Social factors have a powerful influence on human health and longevity. Yet the social dimensions of health are often obscured in public discussions due to the overwhelming focus in health policy on medical care, individual-level risk factor research, and changing individual behaviours. Likewise, in philosophical approaches to health and social justice, the debates have largely focused on rationing problems in health care and on personal responsibility. However, a range of events over the past two decades such as the study of (...) modern famines, the global experience of HIV/AIDS, the international women’s health movement, and the flourishing of social epidemiological research have drawn attention to the robust relationship between health and broad social arrangements. In Health Justice, Sridhar Venkatapuram takes up the problem of identifying what claims individuals have in regard to their health in modern societies and the globalized world. Recognizing the social bases of health and longevity, Venkatapuram extends the ‘Capabilities Approach’ of Amartya Sen and Martha Nussbaum into the domain of health and health sciences. In so doing, he formulates an inter-disciplinary argument that draws on the natural and social sciences as well as debates around social justice to argue for every human being’s moral entitlement to a capability to be healthy. An ambitious integration of the health sciences and the Capabilities Approach, Health Justice aims to provide a concrete ethical grounding for the human right to health, while advancing the field of health policy and placing health at the centre of social justice theory. With a foreword by Sir Michael Marmot, chair of the WHO Commission on the Social Determinants of Health. (shrink)

This essay reads John Locke’s Two Treatises through its nonhuman animal presences, especially the emblematic figures of cattle and “noxious creatures” like “lyons,” “tygers,” and wolves. It argues that the real ground of Lockean human equality is an ongoing practice of subjugating nonhuman animals, and not any attribute of the human species as such. More specifically, the Lockean social compact founded on this equality relies on a “dominion covenant,” an existential “agreement” in which God lends the power of dominion to (...) man and any threats to this order require punishment. This dynamic enables violence toward humans, in the name of their humanity, if they do not properly exert their power of dominion. Critics have connected Locke’s theory of property to indigenous dispossession and his theory of punishment to carceral systems; both processes, I argue, intimately rely on the dominion covenant. Lockean racism is the fulfillment of, and not a deviation from, his account of human equality. (shrink)

The final report of the WHO's Commission on the Social Determinants of Health is the first to apply social epidemiological analysis to global health.

Bréhier revives the possibility of Indian Upaniṣadic influence on Plotinus, specifically in the area of mysticism – asking what in Plotinus’ philosophy is foreign with respect to the Greek philosophical tradition. After Bréhier there are vigorous defenses of Plotinus’ Greek origins – not all of which respond directly to the key issues he raises, or address Plotinus’ mysticism specifically. My purpose in this paper is not to answer Bréhier, but to revisit him, for the purpose of delineating paradigmatic differences between (...) Plotinus’ metaphysics and that in Advaita Vedānta. Starting with differences in their respective texts and conceptions of the Divine, I explore concrete concepts (Māyā, tolma, the forms, gun․as, etc.), so unique to each tradition that they comprise the heart and essence of their differences. I assert as well that their metaphysical distinctions imply dissimilarities in their modes of mysticism. In this effort I uphold numinous experience above historical influences. This paper therefore has four parts: (1) Revisiting Bréhier, Armstrong, and Others; (2) Defining Terms: Texts, Methods, and Conceptions of the Divine (Striking Similarities); (3) Contrasting Advaita Vedānta and the Enneads (Paradigmatic Differences); and (4) Conclusion. (shrink)

The Routledge Handbook of the Philosophy of Public Health is an outstanding reference source to this exciting subject and the first collection of its kind. Comprising over forty chapters by a team of international contributors the handbook covers the following central topics: What is global health?; methodology in public health science; social determinants and health equity; politics and economics; health policy and law; globalization; macroeconomics; securitization; and specific public health challenges such as obesity, cancer, alcohol, tobacco and infectious diseases. Essential (...) reading for students and researchers in political philosophy, bioethics, public health ethics and the philosophy of medicine the handbook will also be very useful for those in related fields, such public health professionals and epidemiologists. (shrink)

