Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the (...) end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

Democracy is rule by the demos, but by what criteria is the demos constituted? Theorists of democracy have tended to assume that the demos is properly defined by national boundaries or by the territorial boundaries of the modern state. In a recent turn, many democratic theorists have advanced the principles of affected interests and coercion as the basis for defining the boundaries of democracy. According to these principles, it is not co-nationals or fellow citizens but all affected or all subjected (...) to coercion who constitute the demos. In this paper, I argue that these recent approaches to the boundary problem are insufficiently attentive to the conditions of democracy. Democracy is not merely a set of procedures; it also consists of substantive values and principles. Political equality is a constitutive condition of democracy, and solidarity is an instrumental condition of democracy. The affected interests and coercion principles create serious problems for the realization of these conditions – problems of size and stability. Building on this critique, this paper presents democratic considerations for why the demos should be bounded by the territorial boundaries of the state, grounded in the state’s role in (1) securing the constitutive conditions of democracy, (2) serving as the primary site of solidarity conducive to democratic participation, and (3) establishing clear links between representatives and their constituents. I examine and reject a third alternative, a global demos bounded by a world state, and conclude by considering some practical implications of my argument. (shrink)

This article brings Gillian Brock and Alex Sager's recently published books into conversation with my book, Immigration and Democracy. It begins with a summary of the main normative arguments of my book to set the stage for critical engagement with Brock and Sager's books. While I agree with Brock's Justice for People on the Move that state power must be justified to both insiders and outsiders, I think she gives too little weight to the value of collective self-determination. I distinguish (...) between justice and collective self-determination and argue that each is an important component of legitimacy. Sager's Against Borders focuses on immigration enforcement and contends that violence is inherent in border controls. Every legal system is backed by the threat of the use of force; the question is whether the use of force by state agents is justified. In contrast to Sager, I argue that the proper response to the injustices of current immigration enforcement is reform, not abolition, of the immigration system. (shrink)

The boundaries of democracy are typically defined by the boundaries of formal status citizenship. Such state-centered theories of democracy leave many migrants without a voice in political decision-making in the areas where they live and work, giving rise to a problem of democratic legitimacy. Drawing on two democratic principles of inclusion, the all affected interests and coercion principles, this article elaborates this problem and examines two responses offered by scholars of citizenship for what receiving states might do. The first approach (...) involves expanding the circle of citizenship to include resident noncitizens. A second approach involves disaggregating the rights conventionally associated with citizenship from the legal status of citizenship and extending some of those rights, including voting rights, to resident noncitizens. This article argues that both approaches fall short of satisfying the democratic principles of inclusion, which call for enfranchising individuals not only beyond the boundaries of citizenship but also beyond territorial boundaries. (shrink)

Immigrant legalization policies pose an ethical dilemma between justice and the rule of law. On the one hand, liberal democracies aspire to the principles of individual liberty and equality. Building on liberal ideals of justice, compelling arguments have been made for granting legal status and a path to citizenship to unauthorized migrants by virtue of the social ties they have developed, their contributions to the host society, and their vulnerability to exploitation. On the other hand, legalization poses a challenge to (...) another important value, the rule of law, which requires government to operate within a framework of law in accordance with well-established public norms. Immigrant legalization programmes are said to undermine the rule of law because they reward lawbreaking, allow queue-jumping, and incentivize further unauthorized migration. This article clarifies each horn of the dilemma, focusing on rule of law arguments. We offer a critical reappraisal of immigrant legalization policies by reflecting on the normative meaning of the rule of law and by examining empirical evidence assessing the effects of legalization. Our central contention is that legalization policies can enhance the rule of law. We offer five rule of law arguments in support of legalization, which help to mitigate the dilemma between justice and the rule of law. We conclude by discussing some policy implications of our analysis. (shrink)

This essay examines Susan Moller Okin’s writing on conflicts between religious freedom and sex equality, and her criticism of ‘political liberal’ approaches to these conflicts, which I take to be a part of her lifelong critique of the public–private distinction. I argue that, while Okin ultimately accepted a version of the distinction, she was much less hopeful than most liberal theorists that private actions could be made just without a great deal of public coercion. This comes through especially in her (...) writing on religion. I suggest an approach to addressing these conflicts that seeks to respect religious liberty more than Okin’s prescriptions suggest she did but which, in my view, is more consistent with Okin’s own liberal commitments. (shrink)