Diversity Reading List

Abstract:

BACKGROUND: The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively on aid expenditures. The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health. METHODS: We undertook a critical review of contemporary accounts of justice. We selected theories that: (i) articulate important and widely held moral intuitions; (ii) have had extensive impact on debates about global justice; (iii) represent diverse approaches to moral reasoning; and (iv) present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks. RESULTS: Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities. CONCLUSIONS: Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important foundation to strengthen collective action.

Publisher’s Note:
Why We Love Dogs, Eat Pigs, and Wear Cows offers an absorbing look at what social psychologist Melanie Joy calls carnism, the belief system that conditions us to eat certain animals when we would never dream of eating others. Carnism causes extensive animal suffering and global injustice, and it drives us to act against our own interests and the interests of others without fully realizing what we are doing. Becoming aware of what carnism is and how it functions is vital to personal empowerment and social transformation, as it enables us to make our food choices more freely—because without awareness, there is no free choice.

Abstract: Some bioethicists argue that conscientious objectors in health care should have to justify themselves, just as objectors in the military do. They should have to provide reasons that explain why they should be exempt from offering the services that they find offensive. There are two versions of this view in the literature, each giving different standards of justification. We show these views are each either too permissive (i.e. would result in problematic exemptions based on conscience) or too restrictive (i.e. would produce problematic denials of exemption). We then develop a middle ground position that we believe better combines respect for the conscience of healthcare professionals with concern for the duties that they owe to patients. Our claim, in short, is that insofar as objectors should have to justify themselves, they should have to do it according to the standard that we defend rather than according to the standards that others have developed.

Diversifying Syllabi: Justice requires us to acknowledge the claims of morally or philosophically unreasonable persons, as long as they are politically reasonable; such people must be tolerated and considered part of the social contract. Toleration as wide public justification is the proper response to the pluralism characteristic of modern democratic societies.

Publisher’s Note:

Decolonizing Universalism develops a genuinely anti-imperialist feminism. Against relativism/universalism debates that ask feminists to either reject normativity or reduce feminism to a Western conceit, Khader's nonideal universalism rediscovers the normative core of feminism in opposition to sexist oppression and reimagines the role of moral ideals in transnational feminist praxis.

Publisher’s Note:
As a botanist, Robin Wall Kimmerer has been trained to ask questions of nature with the tools of science. As a member of the Citizen Potawatomi Nation, she embraces the notion that plants and animals are our oldest teachers. In Braiding Sweetgrass, Kimmerer brings these lenses of knowledge together to show that the awakening of a wider ecological consciousness requires the acknowledgment and celebration of our reciprocal relationship with the rest of the living world. For only when we can hear the languages of other beings are we capable of understanding the generosity of the earth, and learning to give our own gifts in return.

Summary: Considers the particular case of CSMR individuals in detail and makes a strong case for incorporating relational elements into an account of moral personhood.

Abstract: I explore the ethics of altering the body of a child with severe cognitive disabilities in such a way that keeps the child 'forever small.' The parents of Ashley, a girl of six with severe cognitive and developmental disabilities, in collaboration with her physicians and the Hospital Ethics Committee, chose to administer growth hormones that would inhibit her growth. They also decided to remove her uterus and breast buds, assuring that she would not go through the discomfort of menstruation and would not grow breasts. In this way she would stay 'forever small' and be able to be carried and handled by family members. They claimed that doing this would ensure that she would be able to be part of the family and of family activities and to have familial care. But the procedure has raised thorny ethical questions. I wish to explore these questions philosophically by bringing to bear my own experiences as a mother of a grown daughter with severe cognitive impairments.

Summary: In this paper, Kittay advances a conception of justice that 'begins with an acknowledgement of dependency and seeks to organise society so that our well-being is not inversely related to our need for care or to care' (576). Her motivation for advancing this view is that ideals of citizenship in liberal society, including independence and productivity, perpetuate the victimisation, social exclusion, or stigmatisation of people with mental retardation and their carers. This is because liberal definitions of personhood do not provide resources for responding in a morally adequate way to the mutual dependence of people with mental retardation and their carers/advocates. People with mental retardation are inescapably dependent because of their central need for attentive care. And, carers' work is so deeply other-directed that they also do not fit the liberal model of the rationally self-interested actor. Thus, both carers and their charges are vulnerable and need to be advocated for so that they can be seen as having important entitlements to public resources and claims to justice. To this end, Kittay proposes a conception of personhood that is based on relationships. Although those with mental retardation are inherently dependent, they still count as persons because they are able to participate in relationships. This makes them entitled to the satisfactions that make life worth living. To achieve the twin goal of achieving justice for familial or paid carers, Kittay advances a new principle of justice, doulia, which calls for larger society to support those who care for the inexorably dependent. Kittay takes her relational conception of personhood and her principle of doulia to ensure that appropriate forms of social organization exist to support all those who become dependent. She claims her view is needed because principles of charity and beneficence are not adequate since they are consistent with the continued stigmatization of mental retardation and care work, and ground only low-priority social obligations.

Abstract: This essay explicates and evaluates the roles that fetal metaphysics and moral status play in Rosalind Hursthouse's abortion ethics. It is motivated by Hursthouse's puzzling claim in her widely anthologized paper Virtue Ethics and Abortion that fetal moral status and (by implication) its underlying metaphysics are in a way, fundamentally irrelevant to her position. The essay clarifies the roles that fetal ontology and moral status do in fact play in her abortion ethics. To this end, it presents and then develops her fetal metaphysics of the potential and actual human being, which she merely adumbrates in her more extensive treatment of abortion ethics in her book Beginning Lives. The essay then evaluates her fetal ontology in light of relevant research on fetal neural and psychological development. It concludes that her implied view that the late-stage fetus is an actual human being is defensible. The essay then turns to the analysis of late-stage abortions in her paper and argues that it is importantly incomplete.