The development of a human right to water and sanitation under international law has created an imperative to implement human rights in water and sanitation policy. Through forty-three interviews with informants in international institutions, national governments, and non-governmental organizations, this research examines interpretations of this new human right in global governance, national policy, and local practice. Exploring obstacles to the implementation of rights-based water and sanitation policy, the authors analyze the limitations of translating international human rights into local water and (...) sanitation practice, concluding that system operators, utilities, and management boards remain largely unaffected by the changing public policy landscape for human rights realization. To understand the relevance of human rights standards to water and sanitation practitioners, this article frames a research agenda to ensure that human rights aspirations lead to public policy reforms and public health outcomes. (shrink)

Domestic litigation has become a principal strategy for realizing international treaty obligations for the human right to health, providing causes of action for the public’s health and empowering individuals to raise human rights claims for HIV prevention, treatment, and care. In the past 15 years, advocates have laid the groundwork on which a rapidly expanding enforcement paradigm has arisen at the intersection of human rights litigation and HIV/AIDS policy. As this enforcement develops across multiple countries, human rights are translated from (...) principle to practice in the global response to HIV/AIDS, transforming aspirational declarations into justiciable obligations and implementing human rights through national policies and programs. (shrink)

Domestic litigation has become a principal strategy for realizing international treaty obligations for the human right to health, providing causes of action for the public’s health and empowering individuals to raise human rights claims for HIV prevention, treatment, and care. In the past 15 years, advocates have laid the groundwork on which a rapidly expanding enforcement paradigm has arisen at the intersection of human rights litigation and HIV/AIDS policy. As this enforcement develops across multiple countries, human rights are translated from (...) principle to practice in the global response to HIV/AIDS, transforming aspirational declarations into justiciable obligations and implementing human rights through national policies and programs. (shrink)

The right to health was codified in Article 12 of the International Covenant on Economic, Social and Cultural Rights as an individual right, focusing on individual health services at the expense of public health systems. This article assesses the ways in which the individual human right to health has evolved to meet collective threats to the public's health. Despite its repeated expansions, the individual right to health remains normatively incapable of addressing the injurious societal ramifcations of economic globalization, advancing individual (...) rights to alleviate collective inequalities in underlying determinants of health. By examining modern changes to underlying determinants of health, this article concludes that responding to globalized health threats necessitates a collective right to public health. (shrink)

In confronting the insalubrious ramifications of globalization, human rights scholars and activists have argued for greater national and international responsibility pursuant to the human right to health. Codified seminally in Article 12 of the International Covenant on Economic, Social and Cultural Rights, the right to health proclaims that states bear an obligation to realize the “highest attainable standard” of health for all. However, in pressing for the highest attainable standard for each individual, the right to health has been ineffective in (...) compelling states to address burgeoning inequalities in underlying determinants of health, focusing on individual medical treatments at the expense of public health systems. This article contends that the paradigm of individual health, focused on a right to individual medical care, is incapable of responding to health inequities in a globalized world and thereby hampers efforts to operationalize health rights through public health systems. While the right to health has evolved in international discourse over time, this evolution of the individual right to health cannot address the harmful societal ramifications of economic globalization. Rather than relying solely upon an individual right to medical care, envisioning a collective right to public health – a right applied at the societal level to address underlying determinants of health – would alleviate many of the injurious health inequities of globalization. (shrink)

The United Nations (UN) General Assembly High-Level Meeting (HLM) on pandemic prevention, preparedness and response (PPPR) was a missed opportunity to bring high-level commitment and momentum to the global governance of health emergencies. Intended to bring much-needed attention to a policy issue that is rapidly slipping down the international agenda, the fraught diplomacy among member states, lack of consensus on key issues, and weak UN Political Declaration in New York foreshadow a difficult road ahead for upcoming negotiations under the World (...) Health Organization (WHO) in Geneva. This column chronicles the evolving engagement of the UN in global health governance, examines the diplomatic process leading to the UN HLM on PPPR, and assesses the contributions and missed opportunities of its resulting Political Declaration. (shrink)

