This chapter contains section titled: Why Two Theories at All? Why Exclude the Interests of Persons? Why Cut Out the Middle Tier? Is Each Society Master of its Own Fate? Do the Asymmetries Get Rawls the Result He Wants? Conclusion Notes.

One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new drug is rewarded in proportion to its impact on the global disease burden (not through monopoly rents). This reform would bring (...) drug prices down worldwide close to their marginal cost of production and would powerfully stimulate pharmaceutical research into currently neglected diseases concentrated among the poor. Its feasibility shows that the existing medical-patent regime (trade-related aspects of intellectual property rights—TRIPS—as supplemented by bilateral agreements) is severely unjust—and its imposition a human-rights violation on account of the avoidable mortality and morbidity it foreseeably produces. (shrink)

David Miller is right that weak cosmopolitanism is undistinctive and strong cosmopolitanism implausibly curtails associative duties. But there are intermediate views that avoid both of these problems. One such view holds that compatriotism makes no difference to our most important negative duties and that among these is the duty not to impose unjust social institutions upon other human beings. On this view, our duty not to impose an unjust institutional order on foreigners is exactly as stringent as our duty not (...) to impose an unjust institutional order upon our compatriots. This view is not trivial; it has important consequences for our moral responsibilities in the world as it is. And it is compatible with associative duties insofar as these increase what we owe to some without decreasing what we owe to persons at large. (shrink)

On September 30–October 2, 2005, a group of individuals drawn from civil society organizations, governments, international agencies, and academic institutions came together in Montréal, Québec, Canada, for an international workshop entitled “Human Rights and Access to Essential Medicines: The Way Forward.” At the conclusion of the workshop, we drafted the “Montréal Statement on the Human Right to Essential Medicines.” This “Statement” is reprinted at the end of this comment, which offers some background on the problem addressed at the workshop.

We live in a world of radical inequality: Hundreds of millions suffer severe, lifelong poverty. Many others are quite well off and affluent enough significally to improve the lives of the global poor. Does this radical inequality constitute an injustice which we are involved? An affirmative answer finds broad support in different strands of the Western moral tradition, which also support the same program of institutional reform. This reform centers around a Global Resources Dividend, or GRD. A GRD in the (...) amount of one percent of the global social product would raise some $300 Billion a year. This amount is too small to lead to economic dislocation. But it is large enough to eradicate global poverty within one or two decades. (shrink)

In an earlier piece in these pages, I described the health effects of the still massive problem of global poverty: The poor worldwide face greater environmental hazards than the rest of us, from contaminated water, filth, pollution, worms, and insects. They are exposed to greater dangers from people around them, through traffic, crime, communicable diseases, sexual violence, and potential exploitation by the more affluent. They lack means to protect themselves and their families against such hazards, through clean water, nutritious food, (...) satisfactory hygiene, necessary rest, adequate clothing, and safe shelter. They lack the means to enforce their legal rights or to press for political reform. (shrink)

Despite a high and growing global average income, billions of human beings are still condemned to lifelong severe poverty, with all its attendant evils of low life expectancy, social exclusion, ill health, illiteracy, dependency, and effective enslavement. This problem is solvable, despite its magnitude.

We citizens of the affluent countries tend to discuss our obligations toward the distant needy in terms of donations and transfers, assistance and redistribution. This way of conceiving the problem is a serious moral error, and a very costly one for the global poor. It depends on the false belief that the causes of the persistence of severe povery are indigenous to the countries in which it occurs. There are indeed national and local factors that contribute to persistent poverty in (...) developing countries. But global institutional rules also play an important role in its reproduction, in part by sustaining the national and local factors that affluent Westerners most like to blame for the problem. Since these rules are shaped by our governments, in our name, we bear moral responsibility not merely by assisting the distant poor too little, but also, and more significantly, by harming them too much. (shrink)