Objective To determine the knowledge and attitudes of healthcare personnel regarding the provision of non-beneficial futile care in the intensive care units at the major public hospitals in Trinidad and Tobago. Method Prospective data collection was done using a questionnaire administered to the medical and nursing staff of the intensive care units. The questionnaire was designed to capture the opinions regarding the futile care offered to terminally ill patients at the intensive care units. The responses were based on a five-point (...) Likert scale. The influence of factors such as age, gender, duration of work experience, religious belief, ethnicity, occupational category and educational status on the responses were analysed. Results A total of 274 completed responses were obtained from doctors and nurses. The frequency with which the respondents encountered ethical or legal problems in the intensive care unit varied widely from ‘daily’ to ‘yearly’. The majority felt that knowledge of ethics is important, and only 32% knew the legal issues pertaining to their work. Eighty percent of doctors and nurses had no knowledge of an existing Hospital Ethics Committee and its role in ethical dilemmas. Although 62% said their decisions regarding futile care will be influenced by their scientific knowledge, only 32% agreed to withdraw care. Eighty percent said that the government should pass appropriate laws regarding withdrawal of futile care. Conclusions Most healthcare providers in intensive care unit are not knowledgeable in the ethical and legal issues of non-beneficial futile care. There is a need to devise means to bring awareness and educate intensive care unit healthcare providers in this subject. (shrink)

Philosophers who study care—most often, care ethicists—are involved in an ongoing discussion about the concept of care. Despite the significant progress made in this discussion, certain conflicting images of care seem to persist in the literature. On one hand, as feminist theorists across disciplines have highlighted, care is a complex social practice that is mired in inequality and injustice. The deeply gendered nature of caring and the unequal division of care-work creates and cements structural inequalities. On the other hand, care (...) is also thought of as a moral value or an ideal. The ethics of care—a moral theory with decidedly feminist roots—is predicated on the idea that caring is somehow morally valuable. A discrepancy thus arises: care is a social practice that compounds injustices. But it is also a moral value. What is it about care that makes it malleable to such variations? To pick out this complexity and capture the conceptual nuances at play, this paper suggests that we frame the concept of care as a thick ethical concept. I will first demonstrate why this framing is helpful. Then, I will provide accounts of the descriptive and evaluative elements of the concept of care. I hope to show that it is through a thick conceptual framing that we can make sense of care—both as a complex social practice and an important moral value in the worlds that we inhabit. (shrink)

How does one give voice to the unspeakable, inhuman violence that shapes the present, and what remains of humanity in its wake? Adriana Cavarero offers an answer that roots human speech in embodied vulnerability, in contrast to philosophical emphases on disembodied rationality. In the face of what she calls horrorism, which puts humans in proximity to animality, she calls for resuscitating vocality, and therefore humanity, from loss. This article reads Kafka’s short story “A Report to an Academy” – which structurally (...) resembles a slave narrative and concerns a kidnapped ape who learns to speak – to extend Cavarero’s emphasis on vulnerability while challenging her humanism. In Kafka, modern horror’s locus is not animality but the abstract human, and it projects the unstable distinction between voice and noise onto blackened humans and nonhuman animals. (shrink)

I argue for a conception of health as a person's ability to achieve or exercise a cluster of basic human activities. These basic activities are in turn specified through free-standing ethical reasoning about what constitutes a minimal conception of a human life with equal human dignity in the modern world. I arrive at this conception of health by closely following and modifying Lennart Nordenfelt's theory of health which presents health as the ability to achieve vital goals. Despite its strengths I (...) transform Nordenfelt's argument in order to overcome three significant drawbacks. Nordenfelt makes vital goals relative to each community or context and significantly reflective of personal preferences. By doing so, Nordenfelt's conception of health faces problems with both socially relative concepts of health and subjectively defined wellbeing. Moreover, Nordenfelt does not ever explicitly specify a set of vital goals. The theory of health advanced here replaces Nordenfelt's (seemingly) empty set of preferences and society-relative vital goals with a human species-wide conception of basic vital goals, or ‘central human capabilities and functionings’. These central human capabilities come out of the capabilities approach (CA) now familiar in political philosophy and economics, and particularly reflect the work of Martha Nussbaum. As a result, the health of an individual should be understood as the ability to achieve a basic cluster of beings and doings—or having the overarching capability, a meta-capability, to achieve a set of central or vital inter-related capabilities and functionings. (shrink)

