This article defends the classical liberal view of human interactions that gives strong protection to associational freedom except in cases that involve the use of force or fraud or the exercise of monopoly power. That conception is at war with the modern antidiscrimination or human rights laws that operate in competitive markets in such vital areas as employment and housing, with respect to matters of race, sex, age, and increasingly, disability. The article further argues that using the “human rights” (...) label to boost the moral case for antidiscrimination laws gets matters exactly backwards, given that any program of forced association on one side of a status relationship (employer, not employee; landlord, not tenant) is inconsistent with any universal norm governing all individuals regardless of role in all associative arrangements. The articled also discusses the tensions that arise under current Supreme Court law, which protects associational freedom arising out of expressive activities (as in cases involving the NAACP or the Boy Scouts), but refuses to extend that protection to other forms of association, such as those involving persons with disabilities. The great vice of all these arrangements is that they cannot guarantee the stability of mandated win/lose relationships. The article further argues that a strong social consensus against discrimination is insufficient reason to coerce dissenters, given that holders of the dominant position can run their operations as they see fit even if others do otherwise. It closes with a short model human rights statute drafted in the classical liberal tradition that avoids the awkward line drawing and balancing that give rise to modern bureaucracies to enforce modern antidiscrimination laws. (shrink)

This Article addresses a common characteristic of antidiscrimination law: To what extent should one antidiscrimination campaign be held accountable for other, related, discriminatory structures that it does not and cannot purport to correct? Plaintiffs in antidiscrimination cases are sometimes expected to account for the larger social context in which their claim is made. Defendants invoke this larger context as a way of rebutting the discrimination claim, by arguing that the plaintiff’s claim has “discriminatory residue” that would exacerbate (...) related discriminatory structures. For example, in a case in which same-sex couples seek the right to contract with surrogate mothers, the defendant can argue that accepting the plaintiffs’ claim that they are discriminated against on the basis of sexuality might exacerbate the exploitation of surrogate mothers. This Article dubs such rebuttal claims RADARs: reciprocal antidiscrimination arguments. It offers a framework for weighing RADARs’ feasibility, by mapping both their potential and their limitations. It concludes that RADARs can be useful analytical tools for legislators and policymakers when assessing the overall impact of specific antidiscrimination measures. RADARs are also helpful for cause lawyers in considering the long term impacts of antidiscrimination litigation. In contrast, courts should be cautious in accepting RADARs made by defendants in antidiscrimination cases due to the inherent institutional and procedural limitations of adjudication. (shrink)

Until approximately twenty years ago, advances in the study of human genetics had little influence on the practice of medicine. In the 1980s, this changed dramatically with the mapping of the altered genes that cause cystic fibrosis and Huntington disease. In just a few years, these discoveries led to DNA-based tests that enabled clinicians to determine whether prospective parents were carriers of CF or whether an individual carried the Huntington gene and, as a result, would almost certainly develop the disease.Observers (...) interested in the social and economic implications of genetic technology realized that such genetic tests could be used by insurance companies to predict which insurance applicants were likely to become ill or even die from these diseases. (shrink)

Until approximately twenty years ago, advances in the study of human genetics had little influence on the practice of medicine. In the 1980s, this changed dramatically with the mapping of the altered genes that cause cystic fibrosis and Huntington disease. In just a few years, these discoveries led to DNA-based tests that enabled clinicians to determine whether prospective parents were carriers of CF or whether an individual carried the Huntington gene and, as a result, would almost certainly develop the disease.Observers (...) interested in the social and economic implications of genetic technology realized that such genetic tests could be used by insurance companies to predict which insurance applicants were likely to become ill or even die from these diseases. (shrink)

What does morality require of individuals in their dating and sex life? In this article I challenge recent outlines of antidiscrimination duties in the dating sphere and present a plausible alternative: the deliberative duty. This duty avoids the risks and limitations of earlier outlines: it is time-sensitive regarding the malleability of intimate preferences, it avoids being too demanding on the duty-bearer and minimizes the risk of generating mere dutiful attraction behavior towards right-holders. In addition, it is better suited for (...) universal action guidance in the dating sphere than earlier outlines of individual antidiscrimination duties. (shrink)

