This paper presents a reconstruction of and some constructive comments on Thomas Pogge’s conception of global justice. Using Imre Lakatos’s notion of a research program, the paper identifies Pogge’s “hard core” and “protective belt” claims regarding the scope of fundamental principles of justice, the object and structure of duties of global justice, the explanation of world poverty, and the appropriate reforms to the existing global order. The paper recommends some amendments to Pogge’s program in each of the four areas.

Everyone wants to be healthy, but many of us decline to act in healthy ways. Should these choices have any bearing on the ethics of clinical practice and health policy? How may personal responsibility for health be manipulated in health policy debates.

We do not live in a just world. This may be the least controversial claim one could make in political theory. But it is much less clear what, if anything, justice on a world scale might mean, or what the hope for justice should lead us to want in the domain of international or global institutions, and in the policies of states that are in a position to affect the world order. By comparison with the perplexing and undeveloped state of (...) this subject, domestic political theory is very well understood, with multiple highly developed theories offering alternative solutions to well-defined problems. By contrast, concepts and theories of global justice are in the early stages of formation, and it is not clear what the main questions are, let alone the main possible answers. I believe that the need for workable ideas about the global or international case presents political theory with its most important current task, and even perhaps with the opportunity to make a practical contribution in the long run, though perhaps only the very long run. (shrink)

One of the central debates within contemporary Anglo-American political philosophy concerns how to formulate an egalitarian theory of distributive justice which gives coherent expression to egalitarian convictions and withstands the most powerful anti-egalitarian objections. This book brings together many of the key contributions to that debate by some of the world’s leading political philosophers: Richard Arneson, G.A. Cohen, Ronald Dworkin, Thomas Nagel, Derek Parfit, John Rawls, T.M. Scanlon, and Larry Temkin.

Why do people in more unequal societies have worse health and shorter lives than those in less unequal ones? Why do more unequal societies tend to have more violence and weaker community life? This paper discusses the research evidence on the psychosocial pathways which suggest how and why we are affected by inequality.How big income differences are in any society seems to serve as an indicator of the scale of social differentiation and social distances within it. The evidence shows that (...) more hierarchical societies incur a wide range of social costs reflecting the corrosive effects of inequality. But why are we so sensitive to inequality? Epidemiological research on health inequalities and the social determinants of health has demonstrated that the quality of the social environment has powerful effects on health. Particularly important are social status, friendship and early childhood experience. The indications are that poor health may share causal pathways with many other social problems associated with relative deprivation - including violence.Summarizing my recent book, The Impact of Inequality, this paper provides an account of how inequality gets under the skin to affect both health and wellbeing. Rather than making comparisons with some impractical state of complete equality, all the evidence presented shows the importance of the differences in inequality between different states of the USA or between different developed market democracies: it shows that even small increases in equality matter. (shrink)

A normatively adequate public health ethics needs to be anchored in political philosophy rather than in ethics. Its central ethical concerns are likely to include trust and justice, rather than autonomy and informed consent.

El objeto de este ensayo es la extensión al ámbito de las relaciones internacionales de la teoría de la justicia como equidad formulada por el autor en sus anteriores escritos. Así, el Derecho de Genteses concebido como una familia de conceptos políticos ligada a principios de derecho, justicia y bien común, todo lo cual especifica el contenido de una concepción liberal de la justicia formulada para abarcar y ser aplicada al derecho internacional. Los derechos humanos constituyen un elemento central de (...) esta construcción en la medida en que establecen los límites morales al pluralismo entre los pueblos. (shrink)

The origin and justification of human rights, whether anchored in biological theory, natural law theory, or interests theory, as well as their cultural specificity and actual value as international legal instruments are subject to ongoing lively debates. As theoretical and rhetorical discourses challenge and enrich current understanding of the value of human rights and their relevance to democratic governance, they have found their way into public health in recent decades and play today an increasing role in the shaping of health (...) policies, programs and practice. Human rights define the obligations of states to their people and towards each other, create grounds for governmental accountability and inspire recognition of, and action on, factors influencing people’s attainment of the highest possible standard of health. This article highlights the evolution that has brought health and human rights together in mutually reinforcing ways. It draws from the experience gained in the global response to HIV/AIDS, summarizes key dimensions of public health and of human rights and suggests a manner in which these dimensions intersect in a framework for analysis and action. (shrink)