Drawing from the Boulding''s (1956) framework for general systems theory, the need to employ richer paradigm in the study of organizations (Pondy and Mitroff, 1979) is reiterated. It is argued that a better understanding of organizational ethical behavior is contingent upon viewing organizations as symbol processing systems of shared language and meanings. Further, it is proposed that organizations, like individuals, develop into collectivities of shared cognitions and rationale, over a period of time. The study adapts Kohlberg''s (1983) model of moral (...) development to examine if organizations can be viewed as passing through different stages of moral development depending on the type of moral reasoning employed to explain their behaviors in the face of ethical crises. Several cases raising questions about the ethics of corporate behavior were researched. An instrument entitled Organization Response Analysis was constructed using statements made by various spokespersons representing five of these organizations. The instrument was administered to 246 graduate and undergraduate students of business (N = 246). Results indicated a great degree of concurrence among respondents of differing genders, levels of education and work experience in determining the stages of moral development of organizations. Limitations of the current study and implications for future research and practice are discussed. (shrink)

The present article identifies how social determinants of health raise two categories of philosophical problems that also fall within the smaller domain of ethics; one set pertains to the philosophy of epidemiology, and the second set pertains to the philosophy of health and social justice. After reviewing these two categories of ethical concerns, the limited conclusion made is that identifying and responding to social determinants of health requires inter-disciplinary reasoning across epidemiology and philosophy. For the reasoning used in epidemiology to (...) be sound, for its scope and (moral) purpose as a science to be clarified as well as for social justice theory to be relevant and coherent, epidemiology and philosophy need to forge a meaningful exchange of ideas that happens in both directions. (shrink)

This theoretical paper argues for prioritarianism as an ethical underpinning for digital health in contexts of extreme disadvantage. In support of this claim, the paper develops three prioritarian principles for making ethical decisions for digital health programme design, grounded in the normative position that the greater the need, the stronger the moral claim. The principles are positioned as an alternative view to the prevailing utilitarian approach to digital health, which the paper argues is not sufficient to address the needs of (...) the worst off. As researchers of digital health, we must ensure that the most globally marginalised are not overlooked by overtly technocentric implementation practices. Consequently, the paper concludes by advocating for use of the three principles to support stronger critical reflection on the ethics involved in the design and implementation of digital health programmes. (shrink)

Very few studies have looked upon the construct of workplace spirituality in sales organization context. This paper integrates workplace spirituality with sales literature. The paper points out that self-interest transcendence is a common aspect in the workplace spirituality concept which emerged a decade ago and in most of the relationship-oriented selling characteristics—customer orientation, adaptability, service orientation, and ethical selling behavior. Based on the common aspect of self-interest transcendence, we propose that workplace spirituality could be a causal precursor to relationship-oriented selling (...) characteristics. We present guidelines for future research, implications for practice and a few potential downsides of workplace spirituality in sales organization. (shrink)

Spirituality is a hot topic of research in recent times in management arena. Though the organizational researchers have intensely started exploring this area, the studies related to selling organizations are few, and fewer are the studies related to selling organizations with individual as the unit of theory. The present study explores the relationship between ‘individual spirituality at work’ and sales professionals’ ‘job satisfaction’, ‘propensity to leave’ and ‘job commitment’. This work focuses on sales professionals across various industries. A cross-sectional survey (...) method is adopted. Correlation analysis is done to reveal the hypothesized relationships. The results reveal that sales professionals’ spirituality at work is positively related to job satisfaction and job commitment, and negatively related to propensity to leave. The results provide the relevance of spirituality at work to salespeople. The selling organizations can also utilize the information and promote the individual expression of spirituality at work. (shrink)

The article discusses two areas at the intersection of social determinants of health research and social justice theory. The first section examines the affinity between social epidemiology and the capabilities approach. The second section examines how social epidemiology's expansion of the scope of the causal chain and determinants raises questions about epistemology and ontology in epidemiology as well as the field's link to the moral concern for human health.

