This chapter serves as an introduction to the collected volume. In the first section, we aim to provide background on important themes in social egalitarianism and to set the context for understanding which significant questions the chapters in this book pose and attempt to answer. In this section we focus especially on what could be said to characterize socially egalitarian relationships, on which relationships are of concern, and on what might make social egalitarianism distinct. In the second section, we provide (...) a brief explanation of the structure of the book and each of its chapters. (shrink)

What is a just way of spending public resources for health and health care? Several significant answers to this question are under debate. Public spending could aim to promote greater equality in health, for example, or maximize the health of the population, or provide the worst off with the best possible health. Another approach is to aim for each person to have "enough" so that her health or access to health care does not fall under a critical level. This latter (...) approach is called sufficientarian. Sufficientarian approaches to distributive justice are intuitively appealing, but require further analysis and assessment. What exactly is sufficiency? Why do we need it? What does it imply for the just distribution of health or healthcare? This volume offers fresh perspectives on these critical questions. Philosophers, bioethicists, health policy-makers, and health economists investigate sufficiency and its application to health and health care in fifteen original contributions. (shrink)

Many social gradients in health appear steeper for men than for women. I refer to this as the “Steepness Puzzle.” This paper explores the ethical implications of this Puzzle. First, it identifies potential explanations for the Steepness Puzzle, including methodological problems. Second, it highlights two harms associated with the methodological explanation: the consequences of biased epistemic practices and the marginalization of women. It also demonstrates how attempts to flatten the gradients in health could disproportionately favor men or reinforce troubling gendered (...) norms. Finally, I suggest ways to address the methodological problems underlying the Puzzle. (shrink)

The main contribution of this article is to apply Herbert Marcuse’s work in contemporary neoliberal society. Specifically, this article will focus on Marcuse’s critique of advanced industrial society and the role that technology plays in the quantification of the self. In this article, I will argue that in recent years, the development of technology has created the possibility to measure, calculate and quantify even the most trivial aspects of our lives, reducing people to numbers. The quantification of people is done (...) with the specific purpose of enhancing efficacy and productivity. I will unpack this notion by first looking to Marcuse’s critique of an advanced industrial society which he argues has the unique purpose of quantifying people to achieve a universal norm of calculated efficiency. Specifically, I will refer to Marcuse’s critique of industrial rationality as the prevailing rationality in advanced industrial societies which encourages the quantification of people. Secondly, I argue that Marcuse’s critique has evolved in the work of contemporary thinkers such as political economist Wendy Brown and cultural theorist Byung-Chul Han. I argue that Brown expands on Marcuse’s theories and contextualises those theories in contemporary neoliberalism. Specifically, I will focus on the concept of governmentality as a political rationality in neoliberal societies and how it advances a one-dimensional political passivity in neoliberal subjects. Finally, I refer to Han, whose theories explore the influence of new forms of technology in a neoliberal society and the development of the neoliberal subject as a “quantified self”. (shrink)

The main issue in the Masiya judgment was whether the current South African definition of rape—namely non-consensual penetration of a vagina by a penis—should be extended to include anal penetration of both female and male victims. The majority of the Constitutional Court held that anal penetration of female victims should constitute rape, but declined to offer similar protection to male victims. This note argues that this judgment reverts to and reinforces patriarchal stereotypes and dichotomies and that it misunderstands, in a (...) profound way, central concepts such as sex and gender and the gendered nature of rape. It further suggests that, instead of being an aberration, the judgment actually fits into a pattern of conservative judgments about gender and sexuality by the South African Constitutional Court. (shrink)

South African law has traditionally denied property sharing rights to people in non-marital intimate partnerships, but a series of new cases has created the possibility of enforcing universal partnership contracts to claim a share in partnership property. However, evidential biases within these progressive cases reflect a historical disdain for women’s contributions to relationships and a widespread reluctance to believe women’s testimony about the existence of agreements to share. These biases bear strong resemblances to the gender stereotypes which have been the (...) subject of feminist critique in rape law. Central to both rape and universal partnerships is the issue of consent or agreement between men and women. This, in turn, depends on social beliefs about male and female entitlements in the realms of sex and intimate relationships. The paper highlights the commonalities and parallels between the legal treatment of women’s evidence about the existence of contracts on the one hand, and the prejudice faced by complainants in rape cases. (shrink)

