Health, justice, and the environment

In this article, we argue that the scope of bioethical debate concerning justice in health should expand beyond the topic of access to health care and cover such issues as occupational hazards, safe housing, air pollution, water quality, food and drug safety, pest control, public health, childhood nutrition, disaster preparedness, literacy, and many other environmental factors that can cause differences in health. Since society does not have sufficient resources to address all of these environmental factors at one time, it is important to set priorities for bioethical theorizing and policy formation. Two considerations should be used to set these priorities: (1) the impact of the environmental factor on health inequality, and (2) the practicality of addressing the factor.     

Skepticism, Empathy, and Animal Suffering

The suffering of nonhuman animals has become a noted factor in deciding public policy and legislative change. Yet, despite this growing concern, skepticism toward such suffering is still surprisingly common. This paper analyzes the merits of the skeptical approach, both in its moderate and extreme forms. In the first part it is claimed that the type of criterion for verification concerning the mental states of other animals posed by skepticism is overly (and, in the case of extreme skepticism, illogically) demanding. Resting on Wittgenstein and Husserl, it is argued that skepticism relies on a misguided epistemology and, thus, that key questions posed by it face the risk of absurdity. In the second part of the paper it is suggested that, instead of skepticism, empathy together with intersubjectivity be adopted. Edith Stein’s take on empathy, along with contemporary findings, are explored, and the claim is made that it is only via these two methods of understanding that the suffering of nonhuman animals can be perceived.     

Haiti, insecurity, and the politics of asylum

In this article, I seek to show how states of insecurity provoked by ongoing social, economic, and political ruptures in Haiti can disorder individual subjectivity and generate the flight of individuals seeking asylum within and across borders. Nongovernmental actors working in Haiti and with Haitians in the diaspora frequently managed the long-term psychosocial effects of insecurity. Their interventions can range from repressive to compassionate and influence the formation of identity and the embodied experiences of trauma for vulnerable Haitians. The case of a young Haitian refugee who was repatriated to Haiti from the United States in the 1990s demonstrates how insecurity is both an existential state reflecting the disordering of embodied experience, as well as a collective sociopolitical condition the effects of which cannot be managed or contained within national borders. The case is emblematic of the plight of thousands of Haitians affected by the January 12, 2010, earthquake.     

Statecraft,capital and the politics of difference

Hanchard’s Spectre of Race is an important and far-reaching piece of scholarship that makes important contributions to the field of poltiical science and to our understandings of democracy, statecraft and the construction and management of difference. This article analyzes the strengths of Hanchard’s comparative methodology while also raising a number of questions about the nature and functioning of racial regimes. First, it asks where capitalist development generally, and material relations and struggles more specifically, are in hanchard’s theory of race, democracy and statecraft. More specifically, it calls for engagement with the historic, but recently revived school of studies in racial capitalism to think critically about the logic of racial states and their different manifestations. Second, the article raises a number of questions about the coherence of racial regimes, across arms of the state, across time, and across different groups.     

Consequentialism, reasons, value and justice

Over the past 10 years, John Harris has made important contributions to thinking about distributive justice in health care. In his latest work, Harris controversially argues that clinicians should stop prioritising patients according to prognosis. He argues that the good or benefit of health care is providing each individual with an opportunity to live the best and longest life possible for him or her. I call this thesis, opportunism. For the purpose of distribution of resources in health care, Harris rejects welfarism (the thesis that the good of health care is well-being) and argues that utilitarianism in general may lead to de facto discrimination against groups of people needing health care. I argue that well-being is a superior theory of the good of health care to Harris' opportunism. Harris' concerns about utilitarianism can be better addressed by: (i) relating justice more closely to reasons for action; (ii) by conceptualising the relationship between reasons for action and the value of the consequences of those actions as a plateau rather than scalar relationship. Justice can be understood as satisfying as many equally rational claims on resources as possible. The rationality of a person's claim on health resources turns on the strength of that person's reasons to promote certain health-related states of affairs. I argue that the strength of that reason does not track the expected value of that state of affairs in a fully scalar fashion. Rather a person can have most reason to promote some state of affairs, even though he or she could promote other more valuable states of affairs. Thus there can be equal reason for a distributor of public resources to save either of two people, even though one will have a better and more valuable life. This approach, while addressing many of Harris' concerns about utilitarianism, does not imply that doctors should give up prioritising patients according to prognosis altogether, but it does allow that patients with lower but reasonable prognosis should have a share of public resources.     

Transnational politics and the politics of the Russian diaspora

This article sketches out a conceptual framework for exploring the diasporic politics of the Russians in the post-Soviet borderlands. Specific consideration is given to the Russians within Estonia and Latvia, the only two postSoviet states not to grant automatic citizenship to all those resident within their sovereign spaces in 1991. The essay not only examines the Russians in relation to the homeland regimes or nationalizing states in which they are located but also looks at the role of transnational political actors- specifically, the state patron (Russia) and Western transnational political institutions (notably the OSCE)- in shaping diasporic politics. It is argued that by examining the relationships among 'the ethnic patron', 'the West' and 'nationalizing state', we are better placed to understand the ways in which the differing representations of homeland by the Russian minorities themselves are being reconstituted as part of a diverse and unravelling community of identity politics, limited political opportunities and survival strategies.     

Race,class, politics,and the disappearance of work

“When Work Disappears” has shaped research agendas on poverty, racial hierarchy, and urban social and economic dynamics. That is a lot for one article, yet two issues warrant more analysis. They are the ways in which socially defined “race” – rather than or in combination with class – explains the impact of sustained joblessness, and the political behaviours that may emerge in response to work’s disappearance. I point to evidence showing that both race and class have independent associations with the loss of work in poor African-American communities, as well as interactive effects. In the political arena – too often neglected by sociologists studying poverty – sustained, community-wide joblessness or underemployment are associated both with withdrawal from political engagement and with the recent resurgence of right-wing populism. Even after several decades of intensive research, we have more to learn about the interactions of race, class, politics, and the disappearance of work.