Despite a high and growing global average income, billions of human beings are still condemned to lifelong severe poverty, with all its attendant evils of low life expectancy, social exclusion, ill health, illiteracy, dependency, and effective enslavement. This problem is solvable, despite its magnitude.

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in the workplace while respecting individual liberty? Or (...) meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

Feminist standpoint theory remains highly controversial: it is widely advocated, used to guide research and justify its results, and yet is also vigorously denounced. This essay argues that three such sites of controversy reveal the value of engaging with standpoint theory as a way of reflecting on and debating some of the most anxiety-producing issues in contemporary Western intellectual and political life. Engaging with standpoint theory enables a socially relevant philosophy of science.

Feminist standpoint theory has been marginal to mainstream philosophical analyses of science–indeed, it has been marginal to science studies generally–and it has had an uneasy reception among feminist theorists. Critics of standpoint theory have attributed to it untenable foundationalist assumptions about the social identities that can underpin an epistemically salient standpoint, and implausible claims about the epistemic privilege that should be accorded to those who occupy subdominant social locations. I disentangle what I take to be the promising core of feminist (...) standpoint theory from this conflicted history of debate. I argue that non-foundationalist, non-essentialist arguments can be given (and have been given) for attributing epistemic advantage (rather than privilege) to some social locations and standpoints. They presuppose a situated knowledge thesis, and posit contingent advantage relative to epistemic purpose. I illustrate these claims in terms of the epistemic advantages that accrue to a fictional character, from Neely’s novel Blanche on the Lam, who represents a type of standpoint invoked by diverse advocates of standpoint theory: that of a race, class, and gender disadvantaged “insider-outsider” who has no choice, given her social location, but to negotiate the world of the privileged while at the same time being grounded in a community whose marginal status generates a fundamentally different understanding of how the world works. (shrink)

Underdetermination arguments support the conclusion that no amount of empirical data can uniquely determine theory choice. The full content of a theory outreaches those elements of it (the observational elements) that can be shown to be true (or in agreement with actual observations).2 A number of strategies have been developed to minimize the threat such arguments pose to our aspirations to scientific knowledge. I want to focus on one such strategy: the invocation of additional criteria drawn from a pool of (...) cognitive or theoretical values, such as simplicity or generality, to bolster judgements about the worth of models, theories, and hypotheses. What is the status of such criteria? Larry Laudan, in Science and Values, argued that cognitive values could not be treated as self-validating, beyond justification, but are embedded in a three-way reticulational system containing theories, methods, and aims or values, which are involved in mutually supportive relationships (Laudan, 1984). My interest in this paper is not the purportedly self-validating nature of cognitive values, but their cognitive nature. Although Laudan rejects the idea that what he calls cognitive values are exempt from rational criticism and disagreement, he does seem to think that the reticulational system he identifies is independent of non-cognitive considerations. It is this cognitive/non-cognitive distinction that I wish to query in this paper. Let me begin by summarizing those of my own views about inquiry in which this worry about the distinction arises. (shrink)

This is an important book precisely because there is none other quite like it.

Biomedical research is so important that there is a positive moral obligation to pursue it and to participate in itScience is under attack. In Europe, America, and Australasia in particular, scientists are objects of suspicion and are on the defensive.i“Frankenstein science”5–8 is a phrase never far from the lips of those who take exception to some aspect of science or indeed some supposed abuse by scientists. We should not, however, forget the powerful obligation there is to undertake, support, and participate (...) in scientific research, particularly biomedical research, and the powerful moral imperative that underpins these obligations. Now it is more imperative than ever to articulate and explain these obligations and to do so is the subject and the object of this paper.Let me present the question in its starkest form: is there a moral obligation to undertake, support and even to participate in serious scientific research? If there is, does that obligation require not only that beneficial research be undertaken but also that “we”, as individuals and “we” as societies be willing to support and even participate in research where necessary?Thus far the overwhelming answer given to this question has been “no”, and research has almost universally been treated with suspicion and even hostility by the vast majority of all those concerned with the ethics and regulation of research. The so called “precautionary approach”9 sums up this attitude, requiring dangers to be considered more likely and more serious than benefits, and assuming that no sane person would or should participate in research unless they had a pressing personal reason for so doing, or unless they were motivated by a totally impersonal altruism. International agreements and protocols—for example, the Declaration of Helsinki10 and the CIOMS Guidelines11—have been directed principally at …. (shrink)

"--Richard Grandy, Rice University "This is the first compelling diagnosis of what has gone awry in the raging 'science wars.

