Cases of acts of solidarity can be divided into at least two groups. Solidarity in a narrow sense of the term refers to what I label project-related solidarity; it is prevalent in the modern world at least as much as it was found in past worlds. In contrast, the philosophical discussions of "solidarity" refer to the altruism and mutuality typically found in close human relationships. This concept of "solidarity" is theoretically unfruitful and even misleading. I propose to abandon the term (...) "solidarity" in order to regain sight of the individual phenomena. When these are taken into consideration, a return to the community is no longer called for. I rather argue that modern societies are perfectly capable of inspiring feelings of loyalty and civic virtues, though not by resorting to the old sources of "solidarity". Modern forms such as free associations, participation and, not least, the existence of a liberal society itself are sufficient. Public discussions of solidarity are additionally distorted by frequent appeals to a normative sense of the term. The argument put forward in this collectivist context that an obligation of solidarity results from gratefulness to the community is not found to be convincing. Individuals are not obliged to be grateful to a nation in a way that would be normatively binding. (shrink)

The article deals with the issue of solidarity in health care,with particular reference to the Italian context. It presents thedifficulties of the Italian NHS and assesses the current proposalto counter the crisis of the Welfare State by giving upinstitutional arrangements, in order to favour the so-called`social private'. Moreover, it addresses the question ofprioritisation and targeting in the context of health care,arguing for the insufficiency of the standard approach of neutralliberalism, and showing how the concept of solidarity might helpto develop a (...) different account. Lastly, it discusses the case oforgan transplantion in Italy, as an example ofsolidarity-inspired health care policy. (shrink)

Health care services are constantly assessed by their ability to accommodate values popular in contemporary societies. Autonomy, justice, and human dignity have for some time been among such values in the affluent West. Relative newcomers in the field are the notions of and which seem to attract, in particular, Continental European ethicists. a.

We analyse solidarity as a mixture of social justice on the onehand and a set of cultural values and ascriptions on the otherhand. The latter defines the relevant sense of belonging togetherin a society. From a short analysis of the early stages of theDutch welfare state, we conclude that social responsibility wasoriginally based in religious and political associations. In theheyday of the welfare state, institutions such as sick funds,hospitals or nursing homes became financed collectively entirelyand became accessible to people of (...) all denominations. Solidaritywas transformed in a more general category, related to the statusof Dutch citizenship. Responsibility was transformed tocollective responsibility.Financial pressures on the Welfare State have resulted in adebate on choices in health care and in a number of systemreforms, so far relatively small. In the surrounding discourse,justice was linked to private responsibility. Both fromgovernment officials and from participants in the societaldebate, moralistic overtones could be heard concerning the threatof overburdening of the health care system by citizens.In this paper, we develop a concept of reflexive solidarity thatlinks elements of social justice to conceptualisations ofresponsibility that address policy makers and health careinstitutions as well as citizens, in their role of carereceivers. A short analysis of the phenomenon of personal budgetsin care services should prove that our concept of reflexivesolidarity is not empty. Linked to, but beyond the concept ofjustice, issues of social responsibility can be addressed withoutmoralistic overtones. (shrink)