Winner of the 1975 National Book Award, this brilliant and widely acclaimed book is a powerful philosophical challenge to the most widely held political and social positions of our age--liberal, socialist, and conservative.

It is our job now - the job of this book - to influence and develop the unsettled discourse of human rights so as to complete the incomplete idea.

In this book by the award-winning author of Just Healthcare, Norman Daniels develops a comprehensive theory of justice for health that answers three key questions: what is the special moral importance of health? When are health inequalities unjust? How can we meet health needs fairly when we cannot meet them all? Daniels' theory has implications for national and global health policy: can we meet health needs fairly in ageing societies? Or protect health in the workplace while respecting individual liberty? Or (...) meet professional obligations and obligations of justice without conflict? When is an effort to reduce health disparities, or to set priorities in realising a human right to health, fair? What do richer, healthier societies owe poorer, sicker societies? Just Health: Meeting Health Needs Fairly explores the many ways that social justice is good for the health of populations in developed and developing countries. (shrink)

The human right to health has been established in international law since 1976. However, philosophers have often regarded human rights doctrine as a marginal contribution to political philosophy, or have attempted to distinguish ‘human rights proper’ from ‘aspirations’, with the human right to health often considered as falling into the latter category. Here the human right to health is defended as an attractive approach to global health, and responses are offered to a series of criticisms concerning its demandingness.

The twentieth century saw a vigorous debate over the nature of rights. Will theorists argued that the function of rights is to allocate domains of freedom. Interest theorists portrayed rights as defenders of well-being. Each side declared its conceptual analysis to be closer to an ordinary understanding of what rights there are, and to an ordinary understand- ing of what rights do for rightholders. Neither side could win a decisive victory, and the debate ended in a standoff.

This paper offers four arguments against a moral human right to health, two denying that the right exists and two denying that it would be very useful (even if it did exist). One of my sceptical arguments is familiar, while the other is not.The unfamiliar argument is an argument from the nature of health. Given a realistic view of health production, a dilemma arises for the human right to health. Either a state's moral duty to preserve the health of its (...) citizens is not justifiably aligned in relation to the causes of health or it does not correlate with the human right to health. It follows that no one holds a justified moral human right to health against the state.Education and herd immunity against infectious disease both illustrate this dilemma. In the former case, the state's moral duty correlates with the human right to health only if it demands too much from a cause of health; and in the latter, only if it demands nothing from a cause of health (that is, too little). (shrink)

The publication of the Report of the International Bioethics Committee of Unesco on Social responsibility and health provides an opportunity to reshape the conceptual framework of the right to health care and its practical implications. The traditional distinctions between negative and positive, civil-political and economic-social, legal and moral rights are to be questioned and probably overcome if the goal is to pursue ‘the highest attainable standard of health’ as a fundamental human right, that should as such be guaranteed to every (...) human being. What we are called upon to, is the commitment not to exclude now and forever anyone from having access to the ‘excellence’ of scientific and medical progress. Therefore, the addressees of this ‘responsibility’ cannot be just the governments and the states within the limits of their ‘jurisdiction’. The challenge is to tackle at the same time the social and global determinants of health. (shrink)

A just social arrangement must guarantee a right to health care for all. This right should be understood as a positive right to basic human functional capabilities. The present article aims to delineate the right to health care as part of an account of distributive justice in health care in terms of the sufficiency of basic human functional capabilities. According to the proposed account, every individual currently living beneath the sufficiency threshold or in jeopardy of falling beneath the threshold has (...) a legitimate claim to justice. People's entitlements to health care should not be determined on the basis of brute luck and their efforts to maintain healthy lifestyles. The prioritization of competing claim-rights of individuals is guided by two allocation principles: number and benefit-size weighted sufficiency (among people beneath the threshold) and need-weighted utilitarianism (among people above the threshold). (shrink)

In December 2007 it was revealed that the British government is considering the exclusion of certain groups of migrants—those considered to be present “illegally”—from primary health care provided by the National Health Service. At present, practitioners have discretion to accept any individual for NHS treatment regardless of their status. A joint Home Office and Department of Health review is examining this access for foreign nationals, and the likely outcome is the restriction of access to irregular migrants, which would, according to (...) the Institute of Public Policy Research, affect around 390,000 people. In 2004 such groups were excluded from NHS secondary care, most controversially from treatment for HIV, and so the present proposal would bar them from all but emergency health treatment. (shrink)

In recent years more support has been given to the idea of Health Education and there are strong reasons for believing that such schemes of prevention may receive much more financial backing from governments. It is being realised, also, that many of our 'ills' may be attributed to an over-reliance on medical technology. There is reason to believe that in years to come the emphasis will be placed on the fostering of mental health in programmes of Health Education enabling the (...) individual to take a responsible attitude in learning how to seek out health hazards for himself without over-reliance on others. (shrink)

