Takunda Matose

In this commentary, I argue that while the value-systems of healthcare providers and surrogate decision-makers might appear to be incommensurable, they share enough common ground over high-level principles that meaningful engagement between the two groups is possible. This engagement can happen through incompletely theorized agreements that allow discussants to focus on shared values while adhering to competing value-systems. Nonetheless, I argue that the privileging of both healthcare providers and their best interest value system within healthcare creates a continued and unjustified subordination of surrogate decision-makers that threatens to undermine the possibility of meaningful engagement between the two groups. As a solution, I suggest that end-of-life policies be structured in ways that emphasize common ground between healthcare providers and surrogate decision-makers while allowing the dissent of surrogate decision-makers to be a genuinely viable option whenever possible.

This chapter provides an overview of public health in AfricaAfrica in four main sections. One section explores challenges and promises to public health posed by the size and diversity of Africa. The second section explores the challenges and promises of Africa’s infrastructure. The third section explores existing crises like the HIVHIV/AIDSAIDS pandemic and emerging crises like food insecurity. However, in the fourth section, I suggest that Africa’s biggest public health challenges are rooted in stigma and fear.

In this article, I argue that in portending potentially fatal harm to immunocompromised others, certain vaccine-hesitant views create a paradox for democratic deliberation on public health matters. In this paradox, either vaccine-hesitant views entailing potential harm to others are entertained as legitimate public health policy, or these views are disallowed, excluding discussion of competing harms from the deliberative process. In either case, the result is a deliberative process in which some group is not treated with the consideration owed to free and equal persons as required by the terms of democratic membership. I argue for capitalizing on and refining certain epistemic traits exhibited by anti-vaxxers to address vaccine-hesitant views and minimize this paradox. However, I make the case that this paradox cannot be completely resolved, so we should focus on certain demands of justice to protect the most vulnerable.