Sally Song

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust.

This article examines the provocative analogy between feudalism and modern citizenship in Joseph Carens’s case for open borders. The analogy raises a distributive objection against bounded citizenship: modern citizenship is an inherited status assigned by birth and is attached to great advantages or disadvantages, and states reinforce these objectionable inequalities by restricting people’s mobility across borders. I argue the analogy is misleading. The case for bounded citizenship does not stand or fall with feudalism. One can be committed to the value of equality and defend bounded citizenship while rejecting feudalism. A key aspiration of the modern liberal ideal of citizenship is to recognize and promote the equality of citizens. One way to promote the equal standing of citizens is to respect their right of collective self-determination, including the right to make decisions about matters of immigration and membership in their political community. A commitment to equality is compatible with bounded citizenship if we adopt certain qualifications on the right of collective self-determination, including the duty to remedy historical injustice, the duty to extend membership to resident noncitizens, the duty to take in refugees and other necessitous migrants, and the duty to alleviate global poverty through development assistance.