Gender, ‘race’, poverty, health and discourses of health reform in the context of globalization: a postcolonial feminist perspective in policy researchIn this paper, I draw on extant literature and my empirical work to discuss the impact of globalization and healthcare reform on the lives of women — those from countries of the South as well as of the North. First, I review briefly the economic hardships identified in different sectors of the population that have been attributed (...) to how globalization is now working. Second, I examine what these global processes mean for health, with particular focus on poverty, gender, racialization and health. Third, I reflect on how nurse scientists might develop research agendas in the 21st century that would foster social transformation and social justice for all people. The position taken here is not an indictment of globalization. Rather, I argue that globalization is a fact in all of our lives. There are positive aspects of globalization. There are also negative aspects which we must collectively address, given that the issues identified can have deleterious consequences for the world’s poor, women in particular. I suggest that, to construct knowledge for practice and praxis, research agendas of the future should be inclusive of subaltern voices. I argue that drawing on a postcolonial feminist epistemology might help us to define such agendas, and express the multilayered sociopolitical contexts of health and illness in advocacy with policy‐makers. (shrink)

The number and the scale of transboundary public health concerns are increasing. Infectious and non-communicable diseases, international trade in tobacco, alcohol, and other dangerous products as well as the control of the safety of health services, pharmaceuticals, and food are merely a few examples of contemporary transnationalization of health concerns. The rapid development and diffusion of scientific and technological developments across national borders are creating new realms of international health concern, such as aspects of biomedical (...) science, including human reproductive cloning, germ-line therapy, and xenotransplantation, as well as environmental health problems, including climate change, biodiversity loss, and depletion of the ozone layer. Growth in international trade and travel, in combination with population growth, has served to increase the frequency and intensity of health concerns bypassing or spilling over sovereign boundaries.Although health has traditionally been seen an area of limited multilateral cooperation, there is growing awareness that contemporary globalization has led to the proliferation of cross border determinants of health status and is undermining the capacity of nation states to protect health through domestic action alone. (shrink)

The number and the scale of transboundary public health concerns are increasing. Infectious and non-communicable diseases, international trade in tobacco, alcohol, and other dangerous products as well as the control of the safety of health services, pharmaceuticals, and food are merely a few examples of contemporary transnationalization of health concerns. The rapid development and diffusion of scientific and technological developments across national borders are creating new realms of international health concern, such as aspects of biomedical (...) science, including human reproductive cloning, germ-line therapy, and xenotransplantation, as well as environmental health problems, including climate change, biodiversity loss, and depletion of the ozone layer. Growth in international trade and travel, in combination with population growth, has served to increase the frequency and intensity of health concerns bypassing or spilling over sovereign boundaries.Although health has traditionally been seen an area of limited multilateral cooperation, there is growing awareness that contemporary globalization has led to the proliferation of cross border determinants of health status and is undermining the capacity of nation states to protect health through domestic action alone. (shrink)

Metaphors used to describe new technologies mediate public understanding of the innovations. Analyzing the linguistic, rhetorical, and affective aspects of these metaphors opens the range of issues available for bioethical scrutiny and increases public accountability. This article shows how such a multidisciplinary approach can be useful by looking at a set of texts about one issue, the use of a newly developed technique for genetic modification, CRISPRcas9.

One important aspect of globalization is the increasingly dense and influential regime of global rules that govern and shape interactions everywhere. Covering trade, investment, loans, patents, copyrights, trademarks, labor standards, environmental protection, use of seabed resources, production and marketing of weapons, maintenance of public security, and much else, these rules—structuring and enabling, permitting and constraining—have a profound impact on the lives of human beings and on the ecology of our planet. It is therefore important to think carefully, in moral (...) terms, about their design. (shrink)

The author of the article describes globalization processes as inevitable historic and objective phenomena, the driving force of society’s development and progress. It is emphasized that these processes result in harmful effects of global character on the environment and society. In the opinion of the author, one of the most important negative effects of globalization is the increase in environmental pollution which in turn results in the change of climate, extreme ecological situations, and threats to the natural environment (...) and human health. The author argues that one of the main legal instruments for limiting and neutralizing the harmful effect of pollution on the environment and society is the integrated system of environmental legal regulation. The author considers the safeguarding of the environmental objects and resources (climate atmosphere, soil and subsoil, water, air, biologic diversity, etc.) as the object of the legal regulation of the integrated environmental protection. What is more, the author of the article analyzes certain problematic aspects related to climate change and integrated prevention and control of climate pollution which are regulated under the new integrated institute of environmental protection under the environmental protection law. The author compares the provisions of international agreements, the European Union and Lithuanian legislation regarding these relations and concludes that Lithuania has not fully met its international obligations in this field. (shrink)

