JUSTICE, STIGMA, AND THE NEW EPIDEMIOLOGY OF HEALTH DISPARITIES

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of negative interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods.     

Moral Bioenhancement: Much Ado About Nothing?

Recently, some have proposed moral bioenhancement as a solution to the serious moral evils that humans face. Seemingly disillusioned with traditional methods of moral education, proponents of bioenhancement believe that we should pursue and apply biotechnological means to morally enhance human beings. Such proposal has generated a lively debate about the permissibility of moral bioenhancement. We argue here that such debate is specious. The claim that moral bioenhancement is a solution – whether permissible or not – to the serious moral problems that affect human beings is based on several problematic framing assumptions. We evaluate here three of such assumptions: the first rests on a contested understanding of morality, the second consist in a mistaken conception of human moral problems, and the third relates to problematic presuppositions grounding the interpretation of existent scientific evidence presented to defend moral bioenhancement. Once these framing assumptions are identified and critically evaluated, it becomes clear that the moral bioenhancement debate is misguided.     

Who’s afraid of perfectionist moral enhancement? A reply to Sparrow

Robert Sparrow recently argued that state-driven moral bioenhancement is morally problematic because it inevitably invites moral perfectionism. While sharing Sparrow’s worry about state-driven moral bioenhancement, I argue that his anti-perfectionism argument is too strong to offer useful normative guidance. That is, if we reject state-driven moral bioenhancement because it cannot remain neutral between different conceptions of the good, we might have to conclude that all forms of moral enhancement programs ought not be made compulsory, including the least controversial and most popular state-driven program: compulsory (moral) education. In this paper, I argue that, instead, the spirit of Sparrow’s worry should be recast in the language of the capability approach—an approach that strives to enhance people’s capabilities to develop their own conceptions of the good by restricting itself from endorsing thick conceptions of the good. The distinction made regarding thick and thin conceptions of the good helps to capture sentiments against state-driven bioenhancement programs without falling prey to the issues I raise against Sparrow’s anti-perfectionist arguments.     

Willughby’s angel: the pintailed sandgrouse (Pterocles alchata)

Among paintings of birds thought to have been bought in 1663 in Nuremberg by Francis Willughby, and now housed in Nottingham University library, is the painting of a bird called Jangle de Languedoc. Unlike some of the other drawings, this particular one was never used by Ray in his Ornithology of Francis Willughby (1678), who had difficulty in identifying the bird. We show here that this painting was not bought in Nuremberg, but that it was obtained by Ray from Sir Thomas Crew, during his stay in Montpellier in 1665. Furthermore, had Ray looked at Gessner (Historiae animalium liber III qui est de avium natura. Christophus Froschoverus, Tiguri, 1555), Aldrovandi (Ornithologiae, tomus alter. Bononiae, apud Franciscum de Franciscis Senensem, 1600), Jonston (Historiae naturalis de avibus libri VI. Matthaeus Merianus, Frankfurt, 1650) and mostly at Charleton (Gualteri Charletoni Exercitationes de Differentiis & Nominibus Animalium. Theatro Sheldoniano, Oxford, 1677), he would have been able to identify the bird of the painting as alchata or “angel”, specifically a pintailed sandgrouse, Pterocles alchata.     

The priority dispute over the function of the lymphatic system and Glisson's ghost (the 18th-century Hunter-Monro Feud)

Basic Immunology has had only two significant public priority disputes. The first began in the late 1650s and concerned the recognition of the peripheral network of vessels which collects lymph throughout the body. The publication of this major anatomical discovery prompted a priority feud discussed in a previous paper. The subject of this essay is the second dispute which occurred a century later in the late 1750s. It focused on the function of the lymphatic system and precipitated a heated war of words between a young Scotch medical graduate (Alexander Monro) and a noted London anatomist (William Hunter). Their published charges and responses ranged from feigned respect to ad hominen invectives. But in retrospect, the priority claims of both were precluded by the observations and speculations of an Englishman (Francis Glisson) a full century before. The several editions of his work were unknown to Hunter and Monro at the inception of their feud.