Thomas Nagel addresses the conflict between the claims of the group and those of the individual. Nagel attempts to clarify the nature of the conflict – one of the most fundamental problems in moral and political theory – and argues that its reconciliation is the essential task of any legitimate political system.

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)

Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care.

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health (...) and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness.". (shrink)

Irregular migrants are morally entitled to a wide range of legal rights, including basic human and civil rights. Therefore, states ought to create a firewall between those charged with protecting and enforcing these rights and those charged with enforcing immigration laws.

How are we to navigate between duties to compatriots and duties to non-compatriots? Within the literature there are two important kinds of accounts that are thought to offer contrasting positions on these issues, namely, cosmopolitanism and statism. We discuss these two rival accounts. I then outline my position on global justice and how to accommodate insights from both the cosmopolitan and statist traditions within it. Having outlined my ideal theory account of what global justice requires, I discuss the far more (...) pressing question of what our remedial responsibilities are in our decidely non-ideal world: what does the developed world owe to the developing world and what are our responsibilities to non-compatriots, given our situation here and now? I argue that we have considerable responsibilities and I sketch some of the supporting grounds for this view. Finally, I consider how the general account of global justice and remedial responsibilities developed here applies to the case of responsibilities for migrants’ and refugees’ healthcare. (shrink)

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)

Many liberals have argued that a cosmopolitan perspective on global justice follows from the basic liberal principles of justice. Yet, increasingly, it is also said that intrinsic to liberalism is a doctrine of nationalism. This raises a potential problem for the liberal defense of cosmopolitan justice as it is commonly believed that nationalism and cosmopolitanism are conflicting ideals. If this is correct, there appears to be a serious tension within liberal philosophy itself, between its cosmopolitan aspiration on the one hand, (...) and its nationalist agenda on the other. I argue, however, that this alleged conflict between liberal nationalism and cosmopolitan liberalism disappears once we get clear on the scope and goals of cosmopolitan justice and the parameters of liberal nationalism. Liberal nationalism and cosmopolitan global justice, properly understood, are mutually compatible ideals. (shrink)

When denial of medical treatment is being used as a lever to move people out of the country, ethicists and healthcare professionals should speak out.An ugly feature of political life throughout the Western world, and beyond, is the suspicion towards, and maltreatment of, migrants from poor to rich countries. People who would otherwise be horrified at being labelled racist nevertheless find it acceptable to support practices which can range from stigmatisation to confinement in brutalising conditions in “reception” and “removal” centres.1–5An (...) hour spent searching through government and NGO websites concerned with the treatment of asylum seekers and refugees in developed world countries is an hour well spent – but profoundly depressing. This is not only because of the frankly Orwellian language used by the governments of the UK and Australia , or because of the conditions and treatment meted out, but also because of the apparent support these practices have among the voting public. In the pointedly optimistic reports of Her Majesty’s Inspector of Prisons, for example, one can find praise for the fact …. (shrink)

Asgary and Smith (2013) identify an important challenge: the difficult position of physicians caught between the obligation to treat every human being with the same professional rigor, and their feelings of responsibility toward the state and its judicial decisions on asylum requests. The authors show that in some cases this conflict leads to a tendency to "sacrifice their medical responsibilities". The authors' core demand is that health care workers should be independent of the state and judiciary systems, and thus prioritize (...) the interests of the patient. We agree entirely with the authors, that well-performed documenting is the only ethically justifiable option and should not be influenced by a feeling of responsibility for contributing to judicial decisions. However, the authors also address the more general, and ethically more challenging, issue of the responsibility of health care workers and the state toward asylum seekers and ask, how much health care provision is appropriate? (shrink)