In this paper, I explore one way to bring bioethics and environmental ethics closer together. I focus on a question at the interface of health, sustainability, and justice: How well does a society promote health with the use of no more than a just share of environmental capacity? To address this question, I propose and discuss a mode of assessment that combines a measurement of population health, an estimate of environmental sustainability, and an assumption about what constitutes a fair or (...) just share. This mode of assessment provides an estimate of the just and sustainable life expectancy of a population. It could be used to monitor how well a particular society promotes health within just environmental limits. It could also serve as a source of information that stakeholders use when they deliberate about programs, policies, and technologies. The purpose of this work is to focus attention on an ethical task: the need to fashion institutions and forms of life that promote health in ways that recognize the claims of sustainability and justice. (shrink)

: When health care workers migrate from poor countries to rich countries, they are exercising an important human right and helping rich countries fulfill obligations of social justice. They are also, however, creating problems of social justice in the countries they leave. Solving these problems requires balancing social needs against individual rights and studying the relationship of social justice to international justice.

Perhaps the greatest determinant of individual and societal welfare is who raises children and with what degree of discretion. Philosophers have endeavored in myriad ways to provide normative justification for ascribing a right to be a legal parent and to possess particular legal powers as a parent. This Article shows why they fail and offers an alternative theoretical framework for delimiting parental rights. The prevailing tendency in philosophical writing on the topic is to begin with observations and intuitions specific to (...) parent-child relationships. Against that tendency, this Article demonstrates the need to begin with principles at a high level of generality, covering a broad range of human relationships. This yields a much more limited moral right in connection with parenthood than do accounts that fail to generalize. (shrink)

Last year, I flew to two bioethics conferences, one in Europe and one in North America. These were good things to do, or so I thought. But I worry that flying and other activities are contributing to climate changes that will affect the health of vulnerable people, the life prospects of future generations, and the balance of the natural world. Thus, in this paper, I consider how I should respond. To begin, I describe briefly how climate change will impact human (...) health. Then I note how climate change raises issues about justice. But I focus on issues about moral responsibility and responsiveness. (shrink)

Last year I flew to two bioethics conferences, one in Europe and one in North America. I also flew to Taiwan to teach abroad for a year. These were good things to do, or so I thought. I contributed to educational events, learned more about bioethics, and visited with friends and colleagues. But I worry that flying and other activities in my life are contributing to climate changes that will affect the health of vulnerable people, the life prospects of future (...) generations, and the balance of the natural world.I sometimes imagine a dialogue with a young person, twenty years from now, when the climate crisis is much worse.What were you people in bioethics thinking? You flew to conferences all over the world, emitting .. (shrink)

In Australia, Japan, Sweden, and Switzerland, the average life expectancy is now greater than 80 years. But in Angola, Malawi, Sierra Leone, and Zimbabwe, the average life expectancy is less than 40 years. The situation is even worse than these statistics suggest because average figures tend to mask inequalities within countries. What are we to make of a world with such unequal health prospects? What does justice demand in terms of global health? To address these questions, I characterize justice at (...) the local level, at the domestic or social level, and at the international or global level. Because social conditions, structures, and institutions have such a profound influence on the health of populations, I begin by focusing attention on the relationship between social justice and health prospects. Then I go on to discuss health prospects and the problem of global justice. Here I distinguish two views: a cosmopolitan view and a political view of global justice. In my account of global justice, I modify and use the political view that John Rawls developed in The Law of Peoples. I try to show why an adequate political account must include three duties: a duty not to harm, a duty to reconstruct international arrangements, and a duty to assist. (shrink)

Are children of equal, lesser, or perhaps even greater moral importance than adults? This work of applied moral philosophy develops a comprehensive account of how adults as moral agents ascribe moral status to beings - ourselves and others - and on the basis of that account identifies multiple criteria for having moral status. It argues that proper application of those criteria should lead us to treat children as of greater moral importance than adults. This conclusion presents a basis for critiquing (...) existing social practices, many of which implicitly presuppose that children occupy an inferior status, and for suggesting how government policy, law, and social life might be different if it reflected an assumption that children are actually of superior status. (shrink)

When Van Rensselaer Potter coined the English word “bioethics”, he envisioned a field that would bring together biological understanding and ethical values to address global environmental problems. Following Potter’s broad vision of bioethics, I explore ethical ideas that we need to address climate change. However, I develop and emphasize ideas about justice and responsibility in ways that Potter did not. At key points, I contrast the ideas that I develop with those in Potter’s work, but I try to avoid scholarly (...) debates and stay focused on the practical task: developing ideas to help us address climate change. To begin, I describe the problem of climate change. Then I show how it raises deep and serious issues of justice. Since the issues of justice are relatively clear and compelling, I proceed to focus attention on issues of responsibility – on why and how to respond to the structural injustices of climate change. I also note how my emphasis on justice and responsibility raises two new issues. To conclude, I mention the role of ecological citizens in bringing about social change. (shrink)

This Article critiques the debate over the nature of rights on the grounds that theorists have failed to specify and defend an ultimate aim, predominantly deployed a standard of success–ext...

Do societies have an ethical responsibility to care for and about the health of undocumented migrants? Some people claim that societies have no responsibility to care for undocumented migrants because these migrants have no legal right to be in the country. But this view tends to ignore ethical responsibilities that are independent of legal status. Other people claim that all human beings, in virtue of their dignity and status as human beings, have a right to the highest standard of health. (...) But this view tends to ignore ethical responsibilities that arise out of relationships between a society and the undocumented migrants who are living and working in that society. In this article, I take a different approach. In the case of undocumented workers, I try to show how these workers are used in the economy and why a widely accepted pattern of responsibility should be extended to them. In the case of undocumented young people, I try to show how these people are socialized in a society and why a widely accepted pattern of responsibility should be extended to them. Toward the end of this article, I reflect on the nature and limits of these arguments. (shrink)

Pierre Hadot has discussed the deep connections between ancient Western philosophy and spiritual exercises. The author appreciates these connections, but he explains why he explored a different path. He began to write haiku as a form of spiritual practice. He wanted to use these short verses to become more mindful, present, and responsive – in his life and in his work in bioethics. After comparing traditional haiku and modern haiku, the author gives some examples from classical sources. Then he considers (...) how reading and writing haiku might help bioethics to focus less on deliberation and choice, and more on attention and perception. Haiku might help bioethics to attend to the contexts, life conditions, and lifeworlds that shape and situate people’s lives. These short poems might even illuminate some of the backgrounds and existential grounds of ethical life. At the end, the author presents some haiku that he wrote about modern life, young children, older adults, illness, medicine, and death. (shrink)

This short story raises ethical issues about a woman’s request for medical assistance to get pregnant. In this fictional account, a 34-year-old woman has been trying to get pregnant for the last year. Her husband would like to keep trying for one more year, but the woman loses patience. She visits an ob-gyn and requests artificial insemination. She does not intend to tell her husband about this medical assistance. The doctor has helped single women, lesbian couples, and married couples with (...) pregnancies, but he feels conflicted by this request. The doctor and the woman discuss their concerns and plans. Then they decide on a course of action. In a creative way, this story aims to bring to life ethical issues about assisted reproduction, complex relationships, individual choice, non- judgmental attitudes, deception, confidentiality, genetic connections, and social parents. But this story is not a textbook case that illustrates a clearly defined ethical issue. On the contrary, the story shows that some common ethical ideas don’t quite fit the characters’ experiences and the readers’ reactions. (shrink)