Dr Devi Sridhar, Department of Politics and International relations, University of Oxford, All Souls College, High St, OX1 4AL UK, Email: devi.sridhar{at}politics.ox.ac.uk ' + u + '@' + d + ' '//--> Abstract This paper discusses the politics of access to essential medicines and identifies ‘space’ in the current system where health concerns can be strengthened relative to trade. This issue is addressed from a global governance perspective focusing on the main actors who can have the greatest impact. (...) These include developing country coalitions and citizens in developed countries though participation in civil society organisations. These actors have combined forces to tackle this issue successfully, resulting in the 2001 Doha Declaration on Public Health. The collaboration has been so powerful due to the assistance of the media as well as the decision to compromise with pharmaceutical companies and their host countries. To improve access to essential medicines, six C's are needed: coalitions, civil society, citizenship, compromise, communication and collaboration. CiteULike Connotea Del.icio.us What's this? (shrink)

Commentary on Pratt, B., and A. A. Hyder. 2016. Governance of transnational global health research consortia and health equity.

We argue that the inference of CP violation in experiments involving the K0-K0 system in weak interactions of particle physics is facilitated by the assumption of particle trajectories for the decaying particles and the decay products. A consistent explanation in terms of such trajectories is naturally incorporated within the Bohmian interpretation of quantum mechanics.

Embryonic stem cells are derived from the preimplantation embryo and can differentiate into virtually any other cell type, which is governed by lineage specific transcriptions factors binding to cis regulatory elements to mediate changes in gene expression. The reliance on transcriptional regulation to maintain pluripotency makes ESCs a valuable model to study the role of distal CREs such as enhancers in modulating gene expression to affect cell fate decisions. This review will highlight recent advance on transcriptional enhancers, focusing on studies (...) performed in ESCs. In addition, we argue that the Nanog locus, which encodes for an ESC-critical TF, is particularly informative because it contains multiple co-regulated genes and enhancers in close proximity to one another. The unique landscape at Nanog permits the study of ongoing questions including whether multiple enhancers function additively versus synergistically, determinants of gene specificity, and cell-to-cell variability in gene expression. Nanog encodes a transcription factor required to maintain ESC pluripotency. The Nanog locus is an ideal model to study enhancers because it contains multiple highly potent super-enhancers within a small region. Nanog and three super-enhancers are in close physical proximity but only two SEs are required for Nanog expression. (shrink)

The COVID-19 pandemic is affecting countries across the globe. Only a globally coordinated response, however, will enable the containment of the virus. Responding to a request from policy makers for ethics input for a global resource pledging event as a starting point, this paper outlines normative and procedural principles to inform a coordinated global coronavirus response. Highlighting global connections and specific vulnerabilities from the pandemic, and proposing standards for reasonable and accountable decision-making, the ambition of the paper is two-fold: to (...) raise awareness for the justice dimensions in the global response, and to argue for moving health from the periphery to the centre of philosophical debates about social and global justice. (shrink)

