it to achieve its goal of enabling right holders to enjoy any decent life. In making this claim I also explore the requirements of the basic right to health care in terms of Shue’s triumvirate of duties and with reference to several key examples. (shrink)

This chapter considers what type of bioethics is necessary to address contemporary issues in global health. It explores what kind of ethics, or bioethics, is needed to adequately address such concerns, and argues that because the most pressing ethical dilemmas are global, a global framework must be adopted. Moreover, it argues that to adopt a local model of ethics (whether one community, one nation state or one area of jurisdiction) will fail to illuminate key issues of injustice and thus will (...) ultimately fail as an ethical framework. In short, the global nature of current health issues requires that ethics is global. This argument is a practical one, and one which should be uncontroversial given the clear need for this response. Thus this chapter goes on to explore why, if the need for a global ethical approach is so clearly required by the global nature of health concerns, there is still a debate about whether ethics can or should be global. Thus the chapter looks briefly at the arguments against a global approach to ethics and goes on to suggest a global model of ethics which addresses at least some of these concerns. -/- In order to make this argument the chapter begins by outlining why only a global bioethics or ethics is appropriate. It will argue that global bioethics is necessary for both practical and ethical reasons. As a matter of practicality a global approach to bioethics is necessary as health issues are essentially global; and ethically, not to recognize the global implications of health issues is to endorse the significant injustice which occurs in the arena of global health. Given this the chapter will then go on to consider why, given the overwhelming reasons for adopting a global ethical framework, that the debate about whether ethics should be local or global is still ongoing. The chapter will finish with a brief overview of the global ethics model and will suggest that it might address some of the concerns of those who are wary of global approaches. -/- This chapter is available Open Access (http://dx.doi.org/10.5040/9781472544582.ch-003). (shrink)