From: Global health and national borders: the ethics of foreign aid in a time of financial crisis
Singer | Pogge | Shue | Rawls | |
---|---|---|---|---|
Addressed to whom? | Indvidual moral agents | Individuals & national governments | Individuals & national governments | National governments & their peoples |
National borders important? | No | Possibly | Yes | Yes |
Key concepts | Individuals have an obligation to prevent the occurrence of something significantly bad if they can do so at acceptable cost to themselves. | We have a duty not to cause severe harm for minor gain. This obligation remains equally valid if an agent is responsible for causing harm in a jurisdiction outside his or her national borders, and is independent of whether we should privilege obligations to compatriots. | Two basic rights – subsistence and security–constitute pre-conditions for the enjoyment and exercise of all other rights and freedoms. Liberal democratic states have a duty to adopt foreign policies consistent with these fundamental human rights. | Under an idealised form of social contract, representatives of free and equal societies would adopt 8 principles of governance that enable an ideal global community to live together over time in peace, harmony and mutual respect. |
Is health of the global poor important? | Yes | Yes, under certain conditions | Yes, to a limited extent | Yes, if useful to achieve just political arrangements |
Why? | The global rich can ameliorate the suffering of the global poor with little sacrifice to themselves. | The international community is in some instances causally implicated in the genesis and perpetuation of severe poverty and ill health worldwide. | In instances where national governments fail to protect basic rights, others have a duty to guarantee their fulfilment. The right to subsistence guarantees every person worldwide a decent chance at a long and healthy life. | The 8 principles include a duty to “assist other peoples living under unfavourable conditions that prevent their having a just or decent political and social regime.” Empirical evidence shows that population health contributes to just political arrangements. |
What kind of obligation? 2 | Justice | Justice | Justice | Justice or charity3 |
What is the extent of the obligation? | Until suffering has been eliminated | Until causal responsibility for harm has been corrected and adequately compensated4 | Until a basic minimum has been provided | Until the international community has enabled burdened societies to develop just political arrangements |
Which health-related strategies should be privileged? | Poverty alleviation & action on other determinants of health | Examination of national policy coherence to avoid causing or contributing to harms abroad; | Examination of national policy coherence to avoid depriving or contributing to deprivation abroad; | Those that strengthen basic institutions to a minimally decent threshold, enabling further social development. Candidate strategies could (1) promote equality of opportunity (especially in education and training), e.g. through child health; (2) offer additional synergies for development, e.g. by focussing on the rights and fundamental interests of women. |
Provision of health care | Analysis of the effects of global institutions | Provision of aid to ensure subsistence rights6, including guarantees related to the social determinants of health and minimal preventive health care. | ||
Institutional reforms to promote satisfaction of human rights5 |