Abstract The purpose of this paper is to empirically analyse the developmental stages of non-financial reporting in corporations, by interpreting the views of interviewees from major ethical corporations on the six major dimensions of non-financial reporting (identified in the literature) within each stage of the five-stage model of non-financial reporting (developed in this paper). This study is part of a series of papers on Triple Bottom Line reporting (TBL), and its relevance to corporate reporting practices. The TBL is perhaps the (...) pioneer for getting corporations thinking about non-financial reporting. While literature has been done extensively on the TBL framework, empirical data linking TBL and how it has helped, or even hindered corporations progressing through different stages in their non-financial reporting processes is missing. In order to facilitate this analysis, 40 interviews were conducted over 1 year, with 40 corporations selected from various sustainability indexes, focusing on corporations that adopt best practices in this area, and also have a TBL approach to non-financial reporting. The results of the analysis show that TBL certainly got corporations started in the journey of non-financial reporting but has not pushed them far enough to develop a more integrated approach to reporting nor clearly aligning their non-financial reporting performance with their financial performance and business strategy. Content Type Journal Article Category Original Paper Pages 1-33 DOI 10.1007/s13520-011-0010-4 Authors Kaushik Sridhar, Macquarie Graduate School of Management, Macquarie University, Sydney, Australia Journal Asian Journal of Business Ethics Online ISSN 2210-6731 Print ISSN 2210-6723. (shrink)

Situating medical and scientific research within a framework or theory of social justice is long overdue. Attempting to extend principles of research ethics beyond the clinic and lab to other affected people or consequences tolerates or obfuscates injustice. While it must be done, the timescales, methodologies, and commitment to real-world impact are quite different in research ethics versus political philosophy.

This essay identifies three insights about global equity and justice in light of the COVID pandemic. It discusses the need for greater recognition of the role of the global order in the distributio...

"In comparison to medicine, the professional field of public health is far less familiar. What is public health, and perhaps as importantly, what should public health be or become? How do causal concepts shape the public health agenda? How do study designs either promote or demote the environmental causal factors or health inequalities? How is risk understood, expressed, and communicated? Who is public health research centered on? How can we develop technologies so the benefits are more fairly distributed? Do people (...) have a right to public health? How should we integrate ethics into public health practice? The Routledge Handbook of Philosophy of Public Health addresses these questions and more, and is the first collection of its kind. Comprising twenty-six chapters by an international and interdisciplinary team of contributors, the handbook is divided into four clear parts: Concepts and Distinctions Reasons and Actions Distribution and Inequalities Rights and Duties. The Routledge Handbook of Philosophy of Public Health is a field-defining and sustained reflection on the various ethical, political, methodological and conceptual aspects of global public health. As such it is an essential reference source for students and scholars working in political philosophy, bioethics, public health ethics, and the philosophy of medicine, as well as for professionals and researchers in related fields such public health and epidemiology"--. (shrink)

This paper outlines seven challenges in development assistance for health, which in the current financial context, have become even more important to address. These include the following: (1) the proliferation of initiatives, focusing on specific diseases or issues, as well as (2) the lack of attention given to reforming the existing focal health institutions, the WHO and World Bank. (3) The lack of accountability of donors and their influence on priority-setting are part of the reason that there is “initiavitis,” and (...) resistance to creating a strong UN system. (4) Other than absolute quantity of aid, three other challenges linked to donors relate to the quality of aid financing particularly the pragmatic difficulties of financing horizontal interventions, (5) the marginal involvement of developing country governments as aid recipients, and (6) the heavy reliance on Northern-based organizations as managers of funds. (7) The final challenge discussed focuses on two unintended consequences of the recent linking of health and foreign policy for international development assistance. The paper then provides three suggestions for ways forward: creating new mechanisms to hold donors to account, developing national plans and strengthening national leadership in health, and South-South collaboration. (shrink)

Over the past 20 years, international development assistance for health has increased, albeit for some diseases more than others. However, the triple crises of food, fuel, and finance have raised questions regarding whether aid flows will continue to increase, or even be maintained in the coming future. Health and education are often the first victims of budget cuts in times of limited funding and competing priorities as they are viewed to be in the realm of “low politics” as opposed to (...) security and military spending, which are seen as “high politics.” Cuts in overseas development aid will have a drastic impact on countries where external funding makes up a significant proportion of national health budgets. Although global health aid accounts for only 0.3% of total expenditures on health globally, in some countries like the Solomon Islands and Mozambique, for example, 82% and 66% of the national health budgets respectively come from external resources. WHO estimates that 23 countries have over 30% of their total health expenditures funded by donors. (shrink)