Studies concerning the relationship between religion and mental health have provided substantial evidence for the existence of a positive relationship. Nevertheless, it remains largely unclear which aspects of both religion and mental health take part in this relationship. The present study uses multiple measures of religion and of mental health to obtain a more refined view of this relationship. The results show the importance of distinguishing between if a person believes and how a person believes. Religious (...) persons who have a symbolic attitude towards religion scored higher on positive aspects of mental health. No significant results were found for negative mental health. (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)

_Philosophical Aspects of Globalization_ is a collection of essays by leading contemporary Russian philosophers and scholars concerned with addressing pressing questions of globalization and its impact from a philosophical point of view.

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

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

With growing globalization, the governments of many countries are tending to place a disproportionately large emphasis on economy, which often results in budget cuts in health, education and social welfare. Such a tendency has provoked arguments by many individuals concerned. The neo-conservatism represented by ex-US President Reagan and ex-UK Prime Minister Thatcher in the 1980s, known as Reaganomics and Thatcherism, caused public funds for health care and education to be substantially reduced. In developing countries a so-called structural (...) adjustment policy, promoted by the World Bank and the International Monetary Fund, is leading to shrinking budgets for health, education and social security in general. (shrink)

Affecting many spheres of social life, globalization also inevitably affects the functioning of higher education and the legal status of individuals who intend to apply for admission in a country other than the one where they completed a previous stage of their education. The paper considers selected legal aspects of the access to higher education in Poland, primarily in the context of the internationalization of education, and, thus, the internationalization of the recruitment procedure where individual candidates apply for (...) admission to study on the basis of documents authorizing them to pursue higher education in different legal systems. The background for the reflections is the normative content of the right to education and one of its guarantees, namely the principle of equal access to education – in Poland having the status of a constitutional norm. (shrink)

When clinical services aspire to quality improvement, creative and innovative approaches to old problems are needed to drive such change. Whilst new ef orts should be applauded, information on this topic can be somewhat grey from an ethical and research point of view. Within the mental health profession there is currently an expectation to routinely evaluate care and disseminate i ndings. The notion of service enhancements under the guise of routine practice is an interesting and untested ethical issue. Should (...) clinical innovation continue to enjoy such impunity as patient autonomy is often compromised as they are often compelled to accept treatment under the coercion of mental health legislation? We believe that it should not. All involvement in any form of research is voluntary, thus patients should also have the right to decline participation in quality projects if they wish to do so. (shrink)

“HTA is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused, and seek to achieve best value” (EUnetHTA 2007). Even though the assessment of ethical aspects of a health technology is listed as one of the objectives of a HTA process, (...) in practice, the integration of these dimensions into reports remains limited. The article is focused on four points: 1. the HTA concept; 2. the difficult HTA-ethics relationship; 3. the ethical issues in HTA; 4. the methods for integrating ethical analysis into HTA. (shrink)

In today’s globalized world, nations cannot be totally isolated from or indifferent to their neighbors, especially in regards to medicine and health. While globalization has brought prosperity to millions, disparities among nations and nationals are growing raising once again the question of justice. Similarly, while medicine has developed dramatically over the past few decades, health disparities at the global level are staggering. Seemingly, what our humanity could achieve in matters of scientific development is not justly distributed to (...) benefit everyone. In this paper, it will be argued that a global theoretical agreement on principles of justice may prove unattainable; however, a grass-roots change is warranted to change the current situation. The UNESCO Declaration on Bioethics and Human Rights will be considered as a starting point to achieve this change through extracting the main values embedded in its principles. These values, namely, respecting human dignity and tending to human vulnerability with a hospitable attitude, should then be revived in medical practice. Medical education will be one possible venue to achieve that, especially through role models. Future physicians will then become the fervent advocates for a global and just distribution of health care. (shrink)

The health care systems in Austria, Germany and Switzerland owe their institutional structure to different historical developments. While Austria and Germany voted for the Bismarck-Model of social health insurance,Switzerland adopted a voluntary system of health insurance. In all three countries, until very recently, the different challenges which the healthcare sector faced were met by piecemeal approaches and by stop and go policies, which, in the long run were not very successful either in containing costs or in improving (...) efficacy and efficiency. During the 1990 more fundamental reforms in the health care systems of all three countries took place. Germany and Switzerland chose the path of deregulation of the health insurance system, which consequently strengthened the competition between the insurance companies, and, to some extent between the suppliers of medical services. While this can be seen as an essential part of the reform process for these two countries, Austria favors a state-oriented and interventionist approach in order to meet the challenges. (shrink)

