Machine generated contents note: Preface; Introduction; Part I. Global Health, Definitions and Descriptions: 1. What is global health? Solly Benatar and Ross Upshur; 2. The state of global health in a radically unequal world: patterns and prospects Ron Labonte and Ted Schrecker; 3. Addressing the societal determinants of health: the key global health ethics imperative of our times Anne-Emmanuelle Birn; 4. Gender and global health: inequality and differences Lesley Doyal and Sarah Payne; 5. Heath systems and health Martin McKee; Part (...) II. Global Health Ethics, Responsibilities and Justice: Some Central Issues: 6. Is there a need for global health ethics? For and against David Hunter and Angus Dawson; 7. Justice, infectious disease and globalisation Michael Selgelid; 8. International health inequalities and global justice: toward a middle ground Norman Daniels; 9. The human right to health Jonathan Wolff; 10. Responsibility for global health? Allen Buchanan and Matt DeCamp; 11. Global health ethics: the rationale for mutual caring Solly Benatar, Abdallah Daar and Peter Singer; Part III. Analyzing Some Reasons for Poor Health: 12. Trade and health: the ethics of global rights, regulation and redistribution Meri Koivusalo; 13. Debt, structural adjustment and health Jeff Rudin and David Sanders; 14. The international arms trade and global health Salahaddin Mahmudi-Azer; 15. Allocating resources in humanitarian medicine Samia Hurst, Nathalie Mezger and Alex Mauron; 16. International aid and global health Anthony Zwi; 17. Climate change and health: risks and inequities Sharon Friel, Colin Butler and Anthony McMichael; 18. Animals, the environment and global health David Benatar; 19. The global crisis and global health Stephen Gill and Isabella Bakker; Part IV. Shaping the Future: 20. Health impact fund: how to make new medicines accessible to all Thomas Pogge; 21. Biotechnology and global health Hassan Masun, Justin Chakma and Abdallah Daar; 22. Food security and global health Lynn McIntyre and Krista Rondeau; 23. International taxation Gillian Brock; 24. Global health research: changing the agenda Tikki Pang; 25. Justice and research in developing countries Alex John London; 26. Values in global health governance Kearsley Stewart, Gerald T. Keusch and Arthur Kleinman; 27. Poverty, distance and two dimensions of ethics Jonathan Glover; 28. Teaching global health ethics James Dwyer; 29. Towards a new common sense: the need for new paradigms of global health Isabella Bakker and Stephen Gill; Index. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

The progress of history rests on the battle for supremacy of competing ideas.... The power and wealth of western countries give them a dominant role in shaping the international public discourse. This is a privileged position... [an] imbalance of voice in the international discourse [that] has built up a dangerous sense of resentment by the silent majority of the world’s people. The dominant bioethical paradigm that provides the context for research ethics discourse has evolved within western philosophy’s powerful normative framework (...) and is built on a relationship model that explains and underpins the obligations doctors have to their patients. In this one-to-one relationship, the doctor is... (shrink)

The Ebola epidemic in West Africa is not merely a biomedical problem that can be seen in isolation and dealt with only through emergency medical rescue processes. The ethical dilemmas surfaced by this epidemic are also not confined to the usual micro-ethical problems associated with medical care and medical research. The pandemic, as one of many manifestations of failed human and social development that has brought the world to dangerous ‘tipping points’, requires deep introspection and action to address upstream causal (...) processes. (shrink)

It is widely acknowledged that the HIV and AIDS pandemic is a global emergency and that cheap, effective treatment should be provided for as many people as possible worldwide. But there are many challenges to rolling out antiretroviral treatment in resource-poor settings. These include the cost of drugs, sustaining their supply and distribution, the complexity of treatment regimens, selection of patients for treatment, shortage of medical and nursing personnel, inadequacy of healthcare facilities, the need for uninterrupted, lifelong treatment, and monitoring (...) for drug resistance. Great efforts, nationally and internationally, are required to meet these challenges. (shrink)

At this crucial time, on the centenary of major reforms, we invite all concerned stakeholders to join us in much needed rethinking for reforms of professional education in the 21st century. . . . All health professionals in all countries should be educated to mobilise knowledge and to engage in critical reasoning and ethical conduct so that they are competent to participate in patient and population-centred health systems as members of locally responsive and globally connected teams. What this Commission argues (...) for is nothing less than a remoralisation of health professionals’ education. For decades, health professionals have colluded with centres of power (governmental, commercial, institutional, even .. (shrink)

A new context for ethics and ethics education is evident in a rapidly changing world and our threatened planet. The current focus on considerations of inter-personal ethics within an anthropocentric perspective on life should be extended to embrace considerations of global and ecological ethics within an eco-centric perspective on global and planetary health. The pathway to understanding and adapting to this new context includes promoting shifts in life styles from selfish hyper-individualism and wasteful consumerism towards cautious use of limited resources (...) within an increasingly interdependent world in which the equal moral worth of all and sustainability are valued. Critical scholarly approaches to global politics and to the global political economy could facilitate such change and encourage iterative interactive processes instead of seeking conclusive definitive ‘scientific’ solutions to all problems. Hopefully this shift in perspective could be achieved firstly through sensitization to new and increasingly challenging ethical dilemmas, and then by encouraging rational thinking and action based on global and ecological considerations rather than on false economic dogma and the distorted workings of a market civilization. Moving ahead with these activities must begin with promotion of education, learning and self-reflection to foster the widespread development of a global state of mind. Such a shift would require an expanded ethical discourse, with consideration of ethical dilemmas beyond human inter-personal relationships. These should include intra-institutional and inter-institutional relationships, as well as relational ethics between nations in a post-Westphalian world, and between humans and nature in an era now called the Anthropocene, to ensure survival on a planet undergoing entropy.The adverse effects of intense competition could be reduced by encouraging greater cooperation, linking security issues to global health and social justice issues, and using inspirational narratives and examples of moral imagination/moral leadership. These educational programs should be initiated in schools and become mandatory for all first-year College and University students. Such an agenda is feasible given human ingenuity, determination, resilience and adequate resources, but will also require political and social will as its drivers. (shrink)

Offers theoretical and practical guidance for addressing global health, and a deeper understanding of the challenges humanity faces.

A number of high‐profile ethical dilemmas are embedded in the emerging topic of global health. The three books under review here provide various lenses through which to view them. In Ethics in Global Health: Research, Policy, and Practice, Ruth Macklin offers finely honed contemporary arguments and applies them to the future. Global Justice and Bioethics, a collection of essays edited by Joseph Millum and Ezekiel Emanuel, focuses on theories of justice, and in Long‐term Care, Globalization and Justice, Lisa Eckenwiler looks (...) more broadly at the global implications of caring for the aged in wealthy societies. (shrink)