Genetic discrimination is becoming an increasingly important problem in the United States. Information acquired from genetic tests has been used by insurance companies to reject applications for insurance policies and to refuse payment for the treatment of illnesses. Numerous states and the United States Congress have passed or are considering passage of laws that would forbid such use of genetic information by health insurance companies. Here we argue that much of this legislation is severely flawed because of the difficulty in (...) distinguishing genetic from nongenetic tests. In addition, barring the use by insurance companies of a genetic test but not a nongenetic test (conceivably for the same multifactorial disease) raises issues of fairness in health insurance. These arguments suggest that ultimately the problems arising from genetic discrimination cannot be solved by narrowly focused legislation but only by a modification of the entire health care system. (shrink)

Genetic discrimination is becoming an increasingly important problem in the United States. Information acquired from genetic tests has been used by insurance companies to reject applications for insurance policies and to refuse payment for the treatment of illnesses. Numerous states and the United States Congress have passed or are considering passage of laws that would forbid such use of genetic information by health insurance companies. Here we argue that much of this legislation is severely flawed because of the difficulty in (...) distinguishing genetic from nongenetic tests. In addition, barring the use by insurance companies of a genetic test but not a nongenetic test (conceivably for the same multifactorial disease) raises issues of fairness in health insurance. These arguments suggest that ultimately the problems arising from genetic discrimination cannot be solved by narrowly focused legislation but only by a modification of the entire health care system. (shrink)

Sharing-economy firms have opposed the application of antidiscrimination law to their transactions. At the same time, these firms have heralded their ability to achieve antidiscrimination aims without the force of law, and have adopted various measures to address discrimination. This Article documents and assesses these measures, focusing on the relationship between law and norms. Relying on the sharing economy as a case study, this Article shows how law can play a crucial role in spurring antidiscrimination efforts by (...) firms that it does not regulate, but also how antidiscrimination law might nonetheless be undermined by these voluntary efforts. (shrink)

Statistical evidence is crucial throughout disparate impact’s three-stage analysis: during (1) the plaintiff’s prima facie demonstration of a policy’s disparate impact; (2) the defendant’s job-related business necessity defense of the discriminatory policy; and (3) the plaintiff’s demonstration of an alternative policy without the same discriminatory impact. The circuit courts are split on a vital question about the “practical significance” of statistics at Stage 1: Are “small” impacts legally insignificant? For example, is an employment policy that causes a one percent disparate (...) impact an appropriate policy for redress through disparate impact litigation? This circuit split calls for a comprehensive analysis of practical significance testing across disparate impact’s stages. Importantly, courts and commentators use “practical significance” ambiguously between two aspects of practical significance: the magnitude of an effect and confidence in statistical evidence. For example, at Stage 1 courts might ask whether statistical evidence supports a disparate impact (a confidence inquiry) and whether such an impact is large enough to be legally relevant (a magnitude inquiry). Disparate impact’s texts, purposes, and controlling interpretations are consistent with confidence inquires at all three stages, but not magnitude inquiries. Specifically, magnitude inquiries are inappropriate at Stages 1 and 3—there is no discriminatory impact or reduction too small or subtle for the purposes of the disparate impact analysis. Magnitude inquiries are appropriate at Stage 2, when an employer defends a discriminatory policy on the basis of its job-related business necessity. (shrink)

: Can passing antidiscrimination laws ever be a bad idea? Yes, if broad policy reform is abandoned in favor of genetic-specific legislation. But in spite of its serious flaws, both in concept and in practice, genetic-specific legislation is sometimes worth passing anyway—sometimes a bad idea is reasonable.

The increasing availability of digital data reflecting economic and human development, and in particular the availability of data emitted as a by-product of people’s use of technological devices and services, has both political and practical implications for the way people are seen and treated by the state and by the private sector. Yet the data revolution is so far primarily a technical one: the power of data to sort, categorise and intervene has not yet been explicitly connected to a social (...) justice agenda by the agencies and authorities involved. Meanwhile, although data-driven discrimination is advancing at a similar pace to data processing technologies, awareness and mechanisms for combating it are not. This paper posits that just as an idea of justice is needed in order to establish the rule of law, an idea of data justice – fairness in the way people are made visible, represented and treated as a result of their production of digital data – is necessary to determine ethical paths through a datafying world. Bringing together the emerging scholarly perspectives on this topic, I propose three pillars as the basis of a notion of international data justice: visibility, engagement with technology and antidiscrimination. These pillars integrate positive with negative rights and freedoms, and by doing so challenge both the basis of current data protection regulations and the growing assumption that being visible through the data we emit is part of the contemporary social contract. (shrink)