Worldwide, human lives are rapidly improving. Education, health-care, technology, and political participation are becoming ever more universal, empowering human beings everywhere to enjoy security, economic sufficiency, equal citizenship, and a life in dignity. To be sure, there are some specially difficult areas disfavoured by climate, geography, local diseases, unenlightened cultures or political tyranny. Here progress is slow, and there may be set-backs. But the affluent states and many international organizations are working steadily to extend the blessings of modernity through trade (...) and generous development assistance, and it won't be long until the last pockets of severe oppression and poverty are gone. Heavily promoted by Western governments and media, this comforting view of the world is widely shared, at least among the affluent. Pogge's new book presents an alternative view: Poverty and oppression persist on a massive scale; political and economic inequalities are rising dramatically both intra-nationally and globally. The affluent states and the international organizations they control knowingly contribute greatly to these evils - selfishly promoting rules and policies harmful to the poor while hypocritically pretending to set and promote ambitious development goals. Pogge's case studies include the $1/day poverty measurement exercise, the cosmetic statistics behind the first Millennium Development Goal, the War on Terror, and the proposed relaxation of the constraints on humanitarian intervention. A powerful moral analysis that shows what Western states would do if they really cared about the values they profess. (shrink)

Abstract Benefit sharing as envisaged by the 1992 Convention on Biological Diversity (CBD) is a relatively new idea in international law. Within the context of non-human biological resources, it aims to guarantee the conservation of biodiversity and its sustainable use by ensuring that its custodians are adequately rewarded for its preservation. Prior to the adoption of the CBD, access to biological resources was frequently regarded as a free-for-all. Bioprospectors were able to take resources out of their natural habitat and develop (...) commercial products without sharing benefits with states or local communities. This paper asks how CBD-style benefit-sharing fits into debates of justice. It is argued that the CBD is an example of a set of social rules designed to increase social utility. It is also argued that a common heritage of humankind principle with inbuilt benefit-sharing mechanisms would be preferable to assigning bureaucratic property rights to non-human biological resources. However, as long as the international economic order is characterized by serious distributive injustices, as reflected in the enormous poverty-related death toll in developing countries, any morally acceptable means toward redressing the balance in favor of the disadvantaged has to be welcomed. By legislating for a system of justice-in-exchange covering nonhuman biological resources in preference to a free-for-all situation, the CBD provides a small step forward in redressing the distributive justice balance. It therefore presents just legislation sensitive to the international relations context in the 21st century. (shrink)

It helps ordinary citizens evaluate their options and their responsibility for global institutional factors, and it challenges social scientists to address the causes of poverty and hunger that act across borders.The present volume ...

In GIVING WELL: THE ETHICS OF PHILANTHROPY, an accomplished trio of editors bring together an international group of distinguished philosophers, social scientists, lawyers and practitioners to identify and address the most urgent moral questions arising today in the practice of philanthropy.

In this article, the last in the symposium on world poverty and human rights, Pogge replies to his critics Mathias Risse, Alan Patten, Rowan Cruft, Norbert Anwander, and Debra Satz.

Despite a high and growing global average income, billions of human beings are still condemned to lifelong severe poverty with all its attendant evils of low life expectancy, social exclusion, ill health, illiteracy, dependency, and effective enslavement. We citizens of the rich countries are conditioned to think of this problem as an occasion for assistance. Thanks in part to the rationalizations dispensed by our economists, most of us do not realize how deeply we are implicated, through the new global economic (...) order our states have imposed, in this ongoing catastrophe. My sketch of how we are so implicated follows the argument of my book, World Poverty and Human Rights, but takes the form of a response to the books critics. (shrink)

Health Rights is a multidisciplinary collection of seminal papers examining ethical, legal, and empirical questions regarding the human right to health or health care. The volume discusses what obligations health rights entail for governments and other actors; how they relate to and potentially conflict with other rights and values; and how cultural diversity bears on the formulation and implementation of health rights.

This is a short, accessible introduction to John Rawls' thought and gives a thorough and concise presentation of the main outlines of Rawls' theory as well as drawing links between Rawls' enterprise and other important positions in moral and political philosophy.