In 2002 the constitutionality of the Sexual Offences Act, which criminalizes the behaviour of sex workers but fails to punish their clients, was at issue in the South African Constitutional Court. The majority of the Court held that the legislation does not constitute indirect discrimination on the basis of gender. The minority judgment found indirect gender discrimination, but held that the legislation did not infringe upon sex workers’ rights to dignity and privacy. This note argues that the reasoning in both (...) the majority and minority judgments reflects and contributes to detrimental stereotypes of feminine sexuality, which, in turn, exacerbate women’s vulnerability to H.I.V. infection in South Africa. (shrink)

Although the obligation to appoint women as judges originates from the constitutional injunction to consider “the need for the judiciary to reflect broadly the racial and gender composition of South Africa,” gender transformation has lagged behind racial transformation of the bench. During the past four years, however, the lack of women appointees has become a more contested issue. This paper investigates the relationship between gender transformation and racial transformation of the judiciary in public debates around the judiciary. Despite the universally (...) voiced concern about the lack of women judges, the most frequent and acrimonious public disputes continue to centre upon racial issues. The imperative to appoint women judges is often articulated as an alternative to appointing black judges, although the statistics show that the greatest need is for the appointment of black African women. Debates on gender transformation of the bench also remain premised on a formal notion of equality that focuses on numbers of women judges rather than on appointing male or female judges who are committed to challenging gender oppression. This means that the entrenched professional cultures, norms and structures that benefit men are left unchallenged. (shrink)

This article critically examines the competitive, adversarial nature of the Western neoliberal style of democracy. Specifically, this article focuses on Amartya Sen’s notion of a “universal democracy” as a means of addressing socio-economic inequalities through Sen’s capability approach. Sen’s capability theory has become an acclaimed and widely used theory to evaluate and understand development and inequalities. However, we employ a distinctive critique by engaging Amartya Sen through Herbert Marcuse’s analysis of one dimensionality and the adversarial nature of Western democracy. We (...) further highlight how contemporary neoliberal society employ a particular, adversarial form of public participation. Through this, we underline the various neoliberal problemata, such as Western idealism, political passivity, and a “flattening of choice,” within contemporary democracies and locate how their competitive, winner-take-all nature has become essential to contemporary, Western democratic models. Consequently, we argue that democracy, as a functional concept and form of public engagement, should be fundamentally re-examined in order to address inequalities. (shrink)

This volume brings together a collection of ten original essays which present new analyses of social and relational equality in philosophy and political theory. The essays analyze the nature of social equality and its relationship with justice and with politics.

What kind of equality should we value and why? Current debate centres around whether distributive equality is valuable. However, it is not the only (potentially) morally significant form of equality. David Miller and T. M. Scanlon have emphasised the importance of social equality—a strongly egalitarian notion distinct from distributive equality, and which cannot be reduced to a concern for overall welfare or the welfare of the worst-off. However, as debate tends to focus on distribution, social equality has been neglected and (...) we do not have a clear understanding of what it is and why it might be valuable. This paper aims to address this gap. (shrink)

Responding to the nurse’s moral distress in this case depends on a deeper understanding of the source. It is possible that there is concern that resuscitation is morally wrong—perhaps because it wo...

Much research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress. I will identify and aim to resolve two sources of confusion about (...) moral distress: the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and the distinction drawn between moral dilemma and moral distress, which implies that the two are mutually exclusive. In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both. (shrink)

This paper explores the ecosystemic management strategies for inclusive schools due to challenges faced by the schools in the mainstream school where learners from the specialised institutions are referred back to mainstream for inclusive education. Ecosystemic perspective on inclusive education, ecological theories and systems theories underpin this paper. The study was done through interviews, field notes and observations of 120 participants comprising the SMTs, educators and parents. The findings indicate that schools face great challenges in managing inclusive schools. A lot (...) has been published on inclusive education, but none of them offers ecosystemic management strategies for the school management to follow. The article concludes by offering ecosystemic management strategies for successful implementation of inclusive education. (shrink)

Using the Bible in Christian ethics is often not as simple as many would expect it to be. This is particularly the case for the use of the Old Testament. Part of the challenge is the complexity of grasping the customs and norms that are reflected in the Old Testament. They are often at odds with what is acceptable in contemporary thinking. In this article, we examine the difficulty of using the Old Testament in Christian ethics by using the narrative (...) of Judah and Tamar in Genesis 38 as case study. We show that this particular text alerts us to the complex relationship between ethics and culture, not only in the world of the text, but also the world of the interpreter. Based on our analysis of the text we argue for its meta-ethical contribution to the practice of Christian ethics. We do not endeavour to resolve the perceived tension between the implied ethics of the text and that of contemporary interpreters, but view the unresolved tension as one of the text’s key contributions to the practice of Christian ethics. (shrink)