More than forty years have passed since Congress, in response to the Civil Rights Movement, enacted sweeping antidiscrimination laws in the Civil Rights Act of 1964, the Voting Rights Act of 1965, and the Fair Housing Act of 1968. As a signal achievement of that legacy, in 2008, Americans elected their first African American president. Some would argue that we have finally arrived at a postracial America, butThe Imperative of Integration indicates otherwise. Elizabeth Anderson demonstrates that, despite progress toward (...) racial equality, African Americans remain disadvantaged on virtually all measures of well-being. Segregation remains a key cause of these problems, and Anderson skillfully shows why racial integration is needed to address these issues. Weaving together extensive social science findings--in economics, sociology, and psychology--with political theory, this book provides a compelling argument for reviving the ideal of racial integration to overcome injustice and inequality, and to build a better democracy. -/- Considering the effects of segregation and integration across multiple social arenas, Anderson exposes the deficiencies of racial views on both the right and the left. She reveals the limitations of conservative explanations for black disadvantage in terms of cultural pathology within the black community and explains why color blindness is morally misguided. Multicultural celebrations of group differences are also not enough to solve our racial problems. Anderson provides a distinctive rationale for affirmative action as a tool for promoting integration, and explores how integration can be practiced beyond affirmative action. -/- Offering an expansive model for practicing political philosophy in close collaboration with the social sciences, this book is a trenchant examination of how racial integration can lead to a more robust and responsive democracy. (shrink)

Can passing antidiscrimination laws ever be a bad idea? Yes, if broad policy reform is abandoned in favor of genetic‐specific legislation. But in spite of its serious flaws, both in concept and in practice, genetic‐specific legislation is sometimes worth passing anyway.

Law, Economics, and Morality examines the possibility of combining economic methodology and deontological morality through explicit and direct incorporation of moral constraints into economic models. Economic analysis of law is a powerful analytical methodology. However, as a purely consequentialist approach, which determines the desirability of acts and rules solely by assessing the goodness of their outcomes, standard cost-benefit analysis is normatively objectionable. Moderate deontology prioritizes such values as autonomy, basic liberties, truth-telling, and promise-keeping over the promotion of good outcomes. It (...) holds that there are constraints on promoting the good. Such constraints may be overridden only if enough good is at stake. While moderate deontology conforms to prevailing moral intuitions and legal doctrines, it is arguably lacking in methodological rigor and precision. Eyal Zamir and Barak Medina argue that the normative flaws of economic analysis can be rectified without relinquishing its methodological advantages and that moral constraints can be formalized so as to make their analysis more rigorous. They discuss various substantive and methodological choices involved in modeling deontological constraints. Zamir and Medina propose to determine the permissibility of any act or rule infringing a deontological constraint by means of mathematical threshold functions. Law, Economics, and Morality presents the general structure of threshold functions, analyzes their elements and addresses possible objections to this proposal. It then illustrates the implementation of constrained CBA in several legal fields, including contract law, freedom of speech, antidiscrimination law, the fight against terrorism, and legal paternalism. (shrink)

Appeals to intersectionality serve to remind us that social categories like race and gender cannot be adequately understood independently from each other. But what, exactly, is the intersectional thesis a thesis about? Answers to this question are remarkably diverse. Intersectionality is variously understood as a claim about the nature of social kinds, oppression, or experience ; about the limits of antidiscrimination law or identity politics ; or about the importance of fuzzy sets, multifactor analysis, or causal modeling in social (...) science. (shrink)

Twice in the 2020 term, in Bostock and Comcast, the Supreme Court doubled down on the reasoning of “but-for causation” to interpret antidiscrimination statutes. According to this reasoning, an outcome is discriminatory because of some status—say, sex or race—just in case the outcome would not have occurred “but-for” the plaintiff’s status. We think this reasoning embeds profound conceptual errors that render the decisions deeply confused. Furthermore, those conceptual errors tend to limit the reach of antidiscrimination law. In this (...) essay, we first unpack the ambiguity of this but-for causal reasoning. We then show that this reasoning arises from a misapplication of tort law principles within antidiscrimination law, and that, as a result, it is both conceptually and normatively indeterminate. (shrink)