In the absence of centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have stepped forward to advance the rights-based approach to health. Reviewing the efforts of the Pan American Health Organization, this article explores the evolution of human rights in PAHO policy, assesses efforts to mainstream human rights in the Pan American Sanitary Bureau, and analyzes the future of the rights-based approach through regional health governance, providing lessons for other regional health offices and (...) global health institutions. This article explores PAHO's 15-year effort to mainstream human rights through PASB technical units, national capacity-building, the Inter-American human rights system, and the PAHO Directing Council. Through documentary analysis of PAHO policies and semi-structured interviews with key PASB stakeholders, the authors analyze the understandings and actions of policymakers and technical officers in implementing human rights through PAHO governance. Analyzing the themes arising from this narrative, the authors examine the structural role of secretariat leadership, state support, legal expertise, and technical unit commitment in facilitating a rights-based approach to the health in the Americas. Human rights are increasingly framing PAHO efforts, and this analysis of the structures underlying PAHO's approach provides an understanding of the institutional determinants of the rights-based approach to health, highlighting generalizable themes for the mainstreaming of human rights through regional health governance. With this regional-level understanding of health governance, future national-level research can begin to understand the causal forces linking regional human rights work with national policy reforms and public health outcomes. (shrink)

In the development of a rights-based approach to global health governance, international organizations have looked to human rights under international law as a basis for public health. Operationalizing human rights law through global health policy, the World Health Organization has faced obstacles in efforts to mainstream human rights across the WHO Secretariat. Without centralized human rights leadership in an increasingly fragmented global health policy landscape, regional health offices have sought to advance human rights in health governance and support states in (...) realizing a rights-based approach to health. Examining the efforts of the Pan American Health Organization, this article explores the evolution of human rights in PAHO policy, assesses the mainstreaming of human rights in the Pan American Sanitary Bureau, and analyzes the future of the rights-based approach through regional health governance. (shrink)

This is a pivotal moment in the global governance response to pandemic threats, with crucial global health law reforms being undertaken simultaneously in the coming years: the revision of the International Health Regulations, the implementation of the GHSA Legal Preparedness Action Package, and the negotiation of a new Pandemic Treaty. Rather than looking at these reforms in isolation, it will be necessary to examine how they fit together, considering: how these reforms can complement each other to support pandemic prevention, preparedness, (...) and response; what financing mechanisms are necessary to ensure sustainable health governance; and why vital norms of equity, social justice, and human rights must underpin this new global health system. (shrink)

Immunization plays a crucial role in global health security, preventing public health emergencies of international concern and protecting individuals from infectious disease outbreaks, yet these critical public health benefits are dependent on immunization law. Where public health law has become central to preventing, detecting, and responding to infectious disease, public health law reform is seen as necessary to implement the Global Health Security Agenda. This article examines national immunization laws as a basis to implement the GHSA and promote the public's (...) health, analyzing the scope and content of these laws to prevent infectious disease across Sub-Saharan Africa. Undertaking policy surveillance of national immunization laws in 20 Sub-Saharan African countries, this study: developed a legal framework to map the legal attributes relevant to immunization; created an assessment tool to determine the presence of these attributes under national immunization law; and applied this assessment tool to code national legal landscapes. An analysis of these coded laws highlights legal attributes that govern vaccine requirements, supply chains, vaccine administration standards, and medicines quality and manufacturer liability. Based upon this international policy surveillance, it will be crucial to undertake legal epidemiology research across countries, examining the influence of immunization law on vaccination rates and disease outbreaks. (shrink)

In confronting the insalubrious ramifications of globalization, human rights scholars and activists have argued for greater national and international responsibility pursuant to the human right to health. Codified seminally in Article 12 of the International Covenant on Economic, Social and Cultural Rights, the right to health proclaims that states bear an obligation to realize the “highest attainable standard” of health for all. However, in pressing for the highest attainable standard for each individual, the right to health has been ineffective in (...) compelling states to address burgeoning inequalities in underlying determinants of health, focusing on individual medical treatments at the expense of public health systems. This article contends that the paradigm of individual health, focused on a right to individual medical care, is incapable of responding to health inequities in a globalized world and thereby hampers efforts to operationalize health rights through public health systems. While the right to health has evolved in international discourse over time, this evolution of the individual right to health cannot address the harmful societal ramifications of economic globalization. Rather than relying solely upon an individual right to medical care, envisioning a collective right to public health – a right applied at the societal level to address underlying determinants of health – would alleviate many of the injurious health inequities of globalization. (shrink)