Anticipating the ethical impact of emerging technologies is an essential part of responsible innovation. One such emergent technology is the digital twin which we define here as a living replica of a physical system (human or non-human). A digital twin combines various emerging technologies such as AI, Internet of Things, big data and robotics, each component bringing its own socio-ethical issues to the resulting artefacts. The question thus arises which of these socio-ethical themes surface in the process and how they (...) are perceived by stakeholders in the field. In this report we present the results of a qualitative study into the socio-ethical benefits and socio-ethical risks of using digital twins in healthcare. Employing insights from ethics of technology and the Quadruple Helix theory of innovation, we conducted desk research of white literature and 23 interviews with representatives from the four helixes: industry, research, policy and civil society. The ethical scan revealed several important areas where the digital twin can produce socio-ethical value (e.g., prevention and treatment of disease, cost reduction, patient autonomy and freedom, equal treatment) but also several important areas of socio-ethical risks (e.g., privacy and property of data, disruption of existing societal structures, inequality and injustice). We conclude with a reflection on the employed analytical tool and suggestions for further research. (shrink)

In this chapter, Fourie identifies and systematizes the impairments associated with having privilege and evaluates their implications for theories of relational equality and distributive justice. Having certain social privileges, for example, being a man in a patriarchal society, can also be damaging; in other words, there are “impairments of privilege.” Fourie delineates six kinds of impairments—epistemic, evaluative, emotional, health-related, affiliative, and moral. She then goes on to assess the implications of the impairments of privilege for two theories in (...) political philosophy. Relational egalitarianism, she argues, has the theoretical resources to identify and address the problems associated with these impairments, whereas distributive egalitarianism does not. Furthermore, she argues that assessing the impairments of privilege through relational egalitarianism helps to characterize a society of equals: we must address the causes of functional impairments, express respect for the worse off by not normalizing the experiences of the privileged, and minimize competitive positionality. (shrink)

In this article, the concept of inclusivity in the Old Testament is investigated and the theology of 'Otherness' is discussed broadly. Various authors discuss the 'Otherness' in biblical Israel. These views are critiqued and a conclusion is reached that an inclusive reading in the Old Testament, specifically of the known exclusive texts in the Hebrew Bible, is a possibility. To argue for inclusivity in the Old Testament, a view of hospitality is considered and a literary review of inclusive texts is (...) conducted, namely the Books of Ruth, Jonah, Ecclesiastes, Esther and some Deuterocanonical texts. (shrink)

What is a just way of spending public resources for health and health care? Several significant answers to this question are under debate. Public spending could aim to promote greater equality in health, for example, or maximize the health of the population, or provide the worst off with the best possible health. Another approach is to aim for each person to have "enough" so that her health or access to health care does not fall under a critical level. This latter (...) approach is called sufficientarian. Sufficientarian approaches to distributive justice are intuitively appealing, but require further analysis and assessment. What exactly is sufficiency? Why do we need it? What does it imply for the just distribution of health or healthcare? This volume offers fresh perspectives on these critical questions. Philosophers, bioethicists, health policy-makers, and health economists investigate sufficiency and its application to health and health care in fifteen original contributions. (shrink)

The yeast two‐hybrid system is a genetic method that detects protein‐protein interactions. One application is the detection by library screening of new interactors of a protein of known function. In the August issue of Nature Genetics, Fromont‐Racine et al.1 showed for the first time that the construction of the protein interaction map of a complex pathway, such as that of the mRNA splicing machinery, is now possible, because of the combination of recent technical improvements elaborated in several laboratories. With a (...) yeast cell mating procedure that increases screen efficiency, they used their complex yeast genomic library of 5 × 106 clones to test 700 × 106 interactions against 15 proteins. They identified and classified 170 potential interactors, including approximately 70 proteins of previously unknown function. More than 25% of the interactors are probably biologically relevant. The achievements of Fromont‐Racine et al. have opened the way to the systematic analysis of the protein interaction networks of the 6,000 open reading frames‐yeast proteome. This task requires, however, automation of the library screens and creation of a two‐hybrid library database. BioEssays 20:1–5, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

