This book articulates a systematic vision of an international legal system grounded in the commitment to justice for all persons. It provides a probing exploration of the moral issues involved in disputes about secession, ethno-national conflict, "the right of self-determination of peoples," human rights, and the legitimacy of the international legal system itself. Buchanan advances vigorous criticisms of the central dogmas of international relations and international law, arguing that the international legal system should make justice, not simply peace among states, (...) a primary goal, and rejecting the view that it is permissible for a state to conduct its foreign policies exclusively according to what is in the "national interest." He also shows that the only alternatives are not rigid adherence to existing international law or lawless chaos in which the world's one superpower pursues its own interests without constraints. This book not only criticizes the existing international legal order, but also offers morally defensible and practicable principles for reforming it. Justice, Legitimacy, and Self-Determination will find a broad readership in political science, international law, and political philosophy. (shrink)

"In this article, I argue that under current resource constraints, institutional arrangements seeking to ensure commonly accepted egalitarian goals would engender the decrease of health status of many who do not currently enjoy particularly high levels of health.".

v. 1. Editorial introduction -- v. 2. The English and Latin texts (i) -- v. 3. The English and Latin texts (ii).

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.

One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new drug is rewarded in proportion to its impact on the global disease burden (not through monopoly rents). This reform would bring (...) drug prices down worldwide close to their marginal cost of production and would powerfully stimulate pharmaceutical research into currently neglected diseases concentrated among the poor. Its feasibility shows that the existing medical-patent regime (trade-related aspects of intellectual property rights—TRIPS—as supplemented by bilateral agreements) is severely unjust—and its imposition a human-rights violation on account of the avoidable mortality and morbidity it foreseeably produces. (shrink)

This paper discusses obligations of international distributive justice-specifically, obligations rich countries have to transfer resources to poor countries. It argues that the major seven OECD countries each have an obligation to transfer at least one percent of their GDP to developing countries. -/- The strategy of the paper is to defend this position without having to resolve the many debates that attend questions of international distributive justice. In this respect, it belongs to the neglected category of nonideal theory. The key (...) to the strategy is to show that a significant amount of good would be accomplished by a one percent transfer, despite the fact that one percent is quite a small amount. -/- To make this showing, the paper takes health as a fundamental measure of individual well-being and examines the improvement in life expectancy that would likely result from devoting the one percent transfer to the major determinants of health. It adduces data indicating that substantial progress towards raising life expectancy in developing countries to the global average of 64.5 years can be expected from expenditures of $125 per capita, divided between health care, education, and basic nutrition and income support. A one percent transfer from the major seven is enough to cover expenditures on that scale for the poorest fifth of the world's population. (shrink)

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 a democratic society, the social rules are imposed by all upon each. As “recipients” of the rules, we tend to think that they should be designed to engender the best attainable distribution of goods and ills or quality of life. We are inclined to assess social institutions by how they affect their participants. But there is another, oft-neglected perspective which the topic of health equity raises with special clarity: As imposers of the rules, we are inclined to think that (...) harms we inflict through the rules have greater moral weight than like harms we merely fail to prevent or to mitigate. What matters morally is not merely how we affect people, but how we treat them through the rules we impose. While current (consequentialist and Rawlsian) theorizing is dominated by the first perspective and thus supports purely recipient-oriented moral conceptions, an adequate approach to social justice requires a balancing of both. Such balancing results in a relational conception of justice, which distinguishes various ways in which an institutional scheme may causally affect the quality of life of its participants.This essay argues that the strength of our moral reason to prevent or mitigate particular medical conditions depends not only on what one might call distributional factors, such as how badly off the people affected by these conditions are in absolute and relative terms, how costly prevention or treatment would be, and how much patients would benefit from given treatment. Rather, it depends also on relational factors, that is, on how we are related to the medical conditions they suffer. It then discusses some implications of this view for understanding responsibilities for international health outcomes. (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.

Death.--The absurd.--Moral luck.--Sexual perversion.--War and massacre.--Ruthlessness in public life.--The policy of preference.--Equality.--The fragmentation of value.--Ethics without biology.--Brain bisection and the unity of consciousness.--What is it like to be a bat?--Panpsychism.--Subjective and objective.

Nationalism is often dismissed today as an irrational political creed with disastrous consequences. Yet most people regard their national identity as a significant aspect of themselves, see themselves as having special obligations to their compatriots, and value their nation's political independence. This book defends these beliefs, and shows that nationality, defined in these terms, serves valuable goals, including social justice, democracy, and the protection of culture. National identities need not be illiberal, and they do not exclude other sources of personal (...) identity, such as ethnicity or religion. An ethics that gives weight to special relationships is more effective in motivating people to pursue justice and other values because it connects peoples’ duties to their identity; but this is consistent with recognizing some universal values, such as human rights. There are strong reasons for making the boundaries of states and nations coincide wherever possible, but in other cases, nations can achieve forms of self‐determination that fall short of full sovereignty. Multicultural arguments in favour of identity politics and special rights for minority groups ignore the benefits that such groups derive from participating in a shared national identity and the kind of democratic politics that such an identity makes possible. Although national identities are often said to be in decline in an increasingly globalized world, they serve such important purposes that our aim should be to rebuild them in a form that makes them more accessible to excluded cultural minorities. (shrink)

This book develops some of the most important themes of Sen's works over the last decade. He argues in a rich and subtle approach that we should be concerned with people's capabilities rather than their resources or welfare.