Copyright © 2015 by the Society of Criti. Objective: Global lung stress varies considerably with low tidal volume ventilation for acute respiratory distress syndrome. High stress despite low tidal volumes may worsen lung injury and increase risk of death. No widely available parameter exists to assess global lung stress. We aimed to determine whether the volume delivered during a recruitment maneuver is inversely associated with lung stress and mortality in acute respiratory distress syndrome. Design: Substudy of an acute respiratory distress (...) syndrome clinical trial on esophageal pressure-guided positive end-expiratory pressure titration. Setting: U.S. academic medical center. Patients: Forty-two patients with acute respiratory distress syndrome in whom airflow, airway pressure, and esophageal pressure were recorded during the recruitment maneuver. Interventions: A single recruitment maneuver was performed before initiating protocol-directed ventilator management. Recruitment maneuvers consisted of a 30-second breath hold at 40 cm H2O airway pressure under heavy sedation or paralysis. VRM was calculated by integrating the flow-time waveform during the maneuver. End-inspiratory stress was defined as the transpulmonary pressure during end-inspiratory pause of a tidal breath and tidal stress as the transpulmonary pressure difference between end-inspiratory and end-expiratory pauses. Measurements and Main Results: VRM ranged between 7.4 and 34.7 mL/kg predicted body weight. Lower VRM predicted high end-inspiratory and tidal lung stress. After adjusting for Pao2/Fio2 and either driving pressure, tidal volume, or plateau pressure and positive end-expiratory pressure, VRM remained independently associated with both end-inspiratory and tidal stress. In unadjusted analysis, low VRM predicted increased risk of death. VRM remained significantly associated with mortality after adjusting for study arm. Conclusions: Low VRM independently predicts high lung stress and may predict risk of death in patients with acute respiratory distress syndrome. (shrink)

M. K. Gandhi's a series of talks delivered to ashramites at Sabarmati during 1926 and 1927, provides a singular instance in Indian intellectual thought in which the Bhagavad Gita's message of action is transformed into a theory of non-violent resistance. This essay argues that Gandhi's reading of the Gita has to be placed within an identifiable general understanding of the political that emerged among the so-called in the Congress towards the beginning of the twentieth century. Gandhi, we argue, wrested from (...) the their vocabulary and their pre-eminent political text, the Gita, and put them to use in the cause of non-violent politics. But, more importantly, his discourses on the Gita after 1920 suggest an acceptance, on his part, of politics as it actually was. This is where he departed from the projects of Tilak or Aurobindo. The Gita, in Gandhi's hand, became a talismanic device that allowed the satyagrahi his or her involvement in political action while providing protection from the necessary and unavoidable venality of politics and its propensity to violence. (shrink)

In this paper, I discuss the ethical underpinnings to the anthropological analysis of age and reproductive decline in the ‘management’ of infertility, by suggesting that assisted reproductive technologies ‘use’ age and reproductive decline to further endanger women’s bodies by subjecting it to disaggregation into parts that do not belong to them anymore. Here, the category of age becomes a malleable concept to manipulate women seeking fertility management. In ethnographic findings from two Indian ART clinics, amongst women aged between 20 and (...) 35 years visiting an IVF/art clinic in Hyderabad city in South India, and women above 50 years of age visiting an IVF/art clinic in Hisar in North India—reproductive bodies are similarly disaggregated. In case of younger women, the treatment is fixated on rescuing eggs that may be in ‘decline’, and in case of older women, the aim is to engineer a viable pregnancy. Thus, the constant focus on eggs and wombs in infertility treatment creates a body that is not only not whole but also completely without agency. Age becomes a category that has rhetorical value to ‘push’ or persuade women into particular forms of fertility management through infertility medicine. I undertake a problematization of the egg and the uterus through the identification of the recurring motif of the menstrual cycle within IVF treatment to suggest that bodily holism is not part of ART discourse that unethically thrives on promoting technological intrusions to promote its use and normalization. (shrink)