Gillian Brock

Machine generated contents note: Preface; Introduction; Part I. Global Health, Definitions and Descriptions: 1. What is global health? Solly Benatar and Ross Upshur; 2. The state of global health in a radically unequal world: patterns and prospects Ron Labonte and Ted Schrecker; 3. Addressing the societal determinants of health: the key global health ethics imperative of our times Anne-Emmanuelle Birn; 4. Gender and global health: inequality and differences Lesley Doyal and Sarah Payne; 5. Heath systems and health Martin McKee; Part II. Global Health Ethics, Responsibilities and Justice: Some Central Issues: 6. Is there a need for global health ethics? For and against David Hunter and Angus Dawson; 7. Justice, infectious disease and globalisation Michael Selgelid; 8. International health inequalities and global justice: toward a middle ground Norman Daniels; 9. The human right to health Jonathan Wolff; 10. Responsibility for global health? Allen Buchanan and Matt DeCamp; 11. Global health ethics: the rationale for mutual caring Solly Benatar, Abdallah Daar and Peter Singer; Part III. Analyzing Some Reasons for Poor Health: 12. Trade and health: the ethics of global rights, regulation and redistribution Meri Koivusalo; 13. Debt, structural adjustment and health Jeff Rudin and David Sanders; 14. The international arms trade and global health Salahaddin Mahmudi-Azer; 15. Allocating resources in humanitarian medicine Samia Hurst, Nathalie Mezger and Alex Mauron; 16. International aid and global health Anthony Zwi; 17. Climate change and health: risks and inequities Sharon Friel, Colin Butler and Anthony McMichael; 18. Animals, the environment and global health David Benatar; 19. The global crisis and global health Stephen Gill and Isabella Bakker; Part IV. Shaping the Future: 20. Health impact fund: how to make new medicines accessible to all Thomas Pogge; 21. Biotechnology and global health Hassan Masun, Justin Chakma and Abdallah Daar; 22. Food security and global health Lynn McIntyre and Krista Rondeau; 23. International taxation Gillian Brock; 24. Global health research: changing the agenda Tikki Pang; 25. Justice and research in developing countries Alex John London; 26. Values in global health governance Kearsley Stewart, Gerald T. Keusch and Arthur Kleinman; 27. Poverty, distance and two dimensions of ethics Jonathan Glover; 28. Teaching global health ethics James Dwyer; 29. Towards a new common sense: the need for new paradigms of global health Isabella Bakker and Stephen Gill; Index.

Many people believe in what can be described as a 'concentric circles model of responsibilities to others' in which responsibilities are generally stronger to those physically or affectively closer to us - those who, on this model, occupy circles nearer to us. In particular, it is believed that we have special ties to compatriots and, moreover, that these ties entail stronger obligations than the obligations we have to non-compatriots. While I concede that our strongest obligations may generally be to those family and friends with whom we have close personal relationships, those often thought to occupy the inner core, what I want to challenge is the idea that our obligations diminish in strength when we move beyond the boundary of the circles occupied by compatriots and proceed to those more geographically or culturally distant from us. The weight that is typically placed on the boundary between compatriots and non-compatriots in determining the strength of our obligations to others cannot withstand critical scrutiny. In this paper I show that arguments that are supposed to work to justify stronger obligations to compatriots than non-compatriots do not succeed in the ways imagined. I also present the framework of a contractarian-style model which aims to give us a more systematic way to think about our obligations to 'non-core' others, both distant and near. While we can certainly have different kinds of obligations, my analysis shows that our basic obligations to others do not diminish with distance. In addition, my account aims to flesh out what our basic obligations to others are.

I examine how reforming our international tax regime could be an important vehicle by which we can begin to realize global justice. For instance, eliminating tax havens, tax evasion, and transfer pricing schemes are all important to ensure accountability and to support democracies. I argue that the proposals concerning taxation reform are likely to be more effective in tackling global poverty than Thomas Pogge's global resources dividend because they target some of the central issues more effectively. I also discuss many particular proposals for global taxes that have already been floated and implementation prospects and successes.

Frankfurt argues that there are two categories of needs that are at least prima facie morally important (relative to other claims). In this paper I examine Frankfurt's suggestion that two categories of needs, namely, nonvolitional and constrained volitional needs, are eligible for (at least prima facie) moral importance. I show both these categories to be defective because they do not necessarily meet Frankfurt's own criteria for what makes a need morally important. I suggest a further category of needs as being a more promising 'moral importance indicator'.

