There are four basic models for health care systems: the private market insurance model, the national single-payer model, the national health service model, and the social insuranceSocial insurance model. The social justice debate over health care usually focuses on the comparative efficiency and quality of competitive private market insurance and the universal coverage and equity of national health care systems. It is a mistake, however, to think that a universal right to health care services requires (...) a single-payer, government-run, national health care system. The social insurance model of Germany, France, Japan, and many other countries, deserves more attention, as it incorporates the strengths of both market models and national health care models. (shrink)

There are four basic models for health care systems: the private market insurance model, the national single-payer model, the national health service model, and the social insurance model. The social justice debate over health care usually focuses on the comparative efficiency and quality of competitive private market insurance and the universal coverage and equity of national health care systems. It is a mistake, however, to think that a universal right to health care services requires a (...) single-payer, government-run, national health care system. The social insurance model of Germany, France, Japan, and many other countries, deserves more attention, as it incorporates the strengths of both market models and national health care models. (shrink)

The factions debating health care reform in the United States have gravitated toward one of two positions: that just health care is an individual responsibility or that it must be regarded as a national concern. Both arguments overlook a third possibility: that justice in health care is multilayered and requires the participation of multiple and diverse communities. _Communities of Health Care Justice_ makes a powerful ethical argument for treating communities as critical moral actors that play (...) key roles in defining and upholding just health policy. Drawing together the key community dimensions of health care, and demonstrating their neglect in most prominent theories of health care justice, Charlene Galarneau postulates the ethical norms of community justice. In the process, she proposes that while the subnational communities of health care justice are defined by shared place, including those bound by culture, religion, gender, and race that together they define justice. As she constructs her innovative theorization of health care justice, Galarneau also reveals its firm grounding in the work of real-world health policy and community advocates. _Communities of Health Care Justice_ not only strives to imagine a new framework of just health care, but also to show how elements of this framework exist in current health policy, and to outline the systemic, conceptual, and structural changes required to put these justice norms into fuller practice. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the (...) wealthy. After exploring specific discrepancies in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)

The ethic of care has often been opposed to the ethic of justice as offering a different and even a contradictory approach to moral problems. This article argues that, from the perspective of the discourse ethic, both approaches are complementary in a very fundamental sense, since each one applies to one of two stages of moral reasoning that are as different as they are interconnected. It argues, in particular, that while justice is concerned with the justification and (...) elaboration of norms, care is concerned with finding a solution for specific moral situations. The article then places considerations of care at the centre of ideal discourse and subordinates the importance of rational understanding and moral justification to intuitive communication. (shrink)

Reviews the basic Catholic moral principles that apply to health care, then uses them to assess three major current trends in the health care industry.

Among the various human forms alluded to in the Hebrew prayer, mental retardation appears to be one of the most difficult to celebrate. It is the disability that other disabled persons do not want attributed to them. It is the disability for which prospective parents are most likely to use selective abortion (Wertz 2000). And it is the disability that prompted one of the most illustrious United States Supreme Court Justices to endorse forced sterilization, because "three generations of imbeciles are (...) enough." The mentally retarded have at times been objects of pity, compassion, or abuse by their caretakers and society at large. But they have rarely been seen as subjects, as citizens, as persons with equal entitlement to fulfillment. (shrink)

Introduction -- Healing justice and whole self-care -- Oppression, trauma, and healing justice -- Stress and the self-care revolution -- The whole self -- A skillful path of healing justice -- Holistic self-care practices and skills -- Connecting to the body -- Befriending the mind-heart -- Rediscovering spirit -- In the fabric of community -- Cultivating connections between person and planet -- Where the rubber meets the road -- The healing justice organization -- (...) Healing justice on the frontlines -- Widening the circle and coming home -- Notes -- Index. (shrink)