In the United States, amid the fractious politics of attempting to achieve something close to universal access to basic health care, two impressions are likely to feed skepticism about the status of a right to universal access: the moral principles that underlie any right to universal access may seem incredibly "ideal," not well rooted in the society's actual fabric, and the necessary practical and political attempts to limit the scope of universally accessible care to make its achievement realistic may seem (...) marked less by moral rhyme and reason than by the pull of conflicting interests. I try to directly dispel the first of these impressions and to obliquely question the second. The immense political barriers to .. (shrink)

: In The Morality of Freedom, Joseph Raz argues against a right to autonomy. This argument helps to distinguish his theory from his competitors'. For, many liberal theories ground such a right. Some even defend entirely autonomy-based accounts of rights. This paper suggests that Raz's argument against a right to autonomy raises an important dilemma for his larger theory. Unless his account of rights is limited in some way, Raz's argument applies against almost all (purported) rights, not just a right (...) to autonomy. But, on the traditional way of limiting accounts like his, Raz's account actually supports the conclusion that people have a right to autonomy. So, unless there is another way of limiting his account that does not have this consequence, Raz's argument against a right to autonomy does not go through. (shrink)

ABSTRACT Most of the world's health problems afflict poor countries and their poorest inhabitants. There are many reasons why so many people die of poverty‐related causes. One reason is that the poor cannot access many of the existing drugs and technologies they need. Another, is that little of the research and development (R&D) done on new drugs and technologies benefits the poor. There are several proposals on the table that might incentivize pharmaceutical companies to extend access to essential drugs and (...) technologies to the global poor.1 Still, the problem remains – the poor are suffering and dying from lack of access to essential medicines. So, it is worth considering a new alternative. This paper suggests rating pharmaceutical and biotechnology companies based on how some of their policies impact poor people's health. It argues that it might be possible to leverage a rating system to encourage companies to extend access to essential drugs and technologies to the poor. (shrink)

This paper considers the question ‘How should institutions enable people to meet their needs in situations where there is no guarantee that all needs can be met?’ After considering and rejecting several simple principles for meeting needs, it suggests a new effectiveness principle that 1) gives greater weight to the needs of the less well off and 2) gives weight to enabling a greater number of people to meet their needs. The effectiveness principle has some advantage over the main competitors (...) including a principle suggested by David Miller in Principles of Social Justice. Miller argues that his principle accounts for the existing data on individuals’ intuitions about meeting needs. The effectiveness principle better accounts for this data. Furthermore, this paper presents a new experiment on intuitions about meeting need that is consistent with the effectiveness principle but not Miller’s principle. (shrink)

Most of the world's health problems afflict poor countries and their poorest inhabitants. There are many reasons why so many people die of poverty-related causes. One reason is that the poor cannot access many of the existing drugs and technologies they need. Another, is that little of the research and development (R&D) done on new drugs and technologies benefits the poor. There are several proposals on the table that might incentivize pharmaceutical companies to extend access to essential drugs and technologies (...) to the global poor.1 Still, the problem remains – the poor are suffering and dying from lack of access to essential medicines. So, it is worth considering a new alternative. This paper suggests rating pharmaceutical and biotechnology companies based on how some of their policies impact poor people's health. It argues that it might be possible to leverage a rating system to encourage companies to extend access to essential drugs and technologies to the poor. (shrink)

All people have human rights and, intuitively, there is a close connection between human rights, needs, and autonomy. The two main theories about the natureand value of human rights often fail to account for this connection. Interest theories, on which rights protect individuals’ important interests, usually fail to capturethe close relationship between human rights and autonomy; autonomy is not constitutive of the interests human rights protect. Will theories, on which human rights protect individuals’ autonomy, cannot explain why the nonautonomous have (...) a human right to meet their needs. This paper argues that it is possible to account for the close connection between human rights, needs, and autonomy if human rights at least protect individuals’ ability to live minimally good lives. It argues that people need whatever will enable them to live such lives and autonomy is partly constitutive of such a life. This argument also has importantimplications for some other key debates in the human rights literature. (shrink)

The human right to health is crucial in the fight against global poverty. Health and an adequate standard of living are intimately connected. Poor health can make it difficult to overcome poverty, and poverty can make it difficult to attain good health. For the human right to health to be effective, however, it must have sufficient content to do the important normative work of rights. In the first part of this paper I give plausible arguments against the very existence of (...) a human right to health based on its lack of content and extend this to other social rights such as the right to adequate income, housing and education. In the second part of the paper I provide a defense of human social rights, including the human right to health, by arguing that these human rights, though abstract, have enough content to function as rights. (shrink)

This is a review article of Charles Beitz's 2009 book on the philosophy of human rights, The Idea of Human Rights. The article provides a charitable overview of the book's main arguments, but also raises some doubts about the depth of the distinction between Beitz's 'practical' approach to humans rights and its 'naturalistic' counterparts.

The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012.