With each of our three criminal-law topics—defining offenses, apprehending suspects, and establishing punishments—we feel, I believe, strong moral resistance to the idea that our practices should be settled by a prospective-participant perspective. This becomes quite clear when we look at how the “reforms” suggested by institutional viewing might combine once we consider all three topics together: imagine a more extensive and swifter use of the death penalty in homicide cases coupled with somewhat lower standards of evidence; or think of backing (...) a strict-liability criminal statute with the death penalty. Of course, such “reforms” would increase the execution of innocents; but, their proponents will tell us, any penal system involves the punishment of some innocents, and, if it provides for the death penalty, the execution of some innocents. Moreover, why is it worse for innocents to be punished than for innocents to suffer an equivalent harm in some other way? Formulated from a prospective-participant perspective: Why not run a small risk of being innocently executed in exchange for reducing, much more significantly, the risk of dying prematurely in other ways? (shrink)

Is it really necessary to add something like the Health Impact Fund to the existing global patent system? We can divide this question into two parts. First, is there something seriously wrong with the status quo and, if so, what exactly is it? Second, how do we best go about solving the problem; that is, how does the design of the reform proposal address the flaws in the status quo? Jorn Sonderholm, in his critique of the Health Impact Fund, or (...) HIF, raises both of these issues. These criticisms afford us the opportunity to reaffirm our commitment to ameliorating glaring problems with the current system for incentivizing R&D for essential medicines, and to clarify why we believe the HIF is exactly what the world needs. (shrink)

The Global Financial Crisis is acknowledged to be the most severe economic downturn since the 1930s, and one that is unique in its underlying causes, its scope, and its wider social, political and economic implications. This volume explores some of the ethical issues that it has raised.

Contributors from several countries discuss the central moral issues arising in the emerging global order: the responsibilities of the strongest societies, moral priorities for the next decades, and the role of intellectuals in view of the huge gap between widely expressed moral ambitions and prevailing political and economic realities.

One‐third of all human deaths are due to poverty‐related causes, to malnutrition and to diseases that can be prevented or cured cheaply. Yet our politicians, academics, and mass media show little concern for how such poverty might be reduced. They are more interested in possible military interventions to stop human rights violations in developing countries, even though such interventions – at best – produce smaller benefits at greater cost. This Western priority may be rooted in self‐interest. But it engenders, and (...) is sustained by, a deeply flawed moral presentation of global economic cooperation. The new global economic order we impose aggravates global inequality and reproduces severe poverty on a massive scale. On any plausible understanding of our moral values, the prevention of such poverty is our foremost responsibility. (shrink)

Cohen seeks to rescue the concept of justice from those, among whom he includes Rawls, who think that correct fundamental moral principles are fact-sensitive. Cohen argues instead that any fundamental principles of justice, and fundamental moral principles generally, are fact-insensitive and that any fact-sensitive principles can be traced back to fact-insensitive ones. This paper seeks to clarify the nature of Cohen's argument, and the kind of fact-insensitivity he has in mind. In particular, it distinguishes between internal and external fact-sensitivity – (...) that is, whether facts are referenced in the content of the principle, or must otherwise be the case in order for the principle to apply at all. Cohen himself seems likely to endorse internally fact-sensitive fundamental principles. This leads to a discussion of Cohen's Platonism about moral principles and the extent to which his arguments cover all its rivals. 1. (shrink)

Moral universalism centrally involves the idea that the moral assessment of persons and their conduct, of social rules and states of affairs, must be based on fundamental principles that do not, explicitly or covertly, discriminate arbitrarily against particular persons or groups. This general idea is explicated in terms of three conditions. It is then applied to the discrepancy between our criteria of national and global economic justice. Most citizens of developed countries are unwilling to require of the global economic order (...) what they assuredly require of any national economic order, for example, that its rules be under democratic control, that it preclude life-threatening poverty as far as is reasonably possible. Without a plausible justification, such a double standard constitutes covert arbitrary discrimination against the global poor. Key Words: contextualism • corruption • discrimination • Rawls • resource exports • world poverty. (shrink)

This book helps readers identify feasible and morally plausible reforms of global institutional arrangements and international organizations.

