Rawlsian Justice and the Social Determinants of Health

In this article, we suggest that the evidence regarding the social determinants of health calls for a deep re‐thinking of our understanding of distributive justice. Focusing on John Rawls's theory of distributive justice in particular, we argue that a full reckoning with the social determinants of health requires a re‐working of Rawls's principles of justice. We argue first that the social bases of health – a Rawlsian conception of the social determinants of health – should be considered a social primary good. We argue second that including the social bases of health as a social primary good would lead the parties to the original position to choose an additional principle of justice and assign it lexical priority over Rawls's second principle. According to this principle, inequalities in people's share of the social bases of health are to be arranged so as to improve the health status of those least advantaged on the social health gradient.     

社会正义是对健康的最好保障

健康是公民的一项基本权利,社会或政府有义务保障公民的这一权利.公民的健康除了由医疗卫生和生理因素决定外,还由诸多社会因素决定.这些健康的社会决定因素所反映的实际上是社会正义问题,因此要保障公民的健康权利,最根本的是要营造一个正义的社会环境,并建立一个正义的社会保障支持系统.     

社会正义是对健康的最好保障

健康是公民的一项基本权利,社会或政府有义务保障公民的这一权利。公民的健康除了由医疗卫生和生理因素决定外,还由诸多社会因素决定。这些健康的社会决定因素所反映的实际上是社会正义问题,因此要保障公民的健康权利,最根本的是要营造一个正义的社会环境,并建立一个正义的社会保障支持系统。     

Justice,Health, and Healthcare

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness."     

Equality, Priority and Social Justice

The moral principle of giving greater priority to benefiting people, the less well off they are, has been thought by some to share the plausibility of egalitarianism whilst avoiding the less plausible implications of the latter. This paper argues that the 'priority' principle does have an authentic place in our moral thinking, and that it is distinct from the idea of 'equality', but that the latter also has an indispensible role to play. The idea of 'priority'has its place as the expression of the moral standpoint of benevolent and sympathetic concern. 'Equality', in contrast, functions as a conception of social justice, from which it cannot be displaced by the idea of 'priority'.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

企业社会责任与社会公正

企业何以需要承担社会责任?企业承担社会责任的价值指归于何处?又如何能保持企业承担社会责任的持续后劲?诸如此类问题的思考和解决在本质上命系于社会公正或公正的社会环境。企业社会责任与社会公正是一个交融渗透、共生互动的德性共同体。     

社会公平正义与伦理——"第五届两岸伦理学术研讨会"综述

第五届两岸伦理学术研讨会以"社会公平正义与伦理"为主题,就"中、西伦理思想中的公平正义"、"社会公平正义与环境伦理"、"社会公平正义与政治伦理"、"社会公平正义与企业伦理"及中西方传统伦理、生命伦理、家庭伦理、校园道德文化建设等问题进行了广泛交流和深入探讨.     

Justice and Social Conflict

This article analyzes possible effects of ideas of justice, perceptions of injustice, and the use of justice arguments on the emergence, course, and resolution of social conflicts. Four functions of justice are identified: (1) ideas of justice and perceptions of injustice can elicit or evoke social conflicts; (2) justice arguments and rhetorics can be used to support one's own position in a dispute; (3) the basic value and the principles and rules of justice can restrict social conflicts and help to generate ways of conflict resolution; (4) the labelling of conflict resolutions as just can increase the acceptance of the resolution. The analysis is illustrated by making reference to a recent case of international conflict and diplomatic controversy.     

Psychoanalysis,Social Justice,and the Therapeutic Endeavor

Abstract

FREUD'S FREE CLINICS: PSYCHOANALYSIS & SOCIAL JUSTICE, 1918–1938, by Elizabeth Ann Danto. New York: Columbia University Press, 2005, $29.50, 348 pp. Reviewed by William Borden     

社会公正:弘扬集体主义价值观的前提

中国社会正处于前所未有的转型期,市场化过程一方面改变了中国社会的经济结构和组织方式,同时也改变了广大民众的生活态度、价值观念。随着市场化过程的进一步深入,原有的价值观念同社会发展大趋势的矛盾逐步暴露出来。个人主义与集体主义之间日趋激烈的碰撞正是这种矛盾的突出表现,集体主义日渐为社会民众所淡化和遗忘,如果不能正确认识这种现状和疏导这种矛盾,势必影响改革的进一步深入。作者认为社会主义市场经济建设必须坚持集体主义价值观的指导,同时导入公正原则。     

A Social Ecological Conceptual Framework for Understanding Adolescent Health Literacy in the Health Education Classroom

With the rising concern over chronic health conditions and their prevention and management, health literacy is emerging as an important public health issue. As with the development of other forms of literacy, the ability for students to be able to access, understand, evaluate and communicate health information is a skill best developed during their years of public schooling. Health education curricula offer one approach to develop health literacy, yet little is known about its influence on neither students nor their experiences within an educational context. In this article, we describe our experience applying a social ecological model to investigating the implementation of a health education curriculum in four high schools in British Columbia, Canada. We used the model to guide a conceptual understanding of health literacy, develop research questions, select data collection strategies, and interpret the findings. Reflections and recommendations for using the model are offered.     

Social Justice,Fallacies of Argument,and Persistent Bias

The fallacies approach to argument evaluation can exacerbate problems it aims to address when it comes to social bias, perpetuating social injustice. A diagnosis that an argument commits a fallacy may flag the irrelevance of stereotypical characterizations to the line of reasoning without directly challenging the stereotypes. This becomes most apparent when personal bias is part of the subject matter under discussion, in ethotic argument, including ad hominem and ad verecundiam, which may be recognized as fallacious without addressing whether the ethotic presumptions are true. Yap (2013; 2015) makes this case for ad hominem and the pragma-dialectical understanding of fallacies, expanded here to show related patterns in some other fallacies, and employing the argument schemes understanding of fallacies. Adding critical questions increases the ways reasoners can dismiss arguments as fallacious, and could include directly addressing bias, but if an argument fails on a different critical question, that may yet allow the bias to pass. The fallacies approach is a form of meta-debate and techniques of meta-debate need to address the ubiquity of social bias, not convey them as specialized problems. The view that the fallacies approach to argument evaluation can provide neutrality is dangerously false. Arguers thus should avoid using fallacies for argument evaluation where social stereotypes or schemas might be involved, especially when the subject matter relates closely to social justice.

     

正义:社会正义和全球正义

<正>义是理念,理念在历史中显示。非正义是与正义相关而不是相反的概念,它指的是各种事态。鉴于非正义所指事态的多样性,正义理念可被赋予以下内容:个体的基本权利必须被保护和行使;在某时期的实际条件下,这些权利的诸意蕴必须在国家和全球的层面上被诉求和实行。正义由此显示为一个元-原则,并在社会正义和全球正义中得到充实。当前,自由市场和人权的结合加剧了社会和全球非正义,加剧了国家之间和内部业已存在的经济不平等。保护作为清晰思考和界定的基本人权是走出当前困境的出路。