In this chapter, I propose that conceptions of justice in bioethics must be feminist, meaning they must be able to capture how the domains of health, healthcare and medicine exacerbate the subordination of those perceived to be women and girls and how injustice impacts their health. After providing context in the first section, I identify three problems with conceptions of justice in the bioethics literature that interfere with their potential to be feminist. They tend to adopt the ahistoricism and distributivism (...) characteristic of theories of justice that have been dominant in political philosophy, and they often rely on gendered conceptions of health that result in troubling comparisons of men and women’s health. My argument is primarily “negative”: it is a critique of generalist conceptions of justice in bioethics. However, in the final section I present characteristics of what a feminist conception of justice needs to look like and indicate how feminist bioethicists are using such a conception in assessing issues of injustice in bioethics. I emphasize the centrality of actual structural injustices, relational egalitarianism, and the assessment of values in conceptions of health and the health sciences. (shrink)

In this study, the development of faith communities is investigated in different texts and contexts. The socio-religious understanding of various communities, from the time of the Old Testament, to today, has the potential to provide an understanding of ecclesiology and perceptions about what ‘church’ entails. In this study it is not suggested that there is one ideal faith community, nor can the approach of one faith community be adopted by another community. Every community exists within a certain socio-historical context and (...) must be understood as functioning within that framework. Yet it is possible to learn from history by reinterpreting key elements in new contexts. (shrink)

In this paper I argue that certain ways in which the relationship among discrimination, emotions and health is presented can undermine equity. I identify a model of this relationship the discrimination-emotion-health model - and claim that while the model is important for understanding the detrimental impact that discrimination and oppression can have on emotions and health, certain implications of the model are troubling. I identify six critiques of the model, and show that equity could be undermined, for example, when stereotypes (...) of the oppressed are reinforced and the experiences of the privileged are normalized. I then assess the implications of my analysis of the model and its critique for a framework of health equity, demonstrating what such a framework would need to look like in order for it to best represent discrimination as a psychosocial determinant of health. (shrink)

Recent research suggests holding a structural, rather than interpersonal, understanding of racism is associated with greater impetus to address racial disparities. We believe greater acknowledgment of structural racism also functions to mitigate against empathic failures in response to structural injustices. Given South Africa’s situatedness as a country characterized by historical racialized oppression and continuing unjust legacies, it is appropriate to examine these ideas there. Across three studies, we tested the hypotheses that members of advantaged groups’ perspective taking and empathic concern (...) may be compromised in response to people challenging the unequal status quo, and that a priori perceptions about the impact of structural racism may mitigate or exacerbate such empathic failures. In Study 1, a national sample of White South Africans endorsed perceptions of interpersonal racism more readily than perceptions of structural racism, and expressed high levels of competitive victimhood for perceived anti-White structural racism. Studies 2 and 3 showed that White participants at a historically White university responded with impaired perspective taking and intergroup empathy bias in response to people challenging structural disparities. Finally, reduced recognition of continuing structural racism predicted greater intergroup empathy bias, which, in turn, was associated with reduced willingness to engage in intergroup discussions about past harm. We propose that greater acknowledgment of structural racism is necessary not only to surmount intergroup empathic failures, but also to transcend the socioeconomically unequal legacies of apartheid and beyond. (shrink)

One of the most controversial issues in many health care systems is health care rationing. In essence, rationing refers to the denial of - or delay in - access to scarce goods and services in health care, despite the existence of medical need. Scarcity of financial and medical resources confronts society with painful questions. Who should decide which medicine or new treatment will be covered by social security and on which criteria such decisions must be based? Can age, for example, (...) be justified as a selection criterion? Should decision-making be left to health care policymakers, hospital administrators, or rather, to treating physicians? And finally: is there a role for individual patients? These are difficult questions that suggest the need for transparent and democratic decision-making. In reality, however, the rationing debate occurs in a sub rosa world, based on imperfect information, distorted interpretations of effectiveness, and hidden cost concerns. This book explores these and other questions from various perspectives. Each of the book's contributors analyzes the debate from a different angle, in search of fair and just rationing decisions. (shrink)

Freedom is modernity's most important promise, but also its most controversial promise. No other concept has led to so many expectations, disappointments, changes, and destruction. This book examines German theologian and ethicist Wolfgang Huber's concept of "communicative freedom," which is proposed as a contribution to the debate on freedom within modernity. It is argued that communicative freedom integrates radically different understandings of freedom into one comprehensive concept. This concept allows for a constructive and critical affirmation of modernity. (Series: Theology in (...) the Public Square/Theologie in der Offentlichkeit - Vol. 3). (shrink)

