Global Justice and Bioethics

Despite the massive scale of global inequalities, until recently few political philosophers or bioethicists addressed their ethical implications. Questions of justice were thought to be primarily internal to the nation state. Over the last decade or so, there has been an explosion of interest in the philosophical issues surrounding global justice. These issues are of direct relevance to bioethics. The links between poverty and health imply that we cannot separate questions of global health from questions about fair distribution of global resources and the institutions governing the world order. Similarly, as increasing numbers of medical trials are conducted in the developing world, researchers and their sponsors have to confront the special problems of doing research in an unjust world, with corresponding obligations to correct injustice and avoid exploitation.

This book presents a collection of original essays by leading thinkers in political theory, philosophy, and bioethics. They address the key issues concerning global justice and bioethics from two perspectives. The first is ideal theory, which is concerned with the social institutions that would regulate a just world. What is the relationship between human rights and the provision of health care? How, if at all, should a global order distinguish between obligations to compatriots and others? The second perspective is from non-ideal theory, which governs how people should behave in the unjust world in which we actually find ourselves. What sort of medical care should actual researchers working in impoverished countries offer their subjects? What should NGOs do in the face of cultural practices with which they deem unethical? If coordinated international action will not happen, what ought individual states to do?

These questions have more than theoretical interest; their answers are of direct practical import for policymakers, researchers, advocates, NGOs, scholars, and others. This book is the first collection to comprehensively address the intersection of global justice and bioethical dilemmas.

Chair of the Department of Bioethics at the Warren G. Magnuson Clinical Center at the National Institutes of Health; co-editor of ETHICAL ISSUES IN INTERNATIONAL BIOMEDICAL RESEARCH and THE OXFORD TEXTBOOK OF CLINICAL RESEARCH ETHICS