In confronting the insalubrious ramifications of globalization, human rights scholars and activists have argued for greater national and international responsibility pursuant to the human right to health. Codified seminally in Article 12 of the International Covenant on Economic, Social and Cultural Rights, the right to health proclaims that states bear an obligation to realize the “highest attainable standard” of health for all. However, in pressing for the highest attainable standard for each individual, the right to health has been ineffective in (...) compelling states to address burgeoning inequalities in underlying determinants of health, focusing on individual medical treatments at the expense of public health systems. This article contends that the paradigm of individual health, focused on a right to individual medical care, is incapable of responding to health inequities in a globalized world and thereby hampers efforts to operationalize health rights through public health systems. While the right to health has evolved in international discourse over time, this evolution of the individual right to health cannot address the harmful societal ramifications of economic globalization. Rather than relying solely upon an individual right to medical care, envisioning a collective right to public health – a right applied at the societal level to address underlying determinants of health – would alleviate many of the injurious health inequities of globalization. (shrink)

While human rights law has evolved to provide guidance to governments in realizing human rights in public health emergencies, the COVID-19 pandemic has challenged the foundations of human rights in global health governance. Public health responses to the pandemic have undermined international human rights obligations to realize the rights to health and life, human rights that underlie public health, and international assistance and cooperation. As governments prepare for revisions of global health law, new opportunities are presented to harmonize global health (...) law and human rights law, strengthening rights-based governance to respond to future threats. (shrink)

Following from sweeping law reforms across the global health landscape, there is a need to prepare the next generation to advance global health law to ensure justice for a healthier world. Educational programs across disciplines have increasingly incorporated the field of global health law, with new courses examining the law and policy frameworks that apply to the new set of public health threats, non-state actors, and regulatory instruments that structure global health. Such interdisciplinary training must be expanded throughout the world (...) to prepare future practitioners to strengthen global health law — ensuring a foundation for global health in legal studies and law and global health studies. Meeting this imperative for global health law teaching — establishing academic courses and textbooks on global legal responses to shared health threats — will be necessary to support students to address the global health challenges of the future. (shrink)

Dobbs v. Jackson Women’s Health continues a trajectory of U.S. Supreme Court jurisprudence that undermines the normative foundation of public health — the idea that the state is obligated to provide a robust set of supports for healthcare services and the underlying social determinants of health. Dobbs furthers a longstanding ideology of individual responsibility in public health, neglecting collective responsibility for better health outcomes. Such an ideology on individual responsibility not only enables a shrinking of public health infrastructure for reproductive (...) health, it facilitates the rise of reproductive coercion and a criminal legal response to pregnancy and abortion. This commentary situates Dobbs in the context of a long historical shift in public health that increasingly places burdens on individuals for their own reproductive health care, moving away from the possibility of a robust state public health infrastructure. (shrink)

Despite a recent wave in global recognition of the rights of transgender and gender-diverse populations, referred to in this text by the umbrella label of trans*, international law continues to presume a cisgender binary definition of gender — dismissing the lived realities of trans* individuals throughout the world. This gap in international legal recognition and protection has fundamental implications for health, where trans* persons have been and continue to be subjected to widespread discrimination in health care, longstanding neglect of health (...) needs, and significant violations of bodily autonomy. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention, and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; and coordination of law-based public health actions; and information.This action agenda offers options for consideration by those responsible for (...) or interested in ensuring that public health professionals, their legal counsels, and relevant partners understand the legal framework in which they operate and are competent in applying legal authorities to public health emergency preparedness.Competencies are critical to an individual's ability to make effective legal response to all-hazards public emergencies. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention, and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; and coordination of law-based public health actions; and information.This action agenda offers options for consideration by those responsible for (...) or interested in ensuring that public health professionals, their legal counsels, and relevant partners understand the legal framework in which they operate and are competent in applying legal authorities to public health emergency preparedness.Competencies are critical to an individual's ability to make effective legal response to all-hazards public emergencies. (shrink)