This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vaccines are widely and equitably available. It raises health equity concerns related (...) to racial profiling and fairness to people who are vaccine cautious. Part III sets forth a proposal for a flexible pass that certifies people who have been vaccinated, tested, previously infected or granted a conscientious objection. It sets ethical guidelines for the timing and use of flexible passes that promote equity, public health education, antidiscrimination, privacy and flexibility. (shrink)

Indirect discrimination (or disparate impact) is one of the focal points of current antidiscrimination policies. However, few political/moral philosophers have paid substantial attention to indirect discrimination until recently. This contribution provides an overview of the two philosophical questions in this context: the definitional question (DQ) and the moral question (MQ). DQ concerns what distinguishes indirect discrimination from direct discrimination and inequality. Conceptually, either (1) indirect discrimination is not a genuine subtype of discrimination; (2) it is a subtype of discrimination (...) secondary to direct discrimination; or (3) it is a subtype of discrimination independent of direct discrimination. A more substantial distinction between direct and indirect discrimination can be drawn according to the discriminator’s intention, the disproportionateness of intergroup disadvantage, and so forth. MQ addresses what makes indirect discrimination morally wrong. Conceptually, either (1) indirect discrimination cannot be morally wrong qua discrimination in its own right; (2) it can be morally wrong qua discrimination in its own right, where the wrongness must be connected to past direct discrimination; or (3) it can be morally wrong qua discrimination regardless of past direct discrimination. Substantially, possible wrong-making factors of indirect discrimination include the discriminator’s objectionable intentions, the objectionable message that discriminatory practices may carry, and their harmful effects. This framework is a first step for future works that are necessary to yield a comprehensive insight into the relationship between discrimination and inequality and address contemporary forms of discrimination that tend to be indirect rather than direct. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion (...) or injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

A persistent paradox apparently infects disability civil rights claims. On the one hand, these rights claims are often understood to apply only to those who are sufficiently impaired in body or in mind to qualify for them because of the disadvantage they endure. On the other hand, asserting significant impairments threatens to undermine the plausibility of these claims as civil rights rather than as welfare for those who are dependent and in need of extra help. Behind this paradox lies a (...) type of categorical understanding of disability civil rights: that disability civil rights are only for those who fall into a category of disability and that this category should be defined in a particular way, in terms of disadvantaging disablement. In this article, I dispel this paradox by deploying a critical analysis of Elizabeth Barnes’s account of physical disability in her recent book, The Minority Body. In her book, Barnes makes the important critical point that disability is not “bad” difference. Instead, she argues that physical disability is a physical condition that the disability rights community is working to promote justice for. I argue that this account fails as a project of ameliorative social metaphysics because it fails to understand the role of impairment in the construction of disability antidiscrimination law. I also argue that her account risks privileging physical disability and is thus problematic as a starting place for examining disability justice. (shrink)

In this paper, I revisit Kimberlé Crenshaw's argument in “Demarginalizing the Intersection of Race and Sex” (1989) to recover a companion metaphor that has been largely forgotten in the “mainstreaming” of intersectionality in (white-dominated) feminist theory. In addition to the now-famous intersection metaphor, Crenshaw offers the basement metaphor to show how—by privileging monistic, mutually exclusive, and analogically constituted categories of “race” and “sex” tethered, respectively, to masculinity and whiteness—antidiscrimination law functions to reproduce social hierarchy, rather than to remedy it, (...) denying Black women plaintiffs legal redress. I argue that in leaving the basement behind, deployments of “intersectionality” that deracinate the concept from its origins in Black feminist thought also occlude Crenshaw's account of the socio-legal reproduction of hierarchical power. (shrink)

This article examines how claimants alleging multiple discrimination, i.e. discrimination on the basis of two or more grounds, fare under existing antidiscrimination law. It argues that the current statutory regime, both conceptually and practically, hinders multiple discrimination claims. Specifically, the grounds of anti‐discrimination legislation may not adequately address an individual's experience of discrimination, leaving a claimant, or class of claimants, with no effective remedy. Further, in cases of both direct and indirect discrimination, claimants alleging multiple discrimination find it difficult (...) or impossible to identify an appropriate comparator. In sum, despite previous legislative and judicial failures to address issues of multiple discrimination, the forthcoming reforms to anti‐discrimination law promise merely an exacerbation, not an amelioration, of these problems. (shrink)