In this book, an international group of philosophers, economists and theologians focus on the relationship between justice, luck and responsibility in health care. Together, they offer a thorough reflection on questions such as: How should we understand justice in health care? Why are health care interests so important that they deserve special protection? How should we value health? What are its functions and do these make it different from other goods? Furthermore, how much equality should (...) there be? Which inequalities in health and health care are unfair and which are simply unfortunate? Which matters of health care belong to the domain of justice, and which to the domain of charity? And to what extent should we allow personal responsibility to play a role in allocating health care services and resources, or in distributing the costs? With this book, the editors meet a double objective. First, they provide a comprehensive philosophical framework for understanding the concepts of justice, luck and responsibility in contemporary health care; and secondly, they explore whether these concepts have practical force to guide normative discussions in specific contexts of health care such as prevention of infectious diseases or in matters of reproductive technology. Particular and extensive attention is paid to issues regarding end-of-life care. (shrink)

This chapter contains section titled: I Equality of Resources II Justice in Health Care III Why Universal Access Requires In‐kind Transfers IV Conclusion Acknowledgement.

Newcomers and more experienced feminist theorists will welcome this even-handed survey of the care/justice debate within feminist ethics. Grace Clement clarifies the key terms, examines the arguments and assumptions of all sides to the debate, and explores the broader implications for both practical and applied ethics. Readers will appreciate her generous treatment of the feminine, feminist, and justice-based perspectives that have dominated the debate.Clement also goes well beyond description and criticism, advancing the discussion through the incorporation of (...) a broad range of insights into a new integration of the values of care and justice. Care, Autonomy, and Justice marks a major step forward in our understanding of feminist ethics. It is both direct and helpful enough to work as an introduction for students and insightful and original enough to make it necessary reading for scholars. (shrink)

How ought we to respond to strangers in imminent need? Many people suggest that we need justice to temper the partiality of care. In this paper 1 argue that neither care nor justice adequately motivates attention to the suffering of strangers. Rather, a different virtue, compassion grounded in equanimity, is required. I demonstrate that the virtue of compassion alhws the agent to sustain her engagement with suffering strangers without sacrificing her own flourishing.

The aim of this study was to investigate relationships between care and justice reasoning, dispositional empathy variables and meta‐ethical thinking among 128 students from a university of applied sciences. The measures were Skoe’s Ethic of Care Interview, the Defining Issues Test, Davis’s Interpersonal Reactivity Index and Meta‐Ethical Questionnaire. The results showed that levels of care reasoning were positively related to the post‐conventional schema and negatively related to the personal interest schema in justice reasoning. Age, meta‐ethical (...) thinking, the post‐conventional schema and perspective taking predicted care reasoning. Sympathy was positively related to both modes of moral reasoning among men and predicted their care reasoning. The results point out common elements for care and justice reasoning, underscore the importance of perspective taking for moral reasoning and indicate that the relationship between affective‐based empathy and moral reasoning is gender‐specific and far more complex than previous theories suggest. (shrink)

In Justice, Care, and Value Thomas Randall advances the radical potential of care ethics as a distinct (and preferable) theory of distributive justice. Advancing the care ethical literature this book defends a vision of society that can best enable such relations to flourish. Specifically, Randall uses breakthrough arguments to propose a values-driven theory of care ethics that identifies good caring relations through classifying the values of care. He argues that such a theory gives (...) us unique and meaningful solutions to contemporary questions and encourages us to think about distributive justice across personal, political, global, and intergenerational domains. Through this the book makes significant strides to engage care ethics with the broader moral and political philosophy literature. Topical and interdisciplinary, Randall demonstrates that care ethics has the conceptual resources to ground distributive theories of socialism, territorial and natural resource rights, obligations to future generations, and historic redress. The book will be of great interest for academics, researchers, and students in feminist philosophy, but also in liberalism, global and intergenerational theories of justice, and political economy. (shrink)

In each of these areas, he reviews the contributions of earlier care theorists and then extends their arguments to provide a more complete description of the ...