Discussions concerning whether there is a natural right to health care may occur in various forms, resulting in policy recommendations for how to implement any such right in a given society. But health care policies may be judged by international standards including the UN Universal Declaration of Human Rights. The rights enumerated in the UDHR are grounded in traditions of moral theory, a philosophical analysis of which is necessary in order to adjudicate the value of specific policies designed to enshrine (...) rights such as a right to health care. We begin with an overview of the drafting of the UDHR and highlight the primary influence of natural law theory in validating the rights contained therein. We then provide an explication of natural law theory by reference to the writings of Thomas Aquinas, as well as elucidate the complementary “capabilities approach” of Martha Nussbaum. We conclude that a right to health care ought to be guaranteed by the state. (shrink)

Globalization, a process characterized by the growing interdependence of the world's people, impacts health systems and the social determinants of health in ways that are detrimental to health equity. In a world in which there are few countervailing normative and policy approaches to the dominant neoliberal regime underpinning globalization, the human rights paradigm constitutes a widely shared foundation for challenging globalization's effects. The substantive rights enumerated in human rights instruments include the right to the highest attainable level of physical and (...) mental health and others that are relevant to the determinants of health. The rights stipulated in these documents impose extensive legal obligations on states that have ratified these documents and confer health entitlements on their residents. Human rights norms have also inspired civil society efforts to improve access to essential medicines and medical services, particularly for HIV/AIDS. Nevertheless, many factors reduce the potential counterweight human rights might exert, including and specifically the nature of the human rights approach, weak political commitments to promoting and protecting health rights on the part of some states and their lack of institutional and economic resources to do so. Global economic markets and the relative power of global economic institutions are also shrinking national policy space. This article reviews the potential contributions and limitations of human rights to achieving greater equity in shaping the social determinants of health. (shrink)

Despite the prevalence of human rights discourse, the very idea or concept of a human right remains obscure. In particular, it is unclear what is supposed to be special or distinctive about human rights. In this paper, we consider two recent attempts to answer this challenge, James Griffin’s “personhood account” and Charles Beitz’s “practice-based account”, and argue that neither is entirely satisfactory. We then conclude with a suggestion for what a more adequate account might look like – what we call (...) the “structural pluralist account” of human rights. (shrink)

This fully revised and extended edition of James Nickel's classic study explains and defends the conception of human rights found in the Universal Declaration of Human Rights and subsequent human rights treaties. Combining philosophical, legal, and political approaches, Nickel addresses questions about what human rights are, what their content should be, and whether and how they can be justified.

This book is the first in-depth attempt to provide a moral assessment of the heart of the modern human rights enterprise: the system of international legal human rights.

Human rights have become one of the most important moral concepts in global political life over the last 60 years. Charles Beitz, one of the world's leading philosophers, offers a compelling new examination of the idea of a human right.

The face of the world is changing. The past century has seen the incredible growth of international institutions. How does the fact that the world is becoming more interconnected change institutions' duties to people beyond borders? Does globalization alone engender any ethical obligations? In Globalization and Global Justice, Nicole Hassoun addresses these questions and advances a new argument for the conclusion that there are significant obligations to the global poor. First, she argues that there are many coercive international institutions and (...) that these institutions must provide the means for their subjects to avoid severe poverty. Hassoun then considers the case for aid and trade, and concludes with a new proposal for fair trade in pharmaceuticals and biotechnology. Globalization and Global Justice will appeal to readers in philosophy, politics, economics and public policy. (shrink)

Given that there is a forceful case for thinking that the affluent are morally required to devote a substantial proportion of what they have to helping the poor, Garrett Cullity examines, refines and defends an argument of this form. He then identifies its limits.

From the late 1970s through the mid-1980s, a number of philosophers carefully worked out theories of justice in health care. Most of those still working on these issues have turned to clinical applications of the philosophical frameworks developed earlier. Although theories have not received much recent attention in this debate, this paper will offer a new theoretical framework for approaching issues of justice in health care. There are two reasons for thinking that returning to theory would be worth- while. One (...) concerns the fact that our society remains very far from realizing justice in health care. While there are several well-argued theories of just health care whose implementation would take us into the neighborhood of justice, it would also seem - in pluralistic spirit - that adding to the arsenal is helpful. The more good arguments there are for a given conclusion, the more likely it is to be correct and, ultimately, to persuade. -/- It will be contended that a limited right to health care can be grounded in self-respect. The argument will exploit Rawls' key insight that self-respect is a primary social good and will depend on the assumption that, at least in moderately affluent nations, one has a right to the primary social goods. This assumption is not defended here. But it should be noted that a right to the primary social goods is not of interest only to Rawlsians and other liberal deontologists; an enlightened utilitarianism might also vindicate it. The second reason for advocating a return to theory is that self-respect is especially fruitful as a focal concept for addressing issues of justice in health care (and other issues). (shrink)

In his groundbreaking article “Famine, Affluence, and Morality,” Peter Singer gave the following argument: Suffering and death from lack of food and shelter and medicine are bad. If we can do something to help prevent suffering and death from lack of food and shelter and medicine without sacrificing anything morally significant , then we should. So we should help prevent this suffering and death by giving foreign aid.