This chapter serves as an introduction to the collected volume. In the first section, we aim to provide background on important themes in social egalitarianism and to set the context for understanding which significant questions the chapters in this book pose and attempt to answer. In this section we focus especially on what could be said to characterize socially egalitarian relationships, on which relationships are of concern, and on what might make social egalitarianism distinct. In the second section, we provide (...) a brief explanation of the structure of the book and each of its chapters. (shrink)

In this chapter, I propose that conceptions of justice in bioethics must be feminist, meaning they must be able to capture how the domains of health, healthcare and medicine exacerbate the subordination of those perceived to be women and girls and how injustice impacts their health. After providing context in the first section, I identify three problems with conceptions of justice in the bioethics literature that interfere with their potential to be feminist. They tend to adopt the ahistoricism and distributivism (...) characteristic of theories of justice that have been dominant in political philosophy, and they often rely on gendered conceptions of health that result in troubling comparisons of men and women’s health. My argument is primarily “negative”: it is a critique of generalist conceptions of justice in bioethics. However, in the final section I present characteristics of what a feminist conception of justice needs to look like and indicate how feminist bioethicists are using such a conception in assessing issues of injustice in bioethics. I emphasize the centrality of actual structural injustices, relational egalitarianism, and the assessment of values in conceptions of health and the health sciences. (shrink)

In this chapter, Fourie identifies and systematizes the impairments associated with having privilege and evaluates their implications for theories of relational equality and distributive justice. Having certain social privileges, for example, being a man in a patriarchal society, can also be damaging; in other words, there are “impairments of privilege.” Fourie delineates six kinds of impairments—epistemic, evaluative, emotional, health-related, affiliative, and moral. She then goes on to assess the implications of the impairments of privilege for two theories in political philosophy. (...) Relational egalitarianism, she argues, has the theoretical resources to identify and address the problems associated with these impairments, whereas distributive egalitarianism does not. Furthermore, she argues that assessing the impairments of privilege through relational egalitarianism helps to characterize a society of equals: we must address the causes of functional impairments, express respect for the worse off by not normalizing the experiences of the privileged, and minimize competitive positionality. (shrink)

Many social gradients in health appear steeper for men than for women. I refer to this as the “Steepness Puzzle.” This paper explores the ethical implications of this Puzzle. First, it identifies potential explanations for the Steepness Puzzle, including methodological problems. Second, it highlights two harms associated with the methodological explanation: the consequences of biased epistemic practices and the marginalization of women. It also demonstrates how attempts to flatten the gradients in health could disproportionately favor men or reinforce troubling gendered (...) norms. Finally, I suggest ways to address the methodological problems underlying the Puzzle. (shrink)

In this paper I argue that certain ways in which the relationship among discrimination, emotions and health is presented can undermine equity. I identify a model of this relationship the discrimination-emotion-health model - and claim that while the model is important for understanding the detrimental impact that discrimination and oppression can have on emotions and health, certain implications of the model are troubling. I identify six critiques of the model, and show that equity could be undermined, for example, when stereotypes (...) of the oppressed are reinforced and the experiences of the privileged are normalized. I then assess the implications of my analysis of the model and its critique for a framework of health equity, demonstrating what such a framework would need to look like in order for it to best represent discrimination as a psychosocial determinant of health. (shrink)