Globalization, a process characterized by the growing interdependence of the world's people, impacts health systems and the social determinants of health in ways that are detrimental to health equity. In a world in which there are few countervailing normative and policy approaches to the dominant neoliberal regime underpinning globalization, the human rights paradigm constitutes a widely shared foundation for challenging globalization's effects. The substantive rights enumerated in human rights instruments include the right to the highest attainable level of physical and (...) mental health and others that are relevant to the determinants of health. The rights stipulated in these documents impose extensive legal obligations on states that have ratified these documents and confer health entitlements on their residents. Human rights norms have also inspired civil society efforts to improve access to essential medicines and medical services, particularly for HIV/AIDS. Nevertheless, many factors reduce the potential counterweight human rights might exert, including and specifically the nature of the human rights approach, weak political commitments to promoting and protecting health rights on the part of some states and their lack of institutional and economic resources to do so. Global economic markets and the relative power of global economic institutions are also shrinking national policy space. This article reviews the potential contributions and limitations of human rights to achieving greater equity in shaping the social determinants of health. (shrink)

The origin and justification of human rights, whether anchored in biological theory, natural law theory, or interests theory, as well as their cultural specificity and actual value as international legal instruments are subject to ongoing lively debates. As theoretical and rhetorical discourses challenge and enrich current understanding of the value of human rights and their relevance to democratic governance, they have found their way into public health in recent decades and play today an increasing role in the shaping of health (...) policies, programs and practice. Human rights define the obligations of states to their people and towards each other, create grounds for governmental accountability and inspire recognition of, and action on, factors influencing people’s attainment of the highest possible standard of health. This article highlights the evolution that has brought health and human rights together in mutually reinforcing ways. It draws from the experience gained in the global response to HIV/AIDS, summarizes key dimensions of public health and of human rights and suggests a manner in which these dimensions intersect in a framework for analysis and action. (shrink)

La pobreza extrema y la enorme desigualdad global son un mal de nuestro tiempo, pero ¿son una injusticia? Se indican diferentes tipos de obligaciones morales globales y se critican los enfoques que 1) niegan las obligaciones de justicia en un contexto global, 2) priorizan sistemáticamente las obliga..

Gathers fragments of the writings of early Greek philosophers, including Hesiod, Anaximander, Pythagoras, and Zeno.

One would be hard pressed to find a more controversial or nebulous human right than the right to health - a right that stems primarily, although not exclusively, from Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR). While activists, non-governmental organizations, and scholars have made significant progress in promoting a human rights approach to health and the field of health and human rights more generally, the question of a philosophical and conceptual foundation - a theory (...) - for the right to health has fallen through the cracks that emerge from an interdisciplinary intersection of medical ethics, international relations, international human rights law, health policy, health law, and public health law. This Article offers a philosophical justification for a right to health. As such it makes a case for the right to health as a meaningful and operational right and discusses the degree to which this right is necessarily justifiable and enforceable as prescribed in international law. The theoretical framework proposed in this Article builds on and integrates Aristotle's political theory, the capability approach, and a social choice paradigm known as incompletely theorized agreements. This Article draws on these perspectives to develop a theory of a right to health and to explicate societal obligations, both state and non-state, for progressive realization of this right. Finally, this Article argues that sustaining the effort to realize a right to health requires individual and societal commitments to what I call public moral norms. In other words, this Article argues for treating the right to health as an ethical demand for equity in health. This ethical demand will likely involve legal instruments for enforcement, but more likely will require individuals, states, and non-state actors to internalize public ethical norms to enhance implementation and compliance with a right to health in international human rights policy and law. (shrink)

The origin and justification of human rights, whether anchored in biological theory, natural law theory, or interests theory, as well as their cultural specificity and actual value as international legal instruments are subject to ongoing lively debates. As theoretical and rhetorical discourses challenge and enrich current understanding of the value of human rights and their relevance to democratic governance, they have found their way into public health in recent decades and play today an increasing role in the shaping of health (...) policies, programs and practice. Human rights define the obligations of states to their people and towards each other, create grounds for governmental accountability and inspire recognition of, and action on, factors influencing people’s attainment of the highest possible standard of health. This article highlights the evolution that has brought health and human rights together in mutually reinforcing ways. It draws from the experience gained in the global response to HIV/AIDS, summarizes key dimensions of public health and of human rights and suggests a manner in which these dimensions intersect in a framework for analysis and action. (shrink)