After years of progress in terms of gender and sexual rights, since 2012 Europe is facing a so-called gender backlash – opposition directed to issues related to reproductive policies and abortion, violence against women, lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) rights and gay marriages, gender mainstreaming and sex education at schools as well as antidiscrimination policies. In this article, firstly, by taking the anti-gender developments as point of reference, I examine the emergence of anti-gender movement in Europe (...) via the use of what I call troll science. Troll science is based on (distorted) scientific arguments moulded into populist discourse, creating an alternative narrative on the conceptions of gender equality. Similar to troll accounts posting provocative, superfluous and even off-topic messages on social media to start arguments and quarrels aiming to distract, troll science, I argue, creates an alternative narrative opposing the scientific facts and discourses (i.e. climate change, evolution, vaccination and gender theory). Later, I discuss the emerging conservative troll-scientific discourses and the gendered public normative order of Adalet ve Kalkinma Partisi (AKP; Justice and Development Party) government, under the New Turkey. I previously argued that New Turkey and the society under the party’s rule perpetuated by a new set of standards create an alternative narrative on the conceptions of gender equality through troll-science narratives. I concluded by showing how such ideological discourses help create emotional echo chambers – enabling its fast distribution and acceptance by the ideologically conservative groups. Contribution: This paper contributes to the Special Collection Gender Justice, Health and Human Development with the theory of troll-science it introduces to discuss the alternative and anti-gender scientific discourse that is dominating academia. (shrink)

Despite the seemingly widespread agreement that racial and ethnic immigration criteria are always wrong, some cases seem potentially permissible and, in particular, do not seem to wrong either disfavored members or nonmembers. I demonstrate that an “antidiscrimination” approach to understanding when and why discrimination is wrong provides a compelling general explanation for this. The explanation’s key ingredient is the concept of global social status: many groups sharing a race or ethnicity have a social status beyond, and that can differ (...) from, their status in a particular state. (shrink)

Stigma has become an important concept in public health law. It is widely accepted that certain diseases are disfavored in society, leading to discrimination against people identified with them, which in turn has the tendency to drive an epidemic underground—i.e., to make it more difficult for voluntary public health programs to reach and succeed among populations bent on concealing their disease or risk status. The need to reduce stigma and its effects has been used to justify the passage of privacy (...) and antidiscrimination law to protect people with HIV. More recently, stigma has been part of the arsenal of justification for special genetic antidiscrimination and privacy law. Despite its importance, however, there is no single widely accepted definition of stigma in social science, and its relationship to law has been generally under-theorized and unsupported by data, reducing our ability to effectively deploy law and other tools in the anti-stigma cause. (shrink)

Emotions situate actors in relationships and shape their social interactions. Culture defines both the qualities of individual identity and the constitution of social groups with distinctive values and practices. Emotions, then, are necessarily experienced and acted upon in culturally inflected forms that define not only the conventions of their articulation through individual and collective action, but also the very words that name them. This article develops theoretical arguments to support these claims and illustrates their application in a description of differing (...) emotional repertoires, and their consequences, in Aotearoa New Zealand. The effects of resentment and shame in an ethnic politics of rights and antidiscrimination law demonstrate that context is central to a nuanced understanding of how law and emotions connect in the practicalities of enforcing the protections of anti-discrimination law. (shrink)

Stigma has become an important concept in public health law. It is widely accepted that certain diseases are disfavored in society, leading to discrimination against people identified with them, which in turn has the tendency to drive an epidemic underground—i.e., to make it more difficult for voluntary public health programs to reach and succeed among populations bent on concealing their disease or risk status. The need to reduce stigma and its effects has been used to justify the passage of privacy (...) and antidiscrimination law to protect people with HIV. More recently, stigma has been part of the arsenal of justification for special genetic antidiscrimination and privacy law. Despite its importance, however, there is no single widely accepted definition of stigma in social science, and its relationship to law has been generally under-theorized and unsupported by data, reducing our ability to effectively deploy law and other tools in the anti-stigma cause. (shrink)