In spite of vast global improvements in living standards, health, and well-being, the persistence of absolute poverty and its attendant maladies remains an unsettling fact of life for billions around the world and constitutes the primary cause for the failure of developing states to improve the health of their peoples. While economic development in developing countries is necessary to provide for underlying determinants of health – most prominently, poverty reduction and the building of comprehensive primary health systems – inequalities in (...) power within the international economic order and the spread of neoliberal development policy limit the ability of developing states to develop economically and realize public goods for health. With neoliberal development policies impacting entire societies, the collective right to development, as compared with an individual rights-based approach to development, offers a framework by which to restructure this system to realize social determinants of health. The right to development, working through a vector of rights, can address social determinants of health, obligating states and the international community to support public health systems while reducing inequities in health through poverty-reducing economic growth. At an international level, where the ability of states to develop economically and to realize public goods through public health systems is constrained by international financial institutions, the implementation of the right to development enables a restructuring of international institutions and foreign-aid programs, allowing states to enter development debates with a right to cooperation from other states, not simply a cry for charity. (shrink)

The emotion of anger, when chronic, is especially problematic. Frequent and intense experiences of anger predict quite a few adverse health outcomes and are especially implicated in cardiovascular...

In their recent article, Brummett and Muaygil reject Bishop et al.’s framing of the debate over standardization in clinical ethics consultation (CEC) “as one between pro-credentialing procedural and anti-credentialing phenomenological,” claiming that this framing “amounts to a false dichotomy between two extreme approaches to CEC.” Instead of accepting proceduralism and phenomenology as a binary, Brummett and Muaygil propose that these two views should be seen as the extreme ends of a spectrum upon which CEC should be done. However, as evidenced (...) by several inconsistencies within their article, they have failed to fully appreciate the concern animating Bishop et al.’s proposal. Additionally, because of this failure, they do not seem to realize that credentialing ethicists for CEC will only create different problems in Saudi Arabia even as it possibly solves some of the current problems they identify. In this commentary, we highlight and clarify Brummet and Muaygil’s five misunderstandings of Bishop et al. This leads us to conclude that while they claim to be advocating a middle way between proceduralism and phenomenology, in fact they would like for us to standardize another proceduralism, albeit one that incorporates some of the “qualitative” values of American bioethics. (shrink)

In this article, we reflect on our experiences teaching a PWOL course called Philosophy for Living. The course uses modules focused on different historical philosophical ways of life (Epicureanism, Stoicism, Confucianism, Existentialism, etc.) to engage students in exploring how philosophy can be a way of life and how its methods, virtues, and ideas can improve their own lives. We describe and compare our experiences with two central aspects of our approach: engagement with diversity and the use of immersive experiences and (...) assignments. In particular, we discuss how we recognize and center various forms of diversity in philosophy—cultural and gender diversity, but also diversity in how and in what forms philosophy can be done and what “philosophy as a way of life” can be. We also examine how the experimental and experiential aspects of immersive assignments promote deeper understanding and create possibilities for personal transformation. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Recent years have seen a renewed debate over the importance of groupselection, especially as it relates to the evolution of altruism. Onefeature of this debate has been disagreement over which kinds ofprocesses should be described in terms of selection at multiple levels,within and between groups. Adapting some earlier discussions, we presenta mathematical framework that can be used to explore the exactrelationships between evolutionary models that do, and those that donot, explicitly recognize biological groups as fitness-bearing entities.We show a fundamental set (...) of mathematical equivalences between these twokinds of models, one of which applies a form of multi-level selectiontheory and the other being a form of ``individualism.'' However, we alsoargue that each type of model can have heuristic advantages over theother. Indeed, it can be positively useful to engage in a kind ofback-and-forth switching between two different perspectives on theevolutionary role of groups. So the position we defend is a``gestalt-switching pluralism.''. (shrink)

The article is an investigation of a certain form of argument that refers to Leibniz’s Law as its inference ticket (where Leibniz’s Law is understood as the thesis that if x=y.