Globally, universities make use of peer physical examination in health professions students’ teaching of physical examination skills. PPE has many educational benefits, such as teaching normal anatomy and function, development of compassion and empathy, to feel what it is like to be examined from a patient’s perspective, improvement of communication skills, correcting errors in technique and improve confidence. The benefits for patients include protection from repeated examinations by unskilled students. The aim of the study was to investigate health (...) sciences students’ perceptions of the ethical aspects of PPE. A qualitative investigation, which included two focus group interviews with students and one with lecturers, was used for data collection. Most students and lecturers regarded PPE as beneficial, as it provides a safe environment for students in the health sciences to improve their clinical competence and confidence, without fear of embarrassment or failure. Students stated that PPE promoted the development of empathy with and respect for their patients. It was suggested that in a culturally diverse society, guidelines specifically related to religious customs and convictions should be provided to give students an indication of appropriate and acceptable behaviour towards fellow students when practising PPE. The use of PPE in the training of students in the health professions should support the ethical principles of Beauchamp and Childress, namely beneficence, non-maleficence, autonomy and justice/fairness. (shrink)

The emergence of religious fundamentalism in a globalized, post-colonial world poses a significant challenge to the "End of History" narratives common in academic and non-academic literature alike. Globalization, Modernity and the Rise of Religious Fundamentalismproposes that we must seek new explanations for this phenomenon that recasts the relationship between globalization, modernity and religion. One model through which this possible is that of a dialectical kaleidoscopic methodology - one that applies a variety of theoretical tools and takes a truly (...) multi-dimensional perspective. Through the overlapping and complementary approaches of Systems Theory, Field Theory, and Network Theory, this book redefined the concepts of globalization, modernity and religion itself by challenging the inherent misconceptions of ethnocentric biases. It also provides a thorough historical analysis of religious systems from antiquity to the present to show the integration of modern and archaic elements within the structure of religious fundamentalism. Interdisciplinary in nature, Globalization, Modernity and the Rise of Religious Fundamentalism will appeal to students and researchers interested in fields such as Geopolitics, History of Race and Ethnicity, Postcolonialism, Globalisation and Sociology of Religion. (shrink)

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)

This work resulted from a conference held in 2003 that was jointly sponsored by the Rockefeller Archive Center and Quinnipiac University. Drawing upon perspectives from history, philosophy, and the social sciences, as well as public health and medicine, the authors in this volume examine and critique the role of Foundations, most prominently the Rockefeller Foundation, in promoting and expanding the development of Western medicine around the world during the 20th century. The first half of the book examines the historical (...) involvement of philanthropic foundations in public heath, basic medical research, and related social and political issues. These studies range from an examination of the Rockefeller's Foundation's anti-malaria campaigns to the involvement of Foundations in promoting eugenic ideology and population control. The second half of the book considers current situations in which philanthropic foundations are active in promoting public health and westernized medicine, including consideration of the fight against AIDS in Africa, the resurgence of tuberculosis as a major public health threat, and the ongoing war against malaria. Finally, the book concludes with thoughts on the future of health, disease, and public health by Peter C. Goldmark, Jr., a former president of the Rockefeller Foundation. By considering issues of public health and health policy from a wide range of perspectives, this book seeks to contribute both to our understanding of the past successes and failures of growing dominance of Westernized medicine over global health, and to consider present and future possibilities for improving the delivery of health services to the population of the world. (shrink)

Kontekst globalnog stanja stvari ukazujuci na potrebu za razlikovanjem koncepta globalizacije kao opisa stanja i kao politickog projekta. Ovo razlikovanje predstavlja okvir ispitivanja fenomena globalizacije u kome treba da se uvidi njen uticaj na konkretne ljude u konkretnoj situaciji. U tekstu se takodje utvrdjuje znacaj koncepata u posvudasnjoj transformaciji ljudskih zivota. Tako se preko dominantnih koncepata odvija uticaj jedne kulture koja se simbolicki i normativno namece kao 'globalna' premda je 'lokalna' ne samo (i/ili ne vise) teritorijalno, vec po svom materijalistickom (...) pristupu vrednostima. Zato horizontalna komunikacija (globalno omogucena pojavom Interneta) moze da sluzi saopstavanju vrednosti kao uporisnih tacaka duha. Ona moze da doprinese, ne samo sirenju kulturnih krugova, nego i evoluciji svesti da uopstavanje vrednosti do univerzalnosti zahteva transcendiranje partikularnih interesa koji sprecavaju delotvornu konceptualizaciju globalnog antropoloskog smisla. (shrink)