My primary goals in this article are to show: first, that we can identify and justify which basic freedoms are important ones to protect in the global context; second, that we can monitor whether we are making progress with respect to whether more or fewer people are enjoying the important freedoms; third, that we can identify some key institutions that play a central role in fortifying those freedoms; fourth, that we can help build or fortify local capacity with respect to protecting basic freedoms; fifth, that external support and building international institutions can play an important role in securing local capacity to protect basic liberties. The emphasis is on trying to construct local capacity to protect basic freedoms. However external support has a key role to play. I argue that protecting press freedom and building institutions of international justice play crucial roles in securing local capacity to protect basic liberties. We have obligations to support those institutions that would facilitate progress with respect to protection of basic liberties. So, for instance, we have a range of responsibilities to support press freedom in all countries, along with international efforts to bring to justice violators of basic liberties.

In this article I present four central challenges for Hennie Lötter’s book Poverty, Ethics and Justice. The first criticism takes issue with Lötter’s focus on social rather than global justice. Though he seems to be concerned with poverty everywhere, he takes social rather than global justice as the primary unit of analysis and this leads to a certain blindness to the ways in which discharging duties to the poor is a global not just society or state level project. My alternative perspective also gives us more insights into the nature of our duties to one another and can accommodate a wider range of duties. A second set of concerns revolves around what we must do to discharge our duties to the poor and what we need to know to help effectively. We come to appreciate that helping effectively is no easy matter and supplying more guidance would be helpful. Third, after discussing some relevant empirical research, I also discuss the kinds of initiatives that deserve support, that can act as rough guidelines for would-be assisters. These more simplified guidelines do not place such heavy epistemic demands on those aiming to help. Fourth, I explore whether we can offer some more guidelines for determining which of many plausible policy initiatives we should support, given that there are many good ideas and limited resources. I offer one guideline for choosing among what appear to be plausible policies to support.

In his recent review essay, Stan van Hooft raises some interesting potential challenges for cosmopolitan global justice projects, of which my version is one example.1 I am grateful to van Hooft for doing so. I hope by responding to these challenges here, others concerned with developing frameworks for analyzing issues of global justice will also learn something of value. I start by giving a very brief synopsis of key themes of my book, Global Justice,2 so I can address van Hooft’s concerns about the structure of the book. I then outline the normative thought experiment that yields the global justice framework I endorse, in order to address five main concerns van Hooft has with it. These center around problems he foresees about what it would be reasonable to agree to in the face of quite different worldviews. There are five specific concerns he identifies related to reasonableness and I address these in the third and fourth sections of this paper. (Published: 26 May 2010) Citation: Ethics & Global Politics, Vol. 3, No. 2, 2010, pp. 155-170. DOI: 10.3402/egp.v3i2.5175

The facts of global poverty are staggering. Consider, for instance, how 1.5 billion people subsist below the international poverty line, which means about a quarter of the world's current population lives in poverty. There is much talk about how freer markets will help the situation of these people, in particular how it will help the worst off. So far the evidence for this claim is fairly unclear. ‘At any rate, on several accounts, alleviating the worst aspects of poverty would impose fairly small costs on us in more affluent countries, yet we continue to do very little about alleviating this situation. For instance, a 1 per cent tax on world product would make enormous inroads in lifting people out of poverty. Alternatively, simply a shift in priorities could do this without any added taxes: a 1 per cent decrease in military spending in the developed world and a 10 per cent decrease in military spending in the developing world could have the same effect.

In a period of rapid internationalization of trade and increased labor mobility, is it relevant for nations to think about their moral obligations to others? Do national boundaries have fundamental moral significance, or do we have moral obligations to foreigners that are equal to our obligations to our compatriots? The latter position is known as cosmopolitanism, and this volume brings together a number of distinguished political philosophers and theorists to explore cosmopolitanism: what it consists in, and the positive case which can be made for it. Their essays provide a comprehensive overview of both the current state of the debate and the alternative visions of cosmopolitanism with which we can move forward, and they will interest a wide range of readers in philosophy, political theory, and law.

Self-determination does and should play an important role in our conceptions of what it is to treat persons and peoples justly. I write at a time when the Middle East is erupting with demands for more appropriate rule by and for the people. Indigenous peoples around the world have been demanding better control over their traditional lands, over the last few decades in particular. And a serious global recession has affected all local economies since 2008, raising pertinent issues about the wisdom of having a global economy as interlinked as ours has become. Would we not do better to "de-link" from the global economy? Would more robust ideals of self-determination and political and economic autonomy provide better guidance than those that seem to dominate the current discussion of models of global justice?

