L48 Anthro 3283