Contemporary processes of globalization have been accompanied by a serious deterioration in the health of many women across the world. Particularly disturbing is the drastic decline in the health status of many women in the global South, as well as some women in the global North. This paper argues that the health vulnerability of women in the global South is inseparable from their political and economic vulnerability. More specifically, it links the deteriorating health of many (...) Southern women with the neo-liberal economic policies that characterize contemporary economic globalization and argues that this structure is sustained by the heavy burden of debt repayments imposed on many Southern countries. In conclusion, it argues that many Southern debt obligations are not morally binding because they are not democratically legitimate. (shrink)

Der Kinder- und Jugendgesundheitssurvey soll repräsentative, gültige Daten und Erkenntnisse zur gesundheitlichen Situation von Kindern und Jugendlichen in Deutschland als entscheidende Voraussetzung für die Bewertung und die Verbesserung von deren gesundheitlicher Lage schaffen. Forschung und insbesondere Blutentnahmen an nichteinwilligungsfähigen Personen erfordern eine profunde ethische und rechtliche Überprüfung. Der Beitrag befasst sich damit, welche medizinethischen Empfehlungen und welche rechtlichen Grundsätze in Deutschland für die Bewertung relevant sind. Nach geltendem deutschen Recht können Eltern zu Blutentnahmen bei ihren Kindern nur zustimmen, wenn diese (...) in deren individuellem gesundheitlichen Interesse liegen. Ein „gruppenspezifischer Nutzen“, wie er von Medizinethikern national und international als Voraussetzung für ethische Akzeptabilität (bei minimalem Risiko der Untersuchungen) ebenfalls für sinnvoll und wichtig angesehen wird, und der in dem geplanten Survey in jedem Falle gegeben wäre, genügt deutschen Rechtsansprüchen nicht. Im Pretest hat sich der potenzielle individuelle Nutzen der Blutentnahmen bestätigt: Viele Kinder hatten biochemisch nachweisbare Gesundheitsrisiken (z. B. verborgener Nährstoffmangel, allergische Sensibilisierung, Hinweise auf Impflücken oder langfristige Gesundheitsrisiken), die ohne Blutuntersuchung nicht feststellbar gewesen wären. Bei über 90% der Kinder waren nach schriftlicher Einwilligung der Eltern und Jugendlichen sowie informeller Zustimmung der Kinder, die in jedem einzelnen Falle berücksichtigt wurde, Blutentnahmen möglich. Nach der Befragung einer Unterstichprobe ist die Akzeptanz insgesamt gut. (shrink)

Der Kinder- und Jugendgesundheitssurvey soll repräsentative, gültige Daten und Erkenntnisse zur gesundheitlichen Situation von Kindern und Jugendlichen in Deutschland als entscheidende Voraussetzung für die Bewertung und die Verbesserung von deren gesundheitlicher Lage schaffen. Forschung und insbesondere Blutentnahmen an nichteinwilligungsfähigen Personen erfordern eine profunde ethische und rechtliche Überprüfung. Der Beitrag befasst sich damit, welche medizinethischen Empfehlungen und welche rechtlichen Grundsätze in Deutschland für die Bewertung relevant sind. Nach geltendem deutschen Recht können Eltern zu Blutentnahmen bei ihren Kindern nur zustimmen, wenn diese (...) in deren individuellem gesundheitlichen Interesse liegen. Ein „gruppenspezifischer Nutzen“, wie er von Medizinethikern national und international als Voraussetzung für ethische Akzeptabilität (bei minimalem Risiko der Untersuchungen) ebenfalls für sinnvoll und wichtig angesehen wird, und der in dem geplanten Survey in jedem Falle gegeben wäre, genügt deutschen Rechtsansprüchen nicht. Im Pretest hat sich der potenzielle individuelle Nutzen der Blutentnahmen bestätigt: Viele Kinder hatten biochemisch nachweisbare Gesundheitsrisiken (z. B. verborgener Nährstoffmangel, allergische Sensibilisierung, Hinweise auf Impflücken oder langfristige Gesundheitsrisiken), die ohne Blutuntersuchung nicht feststellbar gewesen wären. Bei über 90% der Kinder waren nach schriftlicher Einwilligung der Eltern und Jugendlichen sowie informeller Zustimmung der Kinder, die in jedem einzelnen Falle berücksichtigt wurde, Blutentnahmen möglich. Nach der Befragung einer Unterstichprobe ist die Akzeptanz insgesamt gut. (shrink)

This book measures the current institutional and political realities surrounding globalization against philosophical ideals.