When feminist philosophers first turned their attention to traditional ethical theory, its almost exclusive emphasis upon justice, rights, abstract rationality, and individual autonomy came under special criticism. Women’s experiences seemed to suggest the need for a focus on care, empathetic relations, and the interdependence of persons.The most influential readings of what has become an extremely lively and fruitful debate are reproduced here along with important new contributions by Alison Jaggar and Sara Ruddick. As this volume testifies, there is (...) no agreement on the important questions about the relationship between justice and care, but the debate has deepened and enriched our understanding in many ways. Justice and Care is a valuable collection of readings—an essential tool for anyone studying the state of feminist thought in particular or ethical theory in general. (shrink)

In this paper I argue that the metaphysical ethics of Emmanuel Levinas captures some essential moral intuitions that are central to health care. However, there is an ongoing discussion about the relevance of ethical metaphysics for normative ethics and in particular on the question of the relationship between justice and individualized care. In this paper I take part in this debate and I argue that Levinas' idea of an ethics of the Other that guides politics and (...) class='Hi'>justice can shed important light on issues that are central to priorities in health care. In fact, the ethics of Levinas in seeking the foundation of normativity itself, captures the ethical coreand central values of health care. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has (...) at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

The argument of this article is framed by a debate between the principle of humanity and the principle of justice. Whereas the principle of humanity requires us to care about others and to want to help them meet their vital needs, and so to be partial towards those others, the principle of justice requires us to consider their needs without the intrusion of our subjective interests or emotions so that we can act with impartiality. I argue that (...) a deep form of caring lies behind both approaches and so unites them. In the course of the argument, I reject Michael Slote’s sentimentalist form of an ethics of care, and expound Thomas Nagel’s moral theory, which seems to lie at the opposite end of a spectrum ranging from moral sentiments to impersonal objectivity. Nevertheless, Nagel’s theory of normative realism provides unexpected support for the thesis that a deep and subjective form of caring lies at the base of even our most objective moral reasons. (shrink)

The gendered division of labour in combination with the feminisation of international migration contribute to shortages of care, a phenomenon often called ‘care drain’. I argue that this phenomenon is an issue of global gender justice. I look at two methodological challenges and favourably analyse the suggestions that care drain studies should include the effects of fathers’ and other male caregivers’ migration and, in some cases, the effects of migration within national borders. I also explain why (...) care drain is a problem of distributive justice, by looking at the background conditions that result in much of the care-givers’ migration. (shrink)

During the last decade a “technical” approach has become increasingly influential in health care priority setting. The various country reports illustrate, however, that non-technical considerations cannot be avoided. As they often remain implicit in health care package decisions, this paper aims to make these normative judgements an explicit part of the procedure. More specifically, it aims to integrate different models of distributive justice as well as the principle of solidarity in four different phases of a decision-making procedure, (...) and to identify important moral choices which present themselves. First four important justice models are discussed, then a justification is given for their inclusion in a four-step decision making procedure. This is followed by a discussion of different justice and solidarity problems—with their inherent conceptual difficulties in each of these stages. The paper concludes with a summary of the major moral choices that are to be made in health care package decisions. (shrink)

I address the question of gender bias in ethical theorizing, in particular the claim that an "ethics of justice" is gender biased because it cannot logically accommodate an "ethics of care." I argue against the strong claim that an ethics of justice and an ethics of care are incompatible but suggest that theorizing that crystallizes into a tradition has non-logical as well as logical implications. In order to explain why ethical theorizing has focused on some content (...) and neglected others, one would have to suppose tacit general acceptance of a set of beliefs. It is in considering those beliefs that the charge of gender bias in ethical theorizing might be made to stick. (shrink)

