This paper explores the notion of reciprocity in the context of active pulmonary and laryngeal tuberculosis treatment and related control policies and practices. We seek to do three things: First, we sketch the background to contemporary global TB care and suggest that poverty is a key feature when considering the treatment of TB patients. We use two examples from TB care to explore the role of reciprocity: isolation and the use of novel TB drugs. Second, we explore alternative means of (...) justifying the use of reciprocity through appeal to different moral and political theoretical traditions. We suggest that each theory can be used to provide reasons to take reciprocity seriously as an independent moral concept, despite any other differences. Third, we explore general meanings and uses of the concept of reciprocity, with the primary intention of demonstrating that it cannot be simply reduced to other more frequently invoked moral concepts such as beneficence or justice. We argue that reciprocity can function as a mid-level principle in public health, and generally, captures a core social obligation arising once an individual or group is burdened as a result of acting for the benefit of others. We conclude that while more needs to be explored in relation to the theoretical justification and application of reciprocity, sufficient arguments can be made for it to be taken more seriously as a key principle within public health ethics and bioethics more generally. (shrink)

Contemporary egalitarian theories of justice constrain the demands of equality by responsibility, and do not view as unjust inequalities that are traceable to individuals' choices. This paper argues that, in order to make non-arbitrary determinate judgements of responsibility, any theory of justice needs a principle of stakes , that is, an account of what consequences choices should have. The paper also argues that the principles of stakes seemingly presupposed by egalitarians are implausible, and that adopting alternative principles of stakes amounts (...) to fleshing out the demands of responsibility rather than imposing limits on them. (shrink)

Abstract: In this brief article, I claim that the Contribution Principle invoked by Christian Barry as a key principle for determining who owes what to the global destitute is mistaken as a definitive principle and unjustified as a provisional principle for dealing with global poverty. This principle assumes that merely causing, or contributing to the cause of, a state of affairs may be sufficient to have a special responsibility to bear the costs that this state of affairs entails. I argue (...) that an agent will only have such a special responsibility if he or she has caused a state of affairs (for example, acute destitution) by violating a duty not to do so. Therefore, the Contribution Principle is mistaken. Finally, I tackle two possible responses to my argument. The first claims that states have a duty not to undertake actions that may cause, or contribute to the cause of, acute deprivations. The second claims that although the Contribution Principle may be mistaken as a definitive principle for dealing with global destitution, it is nonetheless correct as a provisional principle. (shrink)

This article considers two prominent, competing approaches to defining the scope of business responsibility for human rights. The first approach advocates extension of business responsibility beyond the boundaries of the enterprise to encompass broader ' spheres of influence'. The second approach advocates a business ' responsibility to respect* human rights (but not a ' positive* duty to protect, promote or fulfil rights).Building on a critical evaluation of these competing accounts of business responsibility, this article outlines a modified account, referred to (...) as a framework of ' spheres of responsibility*. On such an account, business responsibility for human rights outcomes is conceptualised not only in relation to direct ' harms' imposed by business, but also in relation to corporate influence over broader relationships and institutions that shape and constrain the substantive realisation of human rights. (shrink)

This article considers two prominent, competing approaches to defining the scope of business responsibility for human rights. The first approach advocates extension of business responsibility beyond the boundaries of the enterprise to encompass broader ‘spheres of influence’. The second approach advocates a business ‘responsibility to respect’ human rights. Building on a critical evaluation of these competing accounts of business responsibility, this article outlines a modified account, referred to as a framework of ‘spheres of responsibility’. On such an account, business responsibility (...) for human rights outcomes is conceptualised not only in relation to direct ‘harms’ imposed by business, but also in relation to corporate influence over broader relationships and institutions that shape and constrain the substantive realisation of human rights. (shrink)

En este artículo discuto dos tesis que Thomas Pogge deriva de su concepción institucional de los derechos humanos: la tesis de la culpa y la tesis de la violación global. La tesis de la culpa asevera que los ciudadanos que contribuyen a sostener un régimen institucional que viola derechos humanos sin realizar compensaciones en beneficio de las víctimas, se convierten ellos mismos en violadores de derechos humanos. Por su parte, la tesis de la violación global asevera que al imponer regulaciones (...) injustas que tienden a generar pobreza extrema, el régimen internacional actual viola los derechos humanos de los pobres del mundo. Mi intención será probar que ambas tesis son insostenibles ya que se basan en presupuestos errados en materia de responsabilidad. Esto no nos conducirá, sin embargo, a abandonar la concepción institucional de los derechos humanos. Por el contrario, una vez depurada de sus problemas, se trata de una concepción que puede ayudarnos a pensar adecuadamente sobre la responsabilidad por los derechos humanos en un mundo globalizado. In this paper, I discuss two theses that Thomas Pogge derives from his ins-titutional conception of human rights: the thesis of guilt and the thesis of global violation. The thesis of guilt states that citizens who contribute to support an institutional regime that violates human rights without awarding the victims any compensation become themselves human rights violators. The thesis of global violation, on the other hand, states that, by imposing unfair regulations that tend to generate extreme poverty, the current international regime violates the human rights of the world's poor. My intention is to prove that both theses are untenable because both of them are based on wrong assumptions concerning responsibility. This will not lead us, however, to leave the institutional conception of human rights. On the contrary, once debugged of its problems, it can be considered a conception that can help us to think properly about responsibility for human rights in a globalized world. (shrink)