There seems to be popular consensus that multinational corporations (MNCs) should take responsibility for both the intended and unintended consequences of their operations. However, within the discipline of ethics, reflection on the responsibilities of MNCs continues to be highly controversial. In this article, we reflect on one of the more contentious issues in this debate, namely, the moral responsibility of MNCs for the unintended consequences of their operations. It is argued that at least two questions need to be addressed, namely, (...) whether or not MNCs can be held morally responsible for anything and - should this be the case - what it actually means to hold the MNCs responsible. (shrink)

Andrew Walton argues that, a Rawlsian property-owning democracy (POD) requires a fraternal ethos and certain forms of social interaction, such as high trade union membership. The basic structure objection could be used to challenge these claims as it indicates that Rawls’s principles of justice should only be applied to the basic structure of society, and not, for example, to an ethos. Walton has two responses to the objection: firstly, that it does not apply to his argument, and, secondly, even if (...) it were to apply, the objection itself is unconvincing. In this article I argue however that (1) the basic structure objection does apply as a fraternal ethos is difficult to reconcile with Rawls’s understanding of what should be included as part of the basis structure, and (2) although I do not defend the basic structure objection, it is not made explicit in Walton’s argument why the objection should be dismissed as unconvincing. (shrink)

In this article, it is argued that multinational companies (MNCs) that operate in South Africa should include a macroethical perspective in their ethical reflection. MNCs in South Africa are subjected to significant societal changes. At the same time, they are in a position to exert their influence in a way that affects more people than simply their shareholders, clients and employees. It is argued that a macroethical perspective can assist MNCs in coming to terms with these changes by expanding their (...) understanding of their responsibility towards South African society and future generations. (shrink)

What makes the words ‘Africa’ and ‘African’ possible and useful? In this article it is argued that at least four internally coherent concepts of Africa exist, and that none of these concepts are ethically neutral. The article is presented as a contribution to attempts at using the term ‘Africa’ in self-critical, reflexive and constructive ways. It could therefore be of interest to all researchers, particularly those in the humanities and theology, who locate their research within the context of ‘Africa’. It (...) is argued that Africa can be conceived of as a place, a commodity, a condition and an ideal. By drawing on mostly primary sources it is shown that the term ‘Africa’ only relatively recently came to refer to a continent, that Africa as a place and Africa as a condition in need of betterment formed the foundation for its commodification, and that Africa only very recently became a self-description of the people who live on the continent of Africa. Each of these concepts of Africa is shown to be based on a particular logic with both strengths and weaknesses. (shrink)

This study bases itself in the epistemological and methodological development of a broad and interdisciplinary dialogue where various voices in the form of different domains converse in order to establish an integrated whole. The research contributes to the actual corporative question regarding spirituality in the workplace, specifically aimed at the individual in the middle-career phase. This phase is characterised as a re-evaluation period aimed at personal and professional growth. A shift in emphasis to the meaning and sense of work is (...) linked to spiritual intelligence as spirituality can be described and understood as a type of intelligence. The study shows that the middle-career experience provides opportunity for an altered future view. Lifestyle coaching serves as facilitating process and offers guidance in answering existential questions which are included in the spiritual. The probable outcome promises to add meaning as a manifesting component in a dynamic and transforming life strategy. (shrink)

In the South African debate about the role of the media in the new South African society, the African moral philosophy ubuntuism is from time to time raised as a framework for African normative media theory. Up till now, the possibility of using ubuntuism as a normative framework can, however, not yet be described as a focused effort to develop a comprehensive theory on the basis of which media performance could be measured from ‘an African perspective’. Rather, the topic of (...) ubuntuism as normative media theory should be seen in the context of the African Renaissance as part of an intellectual quest to rediscover and re-establish idealized values of traditional African culture and communities and to apply it to contemporary phenomena such as the media. However, given South Africa's history of apartheid in which Christian nationalism was misused as a moral philosophy to mobilize a patriotic media in the service of volk and vaderland, it is not too early to ask critical questions about ubuntuism as a possible framework for normative media theory. Such questioning is the purpose of this article. Against the background of a postmodern and a postcolonial perspective on normative theory, questions related to the following are raised: the expediency of ubuntuism in the context of changed African cultural values, the distinctiveness of ubuntuism as an African moral philosophy, the vulnerability of moral philosophy to political misuse, ubuntuism in the context of the future of normative theory in a globalized world and changed media environment, and, the implications of ubuntuism for journalism practice. It is concluded that ubuntuism may pose a threat to freedom of expression. Given the nature of contemporary South African society and its media system, a postmodern emphasis on diversity and pluralism as the cornerstone of future normative theory is supported. (shrink)