Contemporary research ethics policies started with reflection on the atrocities perpetrated upoconcentration camp inmates by Nazi doctors. Apparently, as a consequence of that experience, the policies that now guide human subject research focus on the protection of human subjects by making informed consent the centerpiece of regulatory attention. I take the choice of context for policy design, the initial prioritization of informed consent, and several associated conceptual missteps, to have set research ethics off in the wrong direction. The aim of (...) this paper is to sort out these confusions and their implications and to offer instead a straightforward framework for considering the ethical conduct of human subject research. In the course of this discussion I clarify different senses of autonomy that have been confounded and present more intelligible justifications for informed consent. I also take issue with several of the now accepted dogmas that govern research ethics. These include: the primacy of informed consent, the protection of the vulnerable, the substitution of beneficence for research's social purpose, and the introduction of an untenable distinction between innovation and research. (shrink)

According to some estimates, less than 10% of the world's biomedical research funds are dedicated to addressing problems that are responsible for 90% of the world's burden of disease. This paper explains why this disparity exists and what should be done about it. It argues that the disparity exists because: 1) multinational pharmaceutical and biotechnology companies do not regard research and development investments on the health problems of developing nations to be economically lucrative; and 2) governmental agencies that sponsor biomedical (...) research face little political pressure to allocate funds for the problems of developing nations. This paper argues that developed nations have an obligation to address disparities related to biomedical research funding. To facilitate this effort, developed countries should establish a trust fund dedicated to research on the health problems of developing nations similar to the Global AIDS Fund. (shrink)

Epistemic diversity is widely approved of by social epistemologists. This paper asks, more specifi cally, how much epistemic diversity, and what kinds of epistemic diversity are normatively appropriate? Both laissez-faire and highly directive approaches to epistemic diversity are rejected in favor of the claim that diversity is a blunt epistemic tool. There are typically a number of diff erent options for adequate diversifi cation. The paper focuses on scientifi c domains, with particular attention to recent theories of smell.

: Feminist standpoint theory remains highly controversial: it is widely advocated, used to guide research and justify its results, and yet is also vigorously denounced. This essay argues that three such sites of controversy reveal the value of engaging with standpoint theory as a way of reflecting on and debating some of the most anxiety-producing issues in contemporary Western intellectual and political life. Engaging with standpoint theory enables a socially relevant philosophy of science.

Th is paper investigates the epistemic powers of democratic institutions through an assessment of three epistemic models of democracy : the Condorcet Jury Th eorem, the Diversity Trumps Ability Th eorem, and Dewey's experimentalist model. Dewey's model is superior to the others in its ability to model the epistemic functions of three constitutive features of democracy : the epistemic diversity of participants, the interaction of voting with discussion, and feedback mechanisms such as periodic elections and protests. It views democracy as (...) an institution for pooling widely distributed information about problems and policies of public interest by engaging the participation of epistemically diverse knowers. Democratic norms of free discourse, dissent, feedback, and accountability function to ensure collective, experimentallybased learning from the diverse experiences of diff erent knowers. I illustrate these points with a case study of community forestry groups in South Asia, whose epistemic powers have been hobbled by their suppression of women's participation. (shrink)

: The underdetermination argument establishes that scientists may use political values to guide inquiry, without providing criteria for distinguishing legitimate from illegitimate guidance. This paper supplies such criteria. Analysis of the confused arguments against value-laden science reveals the fundamental criterion of illegitimate guidance: when value judgments operate to drive inquiry to a predetermined conclusion. A case study of feminist research on divorce reveals numerous legitimate ways that values can guide science without violating this standard.