Many friends of the category of particularised qualities subscribe to the view that particularised qualities have a unique bearer in which they inhere; no such quality then can inhere in two different entities. But it seems that this idea is flawed, for there are apparent counterexamples. An apple's redness is identical with the redness of its skin, though the apple is distinct from its skin. So it seems that a principle of bearer‐uniqueness has to be modified, maybe by excluding certain (...) unwanted cases. However, I argue that the need of a modification is not a direct consequence of the supposed counterexamples. Their dangerous potential for the principle arises if one takes the genitive in expressions of the form ‘a's F‐ness’ to signify the relation of inherence. I propose an alternative view: The genitive signifies a relation which is indeed closely related to inherence, but which is, contrary to inherence itself, partitive. That is, it may hold between a particularised quality and another entity because it holds between the quality and a part of the entity. If one regards the ontologically interesting relation of inherence as non‐partitive, one can still adhere to an unrestricted principle of bearer‐uniqueness. (shrink)

According to the Bayesian paradigm in the psychology of reasoning, the norms by which everyday human cognition is best evaluated are probabilistic rather than logical in character. Recently, the Bayesian paradigm has been applied to the domain of argumentation, where the fundamental norms are traditionally assumed to be logical. Here, we present a major generalisation of extant Bayesian approaches to argumentation that utilizes a new class of Bayesian learning methods that are better suited to modelling dynamic and conditional inferences than (...) standard Bayesian conditionalization, is able to characterise the special value of logically valid argument schemes in uncertain reasoning contexts, greatly extends the range of inferences and argumentative phenomena that can be adequately described in a Bayesian framework, and undermines some influential theoretical motivations for dual function models of human cognition. We conclude that the probabilistic norms given by the Bayesian approach to rationality are not necessarily at odds with the norms given by classical logic. Rather, the Bayesian theory of argumentation can be seen as justifying and enriching the argumentative norms of classical logic. (shrink)

v. 1. Charmides. Lysis. Laches. Protagoras. Euthydemus. Cratylus. Phaedrus. Ion. Symposium.--v. 2. Meno. Euthyphro. Apology. Crito. Phaedo. Georgias. Appendix I: Lesser Hippias. Alcibiades I. Menexenus. Appenddix II: Alcibiades II. Eryxias.--v. 3. Republic. Timaeus. Critias.--v. 4. Pharmenides. Theaetetus. Sophist. Statesman. Philebus.--v. 5 Laws. Index to the writings of Plato.

The implementation of education programmes in different cultures invites the question whether we are justified in doing so in cultures that may reject the programmes’ underlying principles. Are there indeed ethical principles and educational ideals that can be justified as applicable to all cultures? After a consideration of Zygmunt Bauman's postmodern rejection of the possibility of universal ethics, Ι cite and extend Harvey Siegel's defence of multiculturalism as a transcultural ethical ideal. I conclude the paper with a justification of the (...) transcultural normative reach of moral principles that I have elsewhere defended as the ethics of integrity. The paper's significance lies in its justification of educational interventions founded in these principles across different cultures. (shrink)

The article is a critical examination of Joshua Hoffman’s and Gary Rosenkrantz’ approach to the traditional category of individual substance. On several places they offered an analysis of the concept of a substance in terms of some highly sophisticated notion of generic independence. Though ingenious, and even though it might be extensionally adequate, their account cannot provide an informative analysis of the concept in question, because it exhibits a peculiar kind of circularity. It is shown that one cannot establish, on (...) the basis of their analysis, that a given entity is a substance, if one does not already know that it is one in advance. The circularity of their account is examined in detail, and it is explained how it could have arisen. (shrink)

Philosophy & Public Affairs, Volume 50, Issue 2, Page 239-266, Spring 2022.

Far more than the dialectic philosophy of Socrates, the rhetorical humanist tradition avoids objectivist epistemology, charts a traversable path to practical wisdom, and aptly highlights the importance of aesthetic style. In those and other ways, we argue, it offers a preferable historical basis for today’s philosophical counseling. Advocates of that contemporary practice tend to cite Socrates as its historical progenitor and favor the narrow propositional logic that is ascribed to him. Some practitioners, though, have also grown more attuned to metaphorical (...) and narrative elements in a client’s worldview. We aim to supplement their claims by drawing from principles of classical rhetorical theory, showing a way to rethink the practice of philosophical counseling today. (shrink)