In a democratic society, the social rules are imposed by all upon each. As “recipients” of the rules, we tend to think that they should be designed to engender the best attainable distribution of goods and ills or quality of life. We are inclined to assess social institutions by how they affect their participants. But there is another, oft-neglected perspective which the topic of health equity raises with special clarity: As imposers of the rules, we are inclined to think that (...) harms we inflict through the rules have greater moral weight than like harms we merely fail to prevent or to mitigate. What matters morally is not merely how we affect people, but how we treat them through the rules we impose. While current (consequentialist and Rawlsian) theorizing is dominated by the first perspective and thus supports purely recipient-oriented moral conceptions, an adequate approach to social justice requires a balancing of both. Such balancing results in a relational conception of justice, which distinguishes various ways in which an institutional scheme may causally affect the quality of life of its participants.This essay argues that the strength of our moral reason to prevent or mitigate particular medical conditions depends not only on what one might call distributional factors, such as how badly off the people affected by these conditions are in absolute and relative terms, how costly prevention or treatment would be, and how much patients would benefit from given treatment. Rather, it depends also on relational factors, that is, on how we are related to the medical conditions they suffer. It then discusses some implications of this view for understanding responsibilities for international health outcomes. (shrink)

Global Ethics, along with its companion volume Global Justice, will aid in the study of global justice and global ethical issues with significant global dimensions. Some of those issues directly concern what individuals, countries, and other associations ought to do in response to various global problems, such as poverty, population growth, and climate change. Others concern the concepts that are commonly used to discuss such issues, such as "development" and "human rights." And still others concern the legitimacy of various phenomena (...) that structure the global scene, such as national borders, the institutions of national sovereignty and self-determination, and attitudes such as nationalism and patriotism. In recent decades, literature on such issues has started to build up in the Western philosophical tradition. Until now, though, no up-to-date sample of this literature has been available to students and other interested parties. These two books, companion volumes sold separately, fill this gap by providing a sample of the best recent work on these themes. (shrink)

A comparative examination of four alternative ways of understandingwhat human rights are supports an institutional understanding assuggested by Article 28 of the Universal Declaration: Human rightsare weighty moral claims on any coercively imposed institutionalorder, national or international (as Article 28 confirms). Any suchorder must afford the persons on whom it is imposed secure accessto the objects of their human rights. This understanding of humanrights is broadly sharable across cultures and narrows the philosophical and practical differences between the friends ofcivil and (...) political and the champions of social, economic, andcultural human rights. When applied to the global institutionalorder, it provides a new argument for conceiving human rights asuniversal – and a new basis for criticizing this order as tooencouraging of oppression, corruption, and poverty in the developing countries: We have a negative duty not to cooperatein the imposition of this global order if feasible reforms ofit would significantly improve the realization of human rights. (shrink)

"The largest Ebola outbreak to date—first detected in December 2013 and still ongoing as of April 2015—has cast new light on the shortfalls of international public health systems.1 As in previous health crises, scrutiny has reemerged over the pharmaceutical industry’s ability and willingness to innovate new medicines for underserved disease areas. The public debate has intensified following revelations that promising drug candidates to treat Ebola had gone undeveloped despite compelling preclinical results.2 This lack of development is especially troubling because it (...) occurred after a recently implemented U.S. incentive scheme—the Food and Drug Administration’s (FDA) tropical disease priority review voucher program—designed to counteract exactly this problem. Taking Ebola as a case in point, it is useful to examine the short history and ongoing refinement of this voucher program, since it represents one of the most significant legislative efforts to systematically address the relative absence of com- mercial rewards for drugs targeting tropical diseases. This analysis evaluates the voucher program’s effectiveness for both stimulating private sector innovation and achieving positive health impacts among populations most severely burdened by tropical diseases. It then proposes specific recommendations for how law- makers can improve the program’s legislation to better achieve these objectives. ". (shrink)

We citizens of the affluent countries tend to discuss our obligations toward the distant needy mainly in terms of donations and transfers, assistance and redistribution: How much of our wealth, if any, should we give away to the hungry abroad? Using one prominent theorist to exemplify this way of conceiving the problem, I show how it is a serious error — and a very costly one for the global poor.