According to some estimates, less than 10% of the world's biomedical research funds are dedicated to addressing problems that are responsible for 90% of the world's burden of disease. This paper explains why this disparity exists and what should be done about it. It argues that the disparity exists because: 1) multinational pharmaceutical and biotechnology companies do not regard research and development investments on the health problems of developing nations to be economically lucrative; and 2) governmental agencies that sponsor biomedical (...) research face little political pressure to allocate funds for the problems of developing nations. This paper argues that developed nations have an obligation to address disparities related to biomedical research funding. To facilitate this effort, developed countries should establish a trust fund dedicated to research on the health problems of developing nations similar to the Global AIDS Fund. (shrink)

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)

In an earlier piece in these pages, I described the health effects of the still massive problem of global poverty: The poor worldwide face greater environmental hazards than the rest of us, from contaminated water, filth, pollution, worms, and insects. They are exposed to greater dangers from people around them, through traffic, crime, communicable diseases, sexual violence, and potential exploitation by the more affluent. They lack means to protect themselves and their families against such hazards, through clean water, nutritious food, (...) satisfactory hygiene, necessary rest, adequate clothing, and safe shelter. They lack the means to enforce their legal rights or to press for political reform. (shrink)

Several have argued that the aims of scientific research are not always independent of social and ethical values. Yet this is often assumed only to have implications for decisions about what is studied, or which research projects are funded, and not for methodological decisions or standards of evidence. Using the case of the recently developed HPV vaccines, we argue that the social aims of research can also play important roles in justifying decisions about (1) how research problems are defined in (...) drug development, (2) evidentiary standards used in testing drug “success”, and (3) clinical trial methodology. As a result, attending to the social aims at stake in particular research contexts will produce more rational methodological decisions as well as more socially relevant science. (shrink)

"It has long been thought that science is our best hope for realizing objective knowledge, but that, to deliver on this promise, it must be free of the influence of any values that are not purely epistemic. As recent work in philosophy, history, and social studies of science shows, however, things are not so simple. The contributors to this volume ask where and how nonepistemic values are involved in science; they explore the roles these values play at the heart of (...) science, in the assessment of evidence and explanations, and they examine the implications this has for ideals of objectivity."--BOOK JACKET. (shrink)

A new, social epistemology of science that addresses practical as well as theoretical concerns.

Two major reasons feminists are concerned with science relate to science's social effects: that science can be a powerful ally in the struggle for equality for women; and that all too frequently science has been a generator and perpetuator of inequality. This concern with the social effects of science leads feminists to a different mode of appraising science from the purely epistemic one prized by most contemporary philosophers of science. The upshot, I suggest, is a new program for philosophy of (...) science, a program for a socially responsible philosophy of science. (shrink)

Sandra Harding's feminist standpoint epistemology makes two claims. The thesis of epistemic privilege claims that unprivileged social positions are likely to generate perspectives that are “less partial and less distorted” than perspectives generated by other social positions. The situated knowledge thesis claims that all scientific knowledge is socially situated. The bias paradox is the tension between these two claims. Whereas the thesis of epistemic privilege relies on the assumption that a standard of impartiality enables one to judge some perspectives as (...) better than others, the situated knowledge thesis seems to undermine this assumption by suggesting that all knowledge is partial. I argue that a contextualist theory of epistemic justification provides a solution to the bias paradox. Moreover, contextualism enables me to give empirical content to the thesis of epistemic privilege, thereby making it into a testable hypothesis. (shrink)

The underdetermination argument establishes that scientists may use political values to guide inquiry, without providing criteria for distinguishing legitimate from illegitimate guidance. This paper supplies such criteria. Analysis of the confused arguments against value-laden science reveals the fundamental criterion of illegitimate guidance: when value judgments operate to drive inquiry to a predetermined conclusion. A case study of feminist research on divorce reveals numerous legitimate ways that values can guide science without violating this standard.

This article agrees with Philip Kitcher that we should aim for a well-ordered science, one that answers the right questions in the right ways. Crucial to this is to address questions of use: Which scientific account is right for which system in which circumstances? This is a difficult question: evidence that may support a scientific claim in one context may not support it in another. Drawing on examples in physics and other sciences, this article argues that work on the warrant (...) of theories in philosophy of science needs to change. Emphasis should move from the warrant of theories in the abstract to questions of evidence for use. (shrink)