In this collection of essays Onora O'Neill explores and argues for an account of justice that is fundamentally cosmopolitan rather than civic, yet takes serious account of institutions and boundaries, and of human diversity and vulnerability. Starting from conceptions that are central to any account of justice - those of reason, action, judgement, coercion, obligations and rights - she discusses whether and how culturally or politically specific concepts and views, which limit the claims and scope of justice, can be avoided. (...) She then examines the demands and scope of just institutions, arguing that there are good reasons for taking the claims of distant strangers seriously, but that doing so points not to a world without boundaries but to one of porous boundaries and dispersed power. Bounds of Justice will be of interest to a wide range of readers in philosophy, politics and international relations. (shrink)

Commodities and Capabilities presents a set of inter-related theses concerning the foundations of welfare economics, and in particular about the assessment of personal well-being and advantage. The argument presented focuses on the capability to function, i.e. what a person can do or can be, questioning in the process the more standard emphasis on opulence or on utility. In fact, a person's motivation behind choice is treated here as a parametric variable which may or may not coincide with the pursuit of (...) self-interest. Given the large number of practical problems arising from the roles and limitations of different concepts of interest and the judgement of advantage and well-being, this scholarly investigation is both of theoretical interest and practical import. (shrink)

Charles Beitz rejects two highly influential conceptions of international theory as empirically inaccurate and theoretically misleading. In one, international relations is a Hobbesian state of nature in which moral judgments are entirely inappropriate, and in the other, states are analogous to persons in domestic society in having rights of autonomy that insulate them from external moral assessment and political interference. Beitz postulates that a theory of international politics should include a revised principle of state autonomy based on the justice of (...) a state's domestic institutions, and a principle of international distributive justice to establish a fair division of resources and wealth among persons situated in diverse national societies. (shrink)

What are the causes of war? Waltz probes the ideas that thinkers throughout the history of Western civilisation - including St. Augustine, Hobbes, Kant, & Spinoza - have offered to explain the reasons for men & related prescriptions for peace.

In a new preface, Peter Singer discusses the prospects for the ethical approach he advocates."--BOOK JACKET.

Thomas Hobbes took a new look at the ways in which society should function, and he ended up formulating the concept of political science. His crowning achievement, Leviathan, remains among the greatest works in the history of ideas. Written during a moment in English history when the political and social structures as well as methods of science were in flux and open to interpretation, Leviathan played an essential role in the development of the modern world. This edition of Hobbes' landmark (...) work is based on the original text. It incorporates the author's own corrections and retains the period spelling and punctuation, offering both flavorful authenticity and the utmost clarity of expression. (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.

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 dissertation Aristotelian Justice and Health Policy: Capability and Incompletely Theorized Agreements , Jerry Green, and Joseph Newhouse) focuses on the implications for health policy of Aristotelian/Capability lines of reasoning to social justice and efficiency. The monograph draws on philosophical and economic analysis and social choice theory in the examination of health capabilities as: a central focal variable for the assessment of equality and efficiency in health policy; the product of health and other public policies; and the object of social (...) choice. Drawing on moral and political philosophy, the Aristotelian/Capability lines of reasoning provide the basis for the special moral importance of health capabilities as the central focal variable for assessing equality and efficiency in health policy. These lines of thought take a universal view of humans' capability to flourish as an end of political activity and provide an analytical framework to address questions of justice and efficiency in public policy in a way that other philosophical schools do not. Drawing on economic analysis, the monograph makes a case for focusing attention in health economics and health policy on the economics of health, per se, as differentiated from the economics of medical care, and as such emphasizes the analysis of empirical evidence on the instrumental effectiveness and cost-effectiveness of the various determinants of health and the public policies associated with these determinants. Further investigations of the determinants and consequences of variations in health capabilities is necessary to fully understand the patterns and public policies associated with health production. And finally, drawing on social choice literature, this monograph identifies and defends a particular approach to collective decision making in public policy--incompletely theorized agreements . In matters of social decision making about health capabilities in health policy, the ICTA framework is particularly useful and complementary to the capability approach. Health, and thus health capabilities, is a multidimensional concept about which different people have different, and sometimes conflicting, views. Since no unique view of health capabilities exists and is ideal for all evaluative purposes, the pragmatism of both the incomplete ordering of the capability approach and the incompletely theorized agreement on that ordering of the ICTA approach allow for reasoned public policy decision making and analysis in particular situations in the face of plural goods and different, even conflicting, views. (shrink)

This is the text of The Lindley Lecture for 1996, given by T.M. Scanlon, an American philosopher.

In this collection of essays Onora O'Neill explores and argues for an account of justice that is fundamentally cosmopolitan rather than civic, yet takes serious account of institutions and boundaries, and of human diversity and vulnerability. Starting from conceptions that are central to any account of justice - those of reason, action, judgement, coercion, obligations and rights - she discusses whether and how culturally or politically specific concepts and views, which limit the claims and scope of justice, can be avoided. (...) She then examines the demands and scope of just institutions, arguing that there are good reasons for taking the claims of distant strangers seriously, but that doing so points not to a world without boundaries but to one of porous boundaries and dispersed power. Bounds of Justice will be of interest to a wide range of readers in philosophy, politics and international relations. (shrink)