'Foot stands out among contemporary ethical theorists because of her conviction that virtues and vices are more central ethical notions than rights, duties, justice, or consequences - the primary focus of most other contemporary theorists. This volume brings together a dozen essays published between 1957 and 1977, and includes two new ones as well. In the first, Foot argues explicitly for an ethic of virtue, and in the next five discusses abortion, euthanasia, free will/determination, and the ethics of Hume and (...) Nietzsche. The final eight essays chart her growing disenchantment with emotivism and prescriptivism and their account of moral arguments. All the essays embody to some extent her commitment to an ethics of virtue... Foot's style is straightforward and readable, her arguments subtle, ingenious, and some of them important.' Choice. (shrink)

"Foot stands out among contemporary ethical theorists because of her conviction that virtues and vices are more central ethical notions than rights, duties, justice, or consequences--the primary focus of most other contemporary moral theorists....[These] essays embody to some extent her commitment to an ethics of virtue. Foot's style is straightforward and readable, her arguments subtle..."--Choice.

Disparities in socioeconomic status correlate closely with health, so that the lower a person's social position, the worse his health, an effect that the epidemiologist Michael Marmot has labeled the status syndrome. Marmot has argued that differences in autonomy, understood in terms of control, underlie the status syndrome. He has, therefore, recommended that the American medical profession champion policies that improve patient autonomy. In this paper, I clarify the kind of control Marmot sees as connecting differences in socioeconomic status to (...) health disparities. I then discuss his use of Amartya Sen's capabilities approach to justice, arguing that he is unsuccessful in relating autonomy as a descriptive property with a normative framework that can adequately explain why and to what extent we should reduce health disparities. (shrink)

In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came (...) about. In contrast to a medical model, a social model of justice considers how social determinants affect the health of a population. For example, social factors such as access to clean drinking water, education, safe workplaces, and police protection, profoundly affect risk for disease and early death. I examine one important social determinant of health, health care coverage, to show the limits of a medical model and the merits of a broader view. (shrink)

Philosophical and political discussions of health inequalities have largely focused on questions of justice. The general strategy employed by philosophers like Norman Daniels is to identify a certain state of affairs—in his case, equality of opportunity—and then argue that health disparities limiting an individual's or group's access to that condition are unjust, demanding intervention. Recent work in epidemiology, however, has highlighted the importance of socioeconomic status in creating health inequalities. I explore the ways in which theories of justice have been (...) expanded in light of this data, suggesting that more work is required if such theories are to provide an adequate framework for addressing health disparities. I conclude by sketching an alternative possibility for thinking about health disparities outside of the context of justice. (shrink)