Despite the National Science Foundation's recent clarification of the Broader Impacts Criterion used in grant evaluation, it is not clear that this criterion is being understood or applied consistently by grant writers or reviewers. In particular, there is still confusion about how to interpret the requirement for broadening the participation of under-represented groups in science and scepticism about the value of doing so. Much of this stems from uncertainty about why the participation of under-represented groups is desirable or beneficial in (...) the first place. This paper distinguishes three different rationales for the importance of diversity in science and draws out the implications for the kind of diversity that is desirable, as well as how the diversity requirement of the Broader Impacts Criterion should be applied and weighed against other criteria in reviewing particular grants. I argue that there are epistemic, as well as social, benefits to diversity that can help promote scientific progress. (shrink)

In _Sciences from Below_, the esteemed feminist science studies scholar Sandra Harding synthesizes modernity studies with progressive tendencies in science and technology studies to suggest how scientific and technological pursuits might be more productively linked to social justice projects around the world. Harding illuminates the idea of multiple modernities as well as the major contributions of post-Kuhnian Western, feminist, and postcolonial science studies. She explains how these schools of thought can help those seeking to implement progressive social projects refine their (...) thinking to overcome limiting ideas about what modernity and modernization are, the objectivity of scientific knowledge, patriarchy, and Eurocentricity. She also reveals how ideas about gender and colonialism frame the conventional contrast between modernity and tradition. As she has done before, Harding points the way forward in _Sciences from Below_. Describing the work of the post-Kuhnian science studies scholars Bruno Latour, Ulrich Beck, and the team of Michael Gibbons, Helga Nowtony, and Peter Scott, Harding reveals how, from different perspectives, they provide useful resources for rethinking the modernity versus tradition binary and its effects on the production of scientific knowledge. Yet, for the most part, they do not take feminist or postcolonial critiques into account. As Harding demonstrates, feminist science studies and postcolonial science studies have vital contributions to make; they bring to light not only the male supremacist investments in the Western conception of modernity and the historical and epistemological bases of Western science but also the empirical knowledge traditions of the global South. _Sciences from Below_ is a clear and compelling argument that modernity studies and post-Kuhnian, feminist, and postcolonial sciences studies each have something important, and necessary, to offer to those formulating socially progressive scientific research and policy. (shrink)

Helen Longino seeks to break the current deadlock in the ongoing wars between philosophers of science and sociologists of science--academic battles founded on disagreement about the role of social forces in constructing scientific knowledge. While many philosophers of science downplay social forces, claiming that scientific knowledge is best considered as a product of cognitive processes, sociologists tend to argue that numerous noncognitive factors influence what scientists learn, how they package it, and how readily it is accepted. Underlying this disagreement, however, (...) is a common assumption that social forces are a source of bias and irrationality. Longino challenges this assumption, arguing that social interaction actually assists us in securing firm, rationally based knowledge. This important insight allows her to develop a durable and novel account of scientific knowledge that integrates the social and cognitive. Longino begins with a detailed discussion of a wide range of contemporary thinkers who write on scientific knowledge, clarifying the philosophical points at issue. She then critically analyzes the dichotomous understanding of the rational and the social that characterizes both sides of the science studies stalemate and the social account that she sees as necessary for an epistemology of science that includes the full spectrum of cognitive processes. Throughout, her account is responsive both to the normative uses of the term knowledge and to the social conditions in which scientific knowledge is produced. Building on ideas first advanced in her influential book Science as Social Knowledge, Longino brings her account into dialogue with current work in social epistemology and science studies and shows how her critical social approach can help solve a variety of stubborn problems. While the book focuses on epistemological concerns related to the sociality of inquiry, Longino also takes up its implications for scientific pluralism. The social approach, she concludes, best allows us to retain a meaningful concept of knowledge in the face of theoretical plurality and uncertainty. (shrink)

Several have argued that the aims of scientific research are not always independent of social and ethical values. Yet this is often assumed only to have implications for decisions about what is studied, or which research projects are funded, and not for methodological decisions or standards of evidence. Using the case of the recently developed HPV vaccines, we argue that the social aims of research can also play important roles in justifying decisions about (1) how research problems are defined in (...) drug development, (2) evidentiary standards used in testing drug “success”, and (3) clinical trial methodology. As a result, attending to the social aims at stake in particular research contexts will produce more rational methodological decisions as well as more socially relevant science. (shrink)