<b>Objectives:</b> To gather empirical data on how gender and educational level influence bioethical reasoning among medical students by analyzing their use of care versus justice arguments for reconciling a bioethical dilemma. <b>Setting:</b> University Departments of Medical Ethics, Social and Communication Psychology in Germany. Participants: First and fifth year medical students. Design and method: Multidisciplinary, empirical, 2-segment study of ethics in action: In intrapersonal Segment 1, the students were presented with a bioethical dilemma and then administered a 13-item questionnaire (...) to survey their individual preferences for care versus justice arguments in resolving the conflict. The survey questioned 6 justice, 6 care-related items and 1 socially critical item. Data were analysed by gender and year of medical school. In interpersonal Segment 2, the bioethical dilemma from Segment 1 was discussed in gender-mixed and gender-homogeneous groups. Coded transcripts were evaluated to identify prevalences in care versus justice reasoning. <b>Results:</b> Data on 462 medical students were evaluable (n=338 in Segment 1, n=168 in Segment 2, n=44 overlap). Gender and level of education had no effect on moral reasoning in intrapersonal Segment 1, but significantly affected reasoning in interpersonal Segment 2, where women significantly tended to use more care-orientated arguments. Justice arguments predominated the group discussions. <b>Conclusion:</b> Interpersonal contexts affect moral reasoning in medical students, probably by amplifying the socialisation relating to gender and educational level. Care orientation is associated with the female gender. Professional socialisation tends to reduce the diversity and richness of moral reasoning towards a more justice-weighted orientation. Medical ethics should teach both justice and care reasoning modes in order to broaden physicians' ability to reconcile bioethical dilemmas. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Caring for Landscapes of Justice in Perilous Settler EnvironmentsMishuana Goemanindians are the "singing remnants" or "graffiti," in the words of Leanne Betasamosake Simpson ("i am graffiti"). The forms this graffiti takes, our inscriptions on the landscape, are as numerous as our Nations, abundant as our ancestors who loved, lived, and passed down knowledge of our lands and histories. "You are the result of the love of thousands," writes (...) Linda Hogan, who beseeches us to listen to the environment surrounding us (159). Deborah Miranda (Coastal Esselen and Chumash) reminds us that we are also the result of violent histories, in her tribal memoir Bad Indians, a book that relishes the tales of her ancestors who resist and act out to survive. This harm, genocide, and settler mapping of worlds also must be attuned to in our surroundings and in "our bodies [that are] bridges over which our descendants cross, spanning unimaginable landscapes of loss" (Miranda 74). Visual cartographic mapping has been part and parcel of the erasure of California Indians, relegated to the small, contained, and past temporal space of a romanticized mission.This paper centers on the NDN Collective's work and the photography of Cara Romero's project Tongvaland and the works of Gabrielino Tongva artist Mercedes Dorame. The setting of these projects is in the sprawling landscape of Los Angeles, or the homelands of the Gabrielino Tongva people, who call it Tovaangar. I will examine the anti-colonial aesthetics and care practices mapped out in the work rather than presenting a "true" Indigenous map or alternative map. Mapping a history of the landscape by creating a "new" narrative or "true" narrative is not enough. As Maori scholar Linda Tuhwi Smith states, "[w]e believe that history is also about justice, that understanding history will enlighten our decisions about the future. Wrong. History is also about power. In fact, history is mostly about power. … [A] thousand accounts of the truth will not alter the fact that indigenous peoples are still marginal [End Page 50] and do not possess the power to transform history into justice" (34). The Gabrielino Tongva, who comprise an estimated 2,300 people, do not possess the population power and cannot access the form of voting or democracy to make the changes needed just by telling their truth. Across California, people know about the raw deal, the embezzlement, the genocide, and the so-called lost treaties. In fact, under Eisenhower, recompense was paid out in small amounts to Tongva families of the dispossessed. Instead, to continue with the words of Smith, "[i]t is also about reconciling and reprioritizing what is really important about the past with what is important about the present" (111). What Romero and the NDN Collective—made up of numerous tribal leaders, scholars, and other artists—did was relay and prioritize how they wanted to be seen in their homelands. These billboards invite us in, in a gift of sharing, or what tribal cultural leader Craig Torres related to me as a spirit of Maxxa, a sharing, gifting, or swapping of knowledge. Dorame's beautiful and critical installations in public art spaces reflect Maxxa—they invite the viewers to think through land from her curious arrangements. As artists, part of their practice is not that of a Western version of a tortured genius but instead is energized by pulling in community and creating a collective practice. They undo settler space together and with us. The cartographic practices of these California Indians' creative arts exemplify communities of care that must be considered when we think through the unmapping of settler terrains. This question requires an approach of radical care. As Hi'ilei Hobart and Tamara Kneese make clear, the notion of care is "inseparable from systemic inequalities and power systems" (Hobart and Kneese 1).The work of the NDN Collective and Dorame counters a settler-based, commercial map of Los Angeles. Indigenous people, relegated by the settler state as expendable and erasable graffiti, confront capitalist and state ordinances at various scales. Rather than understand this as a subjugated positionality, I posit that graffiti is the critique necessary and valuable to understanding interlocking structures of oppression. In the following words of Leanne... (shrink)

