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"A key text that is helping to define the subfield of global health ethics it is a subfield with substantial promise, which Benatar and Brock's collection has helped.
Table of contents
- Global health ethics: key issues
- Global Health and Global Health Ethics
- Global health ethics: an introduction to prominent theories and relevant topics
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Global health ethics: key issues
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Global Health and Global Health Ethics
Search Advanced search allows to you precisely focus your query. Search within a content type, and even narrow to one or more resources. You can also find results for a single author or contributor. Velji A, Bryant J. Velji, Anvar, and John H. Accessed September 19, Username or Email Please enter User Name. Password Please enter Password. View All Subscription Options. Consequently, many subjects fall within its scope. Whilst several accounts of global health ethics have been conceptualized in the literature, a concise demarcation of the paradigm is still needed.
Through means of a literature review, this paper presents a two-part introduction to global health ethics. Second, a selection of exemplar ethical topics is presented to illustrate the range of topics within global health ethics. Global health ethics is a relatively new term used to conceptualize the process of applying moral value to health issues that are usually characterized by a global level effect or require action coordinated at a global level. Whilst this definition provides a relatively concise account of what phenomena constitute a global health challenge, it does not, however, help us to understand why we should care enough to do something about it.
To answer this, one must first explore the scope of global health phenomena to identify potential ethical issues. Once achieved, one can then develop salient moral arguments for or against potential action including inaction. It is important to note that this account of global health ethics takes a predominantly geographic approach, which infers that global health ethics relates primarily to large-scale, or macro, health phenomena.
In this sense, we could view global health ethics as being concerned primarily with pandemics, natural disasters, poverty, and other phenomena that effect large populations. However, this is not the only approach to global health ethics. It may also refer to health-related topics in themselves through a content approach. This type of approach considers both macro-level and micro-level e. Yet, in its broadest sense, global health ethics is a normative project.
In their description of these approaches, Hunter and Dawson 2 consider normative global health ethics to be a distinct subject in itself. The pioneers and prominent proponents of global health ethics, Benatar, Daar, and Singer 3 , argue that before a new global mindset can be addressed a common set of principles to deal with global health threats must be agreed. For them, the normative approach is conceptualized best by Benetar et al.
Global health ethics is still a relatively new subject, and health-related issues have not always been framed within its paradigm. This is partly due to its infancy but also due to the plurality of debate that inevitably occurs within such a broadly relevant field. The endeavor to develop a robust ethical framework to apply to issues of global health has been a long and complex process. Some academic fields have focused more explicitly on normative global health ethics. Global bioethics and global public health have deliberately encouraged pluralistic debate of pertinent topics using a global forum in order to establish universally guiding norms 9 — However, the emergence of the global health ethics paradigm has also been a political pursuit.
The exchange of norms and best practices in response to a practical necessity to address both macro- and micro-level health phenomena 12 has also resulted in the globalization of health policy discourse 13 and, therefore, has helped in developing the global health ethics paradigm.
- Global Health and Global Health Ethics edited by Solomon Benatar.
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It might then be argued that this is evidence of progress with Hunter and Dawson's 2 normative global health ethics project. This article aims to provide researchers, policy makers, and decision makers with a basic understanding of global health ethics and of some norms principally discussed within the subject area. Through a review of relevant literature, this article delivers a two-part introduction to global health ethics.
First, a brief description is provided of prominent theories used within global health ethics 2 , Then a selection of high-profile, exemplar ethical conflicts are outlined in order to provide some paradigmatic insight into the range of topics that fall within the scope of global health ethics. At this point, it is important to reiterate that the diversity of topics discussed under the title of global health ethics has not always been framed within its paradigm or even discussed in relation to the concept.
Among the most prominent of these are the theories of Peter Singer and Thomas Pogge 2 , 4 , 6 , However, before we discuss these we must first consider two key normative issues for theories of global health ethics: Within global health, we are typically concerned with differences in health and in determinants of health. In order to identify relevant health phenomena and then assess if these are preferable for global health, we must first compare and contrast them against something.
However, not all health inequalities are unjust. We see huge diversity in the world, yet, from an ethical point of view it is not clear what we have a moral duty to remedy or how we should go about remedying it. Nonetheless, it can be agreed that health has special moral importance; therefore, health inequalities are also morally significant. Health justice is principally concerned with reducing unfair and avoidable health inequalities rather than eliminating differences in health states altogether.
Another important issue for global health ethics is whether or not geopolitical boundaries have moral significance. To cosmopolitans, the global geopolitical environment has no moral relevance other than for its potential influence on the certainty of achieving a preferred outcome. They reject an impartial view of morality under the assumption that universal norms are unlikely to be agreed upon in light of the plurality of global cultures.
Yet, these positions can be critically discussed further. Realists argue that national boundaries limit ethical considerations. For them, global society is an anarchical system in which one must prioritize national interests first. Therefore, moral considerations are limited by the state's culture.
Global health ethics: an introduction to prominent theories and relevant topics
However, pluralists take a much weaker stance. For them, diversity and pluralism, at a global level, are not necessarily harmful to national interests. Therefore, whilst pluralists also consider morality to be local, they may also recognize some moral worth in coexisting But what does this mean for global health ethics? At first glance one might assume that the anti-cosmopolitan stance is much less demanding towards global health action.
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We might even believe that this position is selfish. However, anti-cosmopolitan views of morality do not necessarily negate the possibility of global level health action. For example, aid may still be provided to other countries that are suffering under the premise that this protects national interests in the long run. Furthermore, nation states may also place more value in acting upon the imperfect duty of beneficence e.
Therefore, aid may still be given to global health action, at least when this does not conflict with national interests.
The key concerns in preference utilitarianism are that there is a moral imperative to maximize happiness and to avoid suffering. Within Singer's theory of preference utilitarianism, the more affluent should support the least privileged whenever this can be achieved without costing anything of comparable moral significance. Therefore, if we have the capacity to help others at minimal relative cost to ourselves, then it is our moral duty to help, regardless of their proximity to us. Singer 4 builds his theory from a premise he assumes everyone agrees upon, namely, that suffering and premature death are bad or are at least not preferred.
As is common to utilitarian theory, Singer's approach prioritizes the avoidance of suffering and also considers that greater aggregate suffering is of higher moral significance. This cosmopolitan principle takes no account of proximity. For preference utilitarianism, boundaries of communities or nation states are morally irrelevant.
As Singer has consistently argued: Whilst Singer acknowledges that there are psychological differences e. In summary, one is obligated to redistribute a reasonable amount of one's affluence to lessen the suffering of others as long as this does not endanger oneself or one's family. Unlike Singer's substantive approach, Pogge's 6 theory takes greater account of geopolitics using a procedural approach to justice.
Within his theory, rights are derived from within the structure of global society and from its institutions, which he suggests are unjust. Pogge argues from a rights perspective, which distinguishes between negative and positive rights and duties. Negative rights or duties are concrete and always true whereas positive rights or duties to help are weaker but more encompassing.
Pogge's negative moral duties extend only so far as achieving a just society; consequently, inequalities may still remain. However, residual inequalities may still demand action but only under weaker positive duties e. Pogge takes an egalitarian view of morality: