The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and (...) academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

A complimentary assessment of Blum's award-winning book about racism and its affects. Well written as it is, it needs to be supplemented with a definition of racial injustice, and also to analyze racism not only on the level of individual morality but from a human rights perspective that discredits political and economic motives for racism (e.g., by drawing on Hannah Arendt's Origins of Totalitarianism).

Hardly anyone disputes that discrimination can be a grave moral wrong. Yet this consensus masks fundamental disagreements about what makes something discrimination, as well as precisely why acts of discrimination are wrong. Benjamin Eidelson develops systematic answers to those two questions. He claims that discrimination is a form of differential treatment distinguished by its special connection to the differential ascription of some property to different people, and goes on to argue that what makes some cases of discrimination intrinsically wrongful is (...) that they manifest an attitude of disrespect for the personhood of those who are disfavored. He endeavors to specify what this attitude consists in, and to demonstrate how attending to its character can help us to better understand the moral dimensions of different forms of wrongful discrimination. The book concludes with an extended discussion of racial profiling in law enforcement. (shrink)

The paper summarizes recently published data and recommendations about healthcare disparities experienced by African Americans who have Medicare or other healthcare coverage. Against this background the paper addresses the ethics of such disparities and how disadvantages of vulnerable populations like African Americans are typically maintained indecision making about how to respond to such disparities. Considering how to respond to disparities reveals much that vulnerable populations would bring to the policy-making table, if they can also be heard when they get there. (...) The paper argues that vulnerable populations like African Americans need fair representation in bodies deciding what to do about such disparities and that fairness requires proportional representation at all levels of decisions that affect healthcare – a radical change. In this decision setting, howto provide adequate protection of minorities needs much further attention. The most attractive decision-making model is deliberative democracy. The paper shows that in deliberation, fair representation requires not only having a voice in decisions, but a fair hearing of those voices. Achieving a fair hearing requires changes in norms of communication and training of all to give importance to greetings and other measures of civility and trust building, and to be open to diverse forms of expression. Decisions about how to respond to healthcare disparities would include what programs to initiate for whom, howto evaluate the programs, and what to do in response to such evaluations. Conclusions are that achieving such goals will take a sea change in how healthcare institutions and providers do their business, and that social activism at every level will be needed to effect these changes. The discussion highlights many ethical issues that need much greater attention. (shrink)

This book originated as lectures for a course on political philosophy that Rawls taught regularly at Harvard in the 1980s.

ABSTRACT This paper is a case study in public health ethics. It considers whether there is a basis in ethics for political action by health professionals and their associations in response to inhumane treatment. The issue arises from Australia's treatment of asylum seekers and the charge that this treatment has been both immoral and inhumane. This judgement raises several questions of broader significance in bioethics and of significance to the emerging field of public health ethics. These questions relate to the (...) role of health professionals in response to inhumane treatment of people in their charge; to the discipline of public health in light of a growing recognition of its ethical basis; and the role of public health and bioethical associations in response to ethical issues arising in a political context. It is argued that, in serious cases of humanitarian and human rights abuses affecting health and well‐being, there is a case for political action by health professionals, academic and professional institutions, and associations of public health and ethics. (shrink)

There is good evidence that many people harbour attitudes that conflict with those they endorse. In the language of social psychology, they seem to have implicit attitudes that conflict with their explicit beliefs. There has been a great deal of attention paid to the question whether agents like this are responsible for actions caused by their implicit attitudes, but much less to the question whether they can rightly be described as racist in virtue of harbouring them. In this paper, I (...) attempt to answer this question using three different standards, providing by the three dominant kinds of accounts of racism. I argue that on none of these accounts should agents like this be described as racists. However, it would be misleading to say, without qualification, that they are not racists. On none of these accounts are agents like this entirely off the hook. (shrink)

An analysis of 'racism' in terms of disrespect. This article argues against the views that racism should be understood in reductive ways as, variously, an attitude of ill-will (Jorge Garcia), a cognitive object such as ideology (Tommie Shelby), a behavior (Michael Philips), or some disjunctive hybrid (Lawrence Blum). In fact, it argues that racism should be conceptually released from having any one location. The disrespect analysis favored here can accommodate a variety of important desiderata for a theory of racism.

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational (...) issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)

This volume stages a debate between two philosophers, one North American, the other German, who hold different views of the relation of redistribution to ...

The conceptualization and moral analysis of discrimination constitutes a burgeoning theoretical field, with a number of open problems and a rapidly developing literature. A central problem is how to define discrimination, both in its most basic direct sense and in the most prominent variations. A plausible definition of the basic sense of the word understands discrimination as disadvantageous differential treatment of two groups that is in some respect caused by the properties that distinguish the groups, but open questions remain on (...) whether discrimination should be restricted to concern only particular groups, as well as on whether it is best conceived as a descriptive or a moralized concept. Furthermore, since this understanding limits direct discrimination to cases of differential treatment, it requires that we be able to draw a clear distinction between equal and differential treatment, a task that is less simple than it may appear, but that is helpful in clarifying indirect discrimination and statistical discrimination. The second major problem in theorizing discrimination is explaining what makes discrimination morally wrong. On this issue, there are four dominant contemporary answers: the valuational and expressive disrespect accounts, which hold that discrimination is wrong when and if the discriminator misestimates or expresses a misestimate of the moral status of the discriminatee; the unfairness account, which holds that discrimination is wrong when and if the discriminator unfairly increases inequality of opportunity; and the harm account, which holds that discrimination is wrong when and if the discriminator harms the discriminatee. Each of these accounts, however, faces important challenges in simultaneously providing a persuasive theoretical account and matching our intuitions about cases of impermissible discrimination. (shrink)