Older minority Americans experience worse health outcomes than their white counterparts, exhibiting the need for social justice in all areas of their health care. Justice, fairness, and equity are crucial to minimizing conditions that adversely affect the health of individuals and communities. In this paper, Alzheimer's disease (AD) is used as an example of a health care disparity among elderly Americans that requires social justice interventions. Cultural factors play a crucial role in AD screening, diagnosis, (...) and access to care, and are often a barrier to support and equality for minority communities. The “conundrum of health disparities” refers to the interplay between disparity, social justice, and cultural interpretation, and encourages researchers to understand both (1) disparity caused by economic and structural barriers to access, treatment, and diagnosis, and (2) disparity due to cultural interpretation of disease, in order to effectively address health care issues and concerns among elderly Americans. (shrink)

ABSTRACTGiven the existing inequities in climate change, any proposed climate engineering strategy to solve the climate problem must meet a high threshold for justice. In contrast to an overly thin paradigm for justice that demands only a science-based assessment of potential temperature-related benefits and harms, we argue for the importance of attention to recognitional justice. Recognitional justice, we go on to claim, calls for a different type of assessment tool. Such an assessment would pay attention to (...) neglected considerations such as relationships, context, power, vulnerability, narrative, and affect. Here we develop a care-ethics related tool for assessing the justice of climate engineering with stratospheric aerosols, and suggest that qualitative social science methods may be required for its effective application. We illustrate the use of this tool with a case study involving interviews about stratospheric aerosol injection conducted in Kenya, the Solomon Islands... (shrink)

In recent years, the flow of undocumented labor from the global South to richer nations has increased considerably. Many undocumented women workers find employment as caregivers for the dependent elderly, whose numbers are burgeoning in affluent countries. Here we present a profile of undocumented non-citizen caregivers in the United States and delineate some of the key injustices they suffer. After identifying the causal factors responsible for the flow of undocumented labor from the global South to richer nations like the United (...) States, we discuss the criteria that a theory of transnational justice must meet if it is to address the problem of justice for this population. We argue that Iris Young's "social connection" model of responsibility is a promising approach for helping to correct the injustices suffered by undocumented, non-citizen caregivers. (shrink)

This paper asks whether adult children have aduty of justice to act as caregivers for theirfrail, elderly parents. I begin (Sections I.and II.) by locating the historical reasons whyrelationships within families were not thoughtto raise issues of justice. I argue that thesereasons are misguided. The paper next presentsspecific examples showing the relevance ofjustice to family relationships. I point outthat in the United States today, the burden ofcaregiving for dependent parents fallsdisproportionately on women (Sections III. andIV.). The paper goes (...) on to use Rawls''theoretical tool of the veil of ignorance toargue that caring for parents should not belinked to a person''s sex and more generally,that there is no duty of justice to assume therole of caregiver for dependent parents(Sections V.). Although justice does notprovide the moral foundations for parent care,I show that it nonetheless places importantlimits on the instinct to care. I concludethat the voice of justice should be audible,and is intrinsically present, withinfamilies. (shrink)

Palliative care serves both as an integrated part of treatment and as a last effort to care for those we cannot cure. The extent to which palliative care should be provided and our reasons for doing so have been curiously overlooked in the debate about distributive justice in health and healthcare. We argue that one prominent approach, the Rawlsian approach developed by Norman Daniels, is unable to provide such reasons and such care. This is because (...) of a central feature in Daniels' account, namely that care should be provided to restore people's opportunities. Daniels' view is both unable to provide pain relief to those who need it as a supplement to treatment and, without justice-based reasons to provide palliative care to those whose opportunities cannot be restored. We conclude that this makes Daniels' framework much less attractive. (shrink)

Many societies, and nearly all wealthy, developed countries, provide universal access to a broad range of public health and personal medical services. Is such access to health care a requirement of social justice, or is it simply a matter of social policy that some countries adopt and others do not? If it is a requirement of social justice, we should be clear about what kinds of care we owe people and how we determine what care (...) is owed if we cannot possibly meet every health need, as arguably no society can. We should be clear about what constitutes appropriate access to that care, given that there are diverse barriers to access. We must also be able to say why we owe these things as a matter of justice, and, of course, different accounts of social justice will bake and serve this cake in different ways. (shrink)

Health-care goods are goods with peculiar properties, and where they are scarce, societies face potentially explosive distributional conflicts. Animated public and academic debates on the necessity and possible justice of limit-setting in health care have taken place in the last decades and have recently taken a turn toward procedural rather than substantial criteria for justice. This article argues that the most influential account of procedural justice in health-care rationing, presented by Daniels and Sabin, is (...) indeterminate where concrete properties of rationing institutions are concerned. Such properties inscribe substantial norms into institutions. These norms can derive validity only from democratic majority decisions, which must be seen as an instance of pure procedural justice. We therefore have to move the discussion to a meta-level and ask how concrete properties of institutions are being chosen. I suggest four criteria for sufficiently democratic institutional design choice and conclude that as institutional properties are likely to have effects on the resulting distribution of health care, design choices should be empirically informed and taken both democratically and deliberately. (shrink)

This article draws on two studies that have used an ethic of care analysis to explore lay, nursing and social work care for people with dementia. It discusses the political as well as the practice application of ethic of care principles and highlights the necessity to understand both what people do and the meanings with which such practices are imbued in order to identify `good care' and the relationship between this and social justice. Examples of (...) care for people with dementia are discussed by reference to core principles of an ethic of care: attentiveness, responsibility, competence, responsiveness and trust. These illustrate the potential for the development of a shared language within which different disciplines, lay carers and people with dementia can communicate about how needs could best be met in complex and difficult circumstances. (shrink)

The debate about justice and health care has occurred largely at a remove from the institutions it concerns; it has been about our most general moral principles, and about what things we value. This debate has foundered. But if the debate is turned in another direction, toward some moral principles that are widely accepted within those institutions, and toward principles that have to do with control over allocation decisions rather than with actually how to make those decisions, agreement (...) may be nearer at hand. (shrink)

. Morality is often dismissed as irrelevant in what is seen as the global anarchy of rival states each pursuing its national interest. When morality is invoked, it is usually the morality of justice with its associated moral conceptions of individual rights, equality, and universal law. In the area of moral theory, an alternative moral approach, the ethics of care, has been developed in recent years. It is beginning to influence how some see their global responsibilities.

The principle that each individual is entitled to an equal opportunity to benefit from any public health care system, and that this entitlement is proportionate neither to the size of their chance of benefitting, nor to the quality of the benefit, nor to the length of lifetime remaining in which that benefit may be enjoyed, runs counter to most current thinking about the allocation of resources for health care. It is my contention that any system of prioritisation of (...) the resources available for healthcare or of rationing such resources must be governed by this principle. -/- This can have apparently paradoxical conclusions in that it can seem wasteful to give someone with a very slim chance of a lifesaving treatment the same priority as someone with a much better chance. In an important and thoughtful recent paper, Julian Savulescu has concentrated on this apparent weakness and has argued for a particular conception of the good or benefit to be achieved by a healthcare system which purports to demonstrate the inadequacies of an equal opportunities approach to prioritisation and to replace it with an altogether better account. This paper will show that a rational ‘reasons based consequentialism’ is more in line with the equal opportunities approach, which I defended some time ago in these pages, than with that of Savulescu. I shall then examine more closely the conception of equal opportunities in health care and show that if we give weight to an individual's reasons, and what is expected to be good for them, we will opt for exactly the equality based account of distributive justice that I have recommended. (shrink)