Under what conditions do motherhood penalties emerge in countries undergoing transition from state socialism to capitalism? This analysis identifies the ways managers in global financial firms employ gendered assumptions in constructing and implementing labor practices among highly skilled professional workers in Hungary. Relying on 33 in-depth interviews with employers as well as interviews with headhunting firms, labor and employment lawyers, and analysis of antidiscrimination cases brought before Hungary’s Equal Treatment Authority between 2004 and 2008, we identify several strategies global (...) employers use to shed, demote, and marginalize professional mothers. By demonstrating the salience of motherhood as a status characteristic in the postsocialist labor market, our work contributes to existing scholarship on motherhood penalties. Our work also extends this scholarship by showing how the salience of motherhood is strongly conditioned by state-level arrangements that shape the opportunity context in which employers design and carry out employment practices. (shrink)

The aim of this article is to consider whether, when, and why it is morally right to treat members of socially disadvantaged racial or ethnic groups favorably when allocating scarce medical resources. Since the COVID 2019 pandemic has had different impacts on racial and ethnic groups, some U.S. states have given racial and ethnic minorities preferential access to COVID-19 vaccines, leading to controversy over the moral and legal permissibility of doing so. I examine three arguments for affirmative action—the compensation, equality-of-opportunity, (...) and antidiscrimination arguments—and argue that both the equality-of-opportunity and antidiscrimination arguments have the potential to provide well-founded justification for race-based affirmative action for the allocation of scarce medical resources. I also consider further moral requirements that instances of affirmative action based on both or either of the two arguments should comply with for them to be justified. (shrink)

In the recent past a number of empirical studies provided evidence that increasing genetic knowledge leads to new forms of exclusion, disadvantage and stigmatisation. As a consequence, many states have inaugurated special legislation to fight "genetic discrimination".This article focuses on some theoretical, normative and practical problems in the scientific and political debate on genetic discrimination. It puts forward the thesis that the existing antidiscrimination approach is based on the implicit idea that genes are the essence of (human) life. Since (...) genes are held responsible for individual development and personal identity, genetic discrimination is granted a privileged legal status in comparison to other forms of discrimination. As a result the analytical and political concentration on processes of genetic discrimination may reinforce the "geneticization" of body, illness and deviance. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

This Article examines the influence of the Americans with Disabilities Act (ADA) on affective attitudes toward children with disabilities and on the incidence of disability-selective abortion. Applying regression analysis to U.S. natality data, we find that the birthrate of children with Down syndrome declined significantly in the years following the ADA's passage. Controlling for technological, demographic, and cultural variables suggests that the ADA may have encouraged prospective parents to prevent the existence of the very class of people the Act was (...) designed to protect. We explain this paradox by showing how specific ADA provisions could have given rise to demeaning media depictions and social conditions that reinforced negative understandings and expectations among prospective parents about what it means to have a child with a disability. We discuss implications for reproduction law and antidiscrimination policy. (shrink)

After three decades of intensive debate in academic and activist circles, intersectionality has progressively been adopted in public policies. Yet, the challenges of its application are still largely unexplored. This article adopts a discursive approach to study the process of policy implementation of an intersectionality-informed plan in Madrid City Council, Spain. The analysis of materials retrieved through interviews, a focus group, and participant observation enables us to explore how the technical staff interpret intersectionality and links it with other established approaches (...) in equality and antidiscrimination law and policy, namely gender and diversity. We argue that preconceptions and positionality within the institutional structure deeply affect the interpretation of intersectionality and the subsequent action or non-action taken by implementing actors. Our study shows the challenges and opportunities to implement intersectionality in public policies that result from its discursive construction through the frames of gender and diversity. (shrink)

The most remarkable thing about the U.S. Supreme Court's 1998 decision in Bragdon v. Abbott was that it was necessary at all. Seventeen years into the epidemic of the acquired immunodeficiency syndrome, the Supreme Court, by a mere 5-4 majority, finally affirmed what most public health officials, health providers, and lawyers working with people with human immunodeficiency virus believed all along: that individuals with HIV infection are entitled to the protections of antidiscrimination law, and that health care providers must (...) respond to a patient's infection based on reason and science, not fear and prejudice. For individuals with HIV, and for those with other disabilities, the Court's ruling was a critical victory. But the very fact that the issues had to be decided by the Supreme Court and that only five justices joined the majority, shows the fragility of legal rights pertaining to HIV as well as the wide gulf between the perspectives of public health and those of public law. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)