Do any needs defensibly make claims on anyone? If so, which needs and whose needs can defensibly do this? What are the grounds for our responsibilities to meet others' needs, when we have such responsibilities? The distinguished contributors to this volume consider these questions as they evaluate the moral force of needs. They approach questions of obligation and moral importance from a variety of different theoretical perspectives, including contractarian, Kantian, Aristotelian, rights-based, egalitarian, liberal, and libertarian perspectives.

Are consumers in high-income countries complicit in labor exploitation when they buy good produced in sweatshops? To focus attention we consider cases of labor exploitation such as those of exposing workers to very high risks of irreversible diseases, for instance, by failing to provide adequate safety equipment. If I purchase a product made under such conditions, what is my part in this exploitation? Is my contribution one of complicity that is blameworthy? If so, what ought I to do about such participation? I address these questions at fi rst by applying a comprehensive account recently offered by Chiara Lepora and Robert Goodin, and analyzing the results in light of some important empirical issues.

In this paper I argue for there being some deep connections between claims of desert and claims of need, despite the fact that these sorts of claims are frequently pitted against one another. I present an argument to show some conceptual links between desert and needs. Principles underlying why people are thought to be deserving entail principles which commit us to caring about others' needs. I also examine whether we can construct some coherent notion of desert and an argument for why some can have goods on the basis of desert. Here again we find we are committed to a principle which entails that needs must be adequately accommodated if we care about desert.

Are corporations morally defensible sorts of entities? How might we go about showing that they are? Thomas Donaldson offers us the most detailed contractarian justification for the moral defensibility of corporations. In this paper I show how we can significantly develop this sort of justification to yield a more compelling contractarian justification, though one that is importantly conditional. The primary points I take up in this paper are these:1. The question Donaldson poses to generate his contract is not quite as simple as may appear. The sort of transformation we need to consider is more complex than the sort Donaldson describes.2. Partly because of considerations that arise in discussing the first point, the contract we are considering is a more conditionalagreement. The terms of the agreement will vary depending on the kind of state we are assuming prevails. The sort of contract we wantto draw up is at least a three-way contract: between society, productive organizations and the state. The sort of agreement we reach will have the following form: society a agrees to allow productive organizations of type b to exist if we assume state c will do various things (d1 to dn), productive organizations will do various things (e1 to en) and members of society will do various things (f1 to fn). Importantly, if state c is not doing d1 to dn, productive organizations may not be morally defensible.3. The terms of the contract that can be derived would benefit from the introduction of some of Rawls’s apparatus.4. When we consider the right questions, with more of the background institutions filled in, and when we include some more social contract apparatus, we get a better contract which fills in for us not only the obligations of business but, importantly, many obligationsfor government as well.

How are we to navigate between duties to compatriots and duties to non-compatriots? Within the literature there are two important kinds of accounts that are thought to offer contrasting positions on these issues, namely, cosmopolitanism and statism. We discuss these two rival accounts. I then outline my position on global justice and how to accommodate insights from both the cosmopolitan and statist traditions within it. Having outlined my ideal theory account of what global justice requires, I discuss the far more pressing question of what our remedial responsibilities are in our decidely non-ideal world: what does the developed world owe to the developing world and what are our responsibilities to non-compatriots, given our situation here and now? I argue that we have considerable responsibilities and I sketch some of the supporting grounds for this view. Finally, I consider how the general account of global justice and remedial responsibilities developed here applies to the case of responsibilities for migrants’ and refugees’ healthcare.

Opponents of cosmopolitanism often dismiss the position on the grounds that cosmopolitan proposals are completely unrealistic and that they fly in the face of our human nature. We have deep psychological needs that are satisfied by national identification and so all cosmopolitan projects are doomed, or so it is argued. In this essay we examine the psychological grounds claimed to support the importance of nationalism to our wellbeing. We argue that the alleged human needs that nationalism is said to satisfy are: (i) either more complex than initially one might think or (ii) do not necessarily provide very strong grounds for the theses advocated by nationalists or (iii) can be well met in alternate ways than through national identification. Moreover, commitment to cosmopolitanism is not antithetical to meeting these needs: rather, more cosmopolitan worldviews can do quite well in meeting the needs of interest. Moreover, we argue that since nationalism is a fluid and socially constructed phenomenon, quite open to the influence of other factors, the current evidence suggests that central aspects of cosmopolitanism are quite feasible and realistic.