This article defends an ethics of care approach to global justice, which begins with an empirically informed account of injustices resulting from the workings and effects of contemporary neo-liberalism and hegemonic masculinities. Dominant distributive approaches to global justice see the unequal distribution of resources or ?primary goods? as the basic source of injustice. Crucially, however, most of these liberal theories do not challenge the basic structural and ideational ?frames? that govern the global political economy. Instead, they seek (...) to ?correct? unjust patterns of distribution according to an ideal theory. Subjects in these theories are generally understood as abstract, autonomous and impartial; this is in contrast to an ethics of care, which starts with an ontology of the subject as embodied, vulnerable and relational. The first part of this article explores the role and nature of theory in relation to the task of considering injustice on a global scale and offers a critique of the narrow focus in traditional theories of justice on the distribution of ?primary goods?. The second part considers the effects of neo-liberal globalization and hegemonic masculinities on global working families in order to illustrate the relationship between care and global justice. The final section sketches out a care-ethics approach to global injustice, focusing on three features: first, care as a relational approach; second, the focus in care ethics on intersecting structures of injustice; and third, care as a multi-scalar approach to global injustice. (shrink)

The National Institute for Health and Care Excellence (NICE) is the UK’s primary healthcare priority-setting body, responsible for advising the National Health Service in England on which technologies to fund and which to reject. Until recently, the normative approach underlying this advice was described in a 2008 document entitled ‘Social value judgements: Principles for the development of NICE guidance’ (SVJ). In January 2020, however, NICE replaced SVJ with a new articulation of its guiding principles. Given the significant evolution of (...) NICE’s methods between 2008 and 2020, this study examines whether this new document (‘Principles’) offers a transparent account of NICE’s current normative approach. It finds that it does not, deriving much of its content directly from SVJ and failing to fully acknowledge or explain how and why NICE’s approach has since changed. In particular, Principles is found to offer a largely procedural account of NICE decision-making, despite evidence of the increasing reliance of NICE’s methods on substantive decision-rules and ‘modifiers’ that cannot be justified in purely procedural terms. Thus, while Principles tells NICE’s stakeholders much about how the organisation goes about the process of decision-making, it tells them little about the substantive grounds on which its decisions are now based. It is therefore argued that Principles does not offer a transparent account of NICE’s normative approach (either alone, or alongside other documents) and that, given NICE’s reliance on transparency as a requirement of procedural justice, NICE does not in this respect satisfy its own specification of a just decision-maker. (shrink)

Carol Gilligan's In a Different Voice, which appeared in 1982, argued that men tend to conceive morality in terms of rights, justice, and autonomy, whereas women more frequently think in terms of caring, responsibility, and interrelation with others. At about the same time, Nel Noddings in Caring: A Feminine Approach to Ethics and Moral Education sought to articulate and defend in its own right a “feminine” morality centered specifically around the ideal of caring. Since then, there has been a (...) heated debate about the reality of the distinction Gilligan drew and about its potential implications for ethical theory. Discussions of the morality of caring have questioned, in particular, whether any such morality can really provide a total framework for moral thought and action. For in order to deal with our obligations to people we are not acquainted with and address large-scale issues of social morality, any morality of caring seems to require supplementation by typically “masculine” thinking in terms of rights and justice, with the result that caring turns out to be but one part of morality, rather than anything women, or more enlightened men, could find attractive as a total and self-sufficient way of approaching ethical issues. (shrink)

Ancillary care is care that research participants need that is not essential to make the research safe or scientifically valid and is not needed to remedy injuries that eventuate as a result of the research project itself. Ancillary care duties have recently been defended on the grounds of beneficence, entrustment, utility and consent. Justice has also been mentioned as a possible basis of ancillary care duties, but little attention has been paid to this approach. In (...) this paper, the author seeks to rectify this omission by arguing that ancillary care duties can be based on a principle of justice as rectification. (shrink)