The most remarkable thing about the U.S. Supreme Court's 1998 decision in Bragdon v. Abbott was that it was necessary at all. Seventeen years into the epidemic of the acquired immunodeficiency syndrome, the Supreme Court, by a mere 5-4 majority, finally affirmed what most public health officials, health providers, and lawyers working with people with human immunodeficiency virus believed all along: that individuals with HIV infection are entitled to the protections of antidiscrimination law, and that health care providers must (...) respond to a patient's infection based on reason and science, not fear and prejudice. For individuals with HIV, and for those with other disabilities, the Court's ruling was a critical victory. But the very fact that the issues had to be decided by the Supreme Court and that only five justices joined the majority, shows the fragility of legal rights pertaining to HIV as well as the wide gulf between the perspectives of public health and those of public law. (shrink)

Rights, Democracy, and Fulfillment in the Era of Identity Politics develops a critical theory of human rights and global democracy. Ingram both develops a theory of rights and applies it to a range of concrete and timely issues, such as the persistence of racism in contemporary American society; the emergence of so-called 'whiteness theory;' the failure of identity politics; the tensions between emphases on antidiscrimination and affirmative action in the Americans With Disabilities Act of 1990; the great unresolved issues (...) of workplace democracy; and the dilemmas of immigration policy for the U.S. and Europe. (shrink)

Analyzing three key cases that arose in 1993, I argue that the practice of sending in "testers" -- persons posing as job applicants -- to ferret out workplace discrimination is easier to defend from an ethical standpoint in an agency's investigation stems from an actual complaint. By contrast, defendants may rightfully challenge the legitimacy of the procedures used for "test" subjects when an investigation is based solely on the general goals of an antidiscrimination agency.

Bernard Dickens seeks to undermine the legal and ethical protections accorded to health care workers and hospitals conscientiously objecting to abortion. First, he appeals to the rationale of antidiscrimination laws as a basis for arguing against conscientious objection. Second, he argues that conscientious objection undermines the rights of patients and their autonomy. Third, he holds that conscientiously objecting doctors have a duty to refer patients for abortion. Fourth, he believes that Kant’s principle of respect for humanity as an end (...) in itself is violated by conscientious objection to abortion. Fifth, Dickens quotes remarks by Pope John Paul II as support for the idea that physicians should not conscientiously object to abortion. Finally, he posits that institutions, such as Catholic hospitals, have a responsibility to provide abortions. I argue that all of the arguments offered by Dickens against conscientious objection are unsound. (shrink)

The current explosion of genetic knowledge and the rapid proliferation of genetic tests has rightly provoked concern that we are approaching a future in which people will be labeled and disadvantaged based on genetic information. Indeed, some have already suffered harm, including denial of health insurance. This concern has prompted an outpouring of analysis. Yet almost all of it approaches the problem of genetic disadvantage under the rubric of “genetic discrimination.”This rubric is woefully inadequate to the task at hand. It (...) ignores years of commentary on race and gender demonstrating the limits of antidiscrimination analysis as an analytic framework and corrective tool. Too much discussion of genetic disadvantage proceeds as if scholars of race and gender had not spent decades critiquing and developing antidiscrimination theory.Indeed, there are multiple links among race, gender, and genetics. Dorothy Roberts has discussed the historical links between racism and genetics, while she and others have begun to map connections between gender and genetics. (shrink)

This article discusses the assumptions that are necessary to derive the conclusion that veganism - avoiding the use of animal products from conventional agriculture, hunting and fishing - is a moral duty. Using a formal-axiomatic framework, it is shown that twenty assumptions or axioms are sufficient to come to the conclusion. The argument is made as parsimonious as possible, using the weakest conditions, the most restrictive definitions and most reliable empirical facts. The argument assumes an antidiscrimination principle and a (...) weak basic right not to be used merely a means for someone else’s non-vital ends. It demonstrates that being a human is not morally relevant whereas sentience is a morally relevant criterion that meets the assumptions. If one does not agree with the conclusion that veganism is a moral duty, logical consistency requires that one must be able to indicate at least one axiom that one rejects. The argument makes hidden assumptions visible and provides a framework for a review of the philosophical literature about animal rights and vegetarianism/veganism. (shrink)