Cosmopolitans believe that all human beings have equal moral worth and that our responsibilities to others do not stop at borders. Various cosmopolitans offer different interpretations of how we should understand what is entailed by that equal moral worth and what responsibilities we have to each other in taking our equality seriously. Two suggestions are that a cosmopolitan should endorse a 'global difference principle' and a 'principle of global equality of opportunity'. In the first part of this paper I examine whether these two suggestions are compelling. I argue against a global difference principle, but for an alternative 'needs-based minimum floor principle' (where these are not coextensive, as I explain). I develop a model of cosmopolitan justice, which allows us to address not only matters of global distributive justice, but other global justice issues as well. Though I support what I refer to as a negative version of the global equality of opportunity principle, I argue that a more positive version of the ideal remains elusive. In the second part of this paper, I reflect on what bearing these results have on two central sets of questions: First, what kind of ideal are we after in the domain of cosmopolitan justice and what practical implications can we reasonably expect from it? Second, what sort of ideal of egalitarianism is compelling and does my model of cosmopolitan justice adequately reflect the legitimate concerns of egalitarians?

Cindy Holder and Bruce Landesman pose several interesting challenges for my account of Global Justice. In this article I address their concerns by discussing the content of what we owe one another. When we appreciate all the components of what it is to have a decent life, this will commit us to a much richer picture of what we owe one another than is commonly assumed when talking of decent lives. There is also considerable scope for concern with inequality when that fuller picture is presented. I discuss and clarify the importance of a shared state in securing global justice and also how, in the absence of shared state structures, we are to see our options for ensuring that our institutions treat all human beings as having equal moral worth. There is scope for compatriot partiality and appropriate attention to non-compatriots. I explain how these can readily be combined.

In this critical discussion of Simon Caney's global political theory, I focus on two broad areas. In the first area, I consider Caney's suggestions concerning global equality of opportunity and note several problems with how we might develop these ideas. Some of the problems concern aggregation, while others point to difficulties with what equality of opportunity means in a culturally plural world, where different societies might value, construct, and rank goods in different ways. In the second broad area of criticism I argue that Caney has been unfair to contractarians and I rally to their defense.

In this paper I argue that if we are to have any defensible property rights at all, we must recognize a fundamental commitment to helping those in need. The argument has significant implications for all who claim defensible property rights. In this paper I concentrate on some of the implications this argument has for redefining business obligations. In particular, I show why those who typically would be quite resistant to the idea that businesses have any obligations to assist others in need must acknowledge this fundamental obligation. I also suggest how this argument contributes to our understanding of the normative basis of Stakeholder Theory.

What kind of role, if any, can immigration policies play in moving us towards global justice? On one view, the removal of restrictions on immigration might seem to constitute great progress in realizing the desired goal. After all, people want to emigrate mainly because they perceive that their prospects for better lives are more likely to be secured elsewhere. If we remove restrictions on their ability to travel, would this not constitute an advance over the status quo in which people are significantly prevented, through tough immigration restrictions, from seeking a better life for themselves and their dependants? In particular, it might seem that a cosmopolitan must be committed to reducing restrictions on immigration. On one common account of what cosmopolitanism is, the central idea is that every person has global stature as the ultimate unit of moral concern and is therefore entitled to equal respect and consideration no matter what her citizenship status or other affiliations happen to be. It is frequently supposed that a cosmopolitan must be committed to more open borders, and that developed countries restricting entry to people from developing countries is unjust and inconsistent with a commitment to our equal moral worth. However, as I argue, removing restrictions on immigration could constitute a considerable step backward for global justice. In order to appreciate why this is the case, we need to review some relevant empirical evidence that our policy recommendations must take into account. As we see, considerable benefits accrue to the immigrant and host nation, but significant costs must often be born in states of origin. As one example, we consider the effects of remittances often believed to be highly beneficial to the global poor. I discuss evidence indicating that patterns associated with remittances are not always at all desirable. Migration policies need to be better managed so that they do benefit the relevant stakeholders. In section 4 I give examples of how this might work. In section 5 we investigate what kinds of policy recommendations would be best given our findings.

David Miller offers us a sophisticated account of how we can reconcile global obligations and duties to co?nationals. In this article I focus on four weaknesses with his account such as the following two. First, there remains considerable unclarity about the strength of the positive duties we have to non?nationals and how these measure up relative to other positive duties, such as the ones Miller believes we have to co?nationals to implement civil, political, or social rights. Second, just how responsibilities for enacting our global commitments will be assigned still needs further development. A unifying theme of my criticisms concerns Miller?s account of how we are to mediate responsibilities to fellow?nationals and the partiality we may defensibly show co?nationals. In the final section I sketch an alternative way of conceptualizing our duties to fellow?nationals and duties to non?nationals, which can give more systematic advice about the partiality we may defensibly show co?nationals