It has become commonplace within feminist theory to claim that women’s lives are constructed by multiple, intersecting systems of oppression. In this thesis, I challenge the consensus that oppression is aptly captured by the theoretical model of “intersectionality.” While intersectionality originates in Black feminist thought as a purposive intervention into US antidiscrimination law, it has been detached from that context and harnessed to different representational aims. For instance, it is often asserted that intersectionality enables a representational politics that overcomes (...) legacies of exclusion within hegemonic Anglo-American feminism. I argue that intersectionality reinscribes the political exclusion of racialized women as a feature of their embodied identities. That is, it locates the failure of political representation in the “complex” identities of “intersectional” subjects, who are constructed as unrepresentable in terms of “race” or “gender” alone. Further, I argue that intersectionality fails to supplant race- and class-privileged women as the normative subjects of feminist theory and politics. In Chapter One, I demonstrate that intersectionality illicitly imports unitary concepts of “race,” “gender,” and “class.” In Chapter Two, I argue that intersectionality lacks a theory of hierarchy: it is a “flat geography” which cannot capture vertical and horizontal lines of power. In Chapter Three, I explore the role of analogical reasoning in rendering racialized women invisible both as gendered and as racialized subjects in twentieth-century social movements. To concretize this argument, I turn to Simone de Beauvoir’s use of race-sex analogies to describe (white, bourgeois) “women’s” situation in The Second Sex. In Chapter Four, I advance a programmatic unified account of oppression. I suggest that the possibility of a unified theory (as opposed to an intersectional one) is intimated in the concrete articulation of race, class, and gender. My point of departure is a phenomenology of capitalism, which reveals that these are all fundamentally modes of exploitation and appropriation. In Chapter Five, I theorize how they are made visible (and invisible) on the body. I extend Frantz Fanon’s account of “epidermalization,” drawing upon the marxian concepts of “fetishism” and “mode of appearance” to elaborate four structures of gendered racialized perception: first, the “miscegenation taboo” structures perceptions of the “purity” of whiteness and the “polluting” effects of blackness. Whiteness, theorised as a “possessive investment” and as “property” is defined by the right to exclude. Second, the “episteme of tellable differences” produces the conviction that we can automatically “tell the difference” between a body placed in one “racial” or gender category, and another—while bodies that temporarily confound classification cause fear and consternation. Third, the “race/reproduction bind” names the axiomatic assumption that “race” is reproduced through (heterosexual) procreation and that “race” is, therefore, biologically inheritable. Finally, the “fear/criminalisation reflex” refers to the bidirectional equation of particular racialised-gendered bodies with crime, and of crime with those bodies; this a function of the discursive use of ‘crime’ as an alibi for “race’” the systemic racialisation of punitive carceral institutions, and the historical origins of “race” in transatlantic chattel slavery, which shaped perceptual-cognitive associations of freedom with whiteness and captivity with blackness. (shrink)

BackgroundThe issue of stigma is very important in the battle against HIV/aids in Africa since it may affect patient attendance at healthcare centres for obtaining antiretroviral medications and regular medical check-ups. Stigmatization creates an unnecessary culture of secrecy and silence based on ignorance and fear of victimization. This study was designed to determine if there is external stigmatization of people living with HIV and AIDS by health care workers at a tertiary hospital in KwaZulu-Natal province, South Africa. The study investigated (...) the impact of knowledge of HIV/aids by HCWs on treatment of patients, as well as the comfort level and attitude of HCWs when rendering care to PLWHA.MethodsA descriptive cross sectional study was designed to collect data using an anonymous self-administered structured questionnaire from 334 HCWs. The study was conducted in clinical departments of a large multidisciplinary 922-bed tertiary care teaching hospital in Durban, KZN.ResultsOverall HCWs had an above average knowledge about HIV/aids although some gaps in knowledge were identified. Tests of statistical significance showed that there was association between level of education and knowledge of HIV/aids ; occupation and knowledge of HIV/aids ; and gender and knowledge of HIV/aids. Test for comfort level was only significant for gender, with males showing more comfort and empathy when dealing with PLWHA. The study also revealed that patients were sometimes tested for HIV without informed consent before surgery, due to fear of being infected, and there was some gossiping about patients' HIV status by HCWs, thereby compromising patient confidentiality. The majority of HCWs showed a willingness to report incidents of stigmatization and discrimination to higher authorities, for better monitoring and control.ConclusionsAlthough knowledge, attitude and comfort level of HCWs taking care of PLWHA was above average, enforcement of existing antidiscrimination laws and continuing education in medical ethics and healthcare law, would greatly improve the performance of HCWs taking care of PLWHAs. More psychological support and counselling should be provided to HCWs, to further reduce the impact of stigmatization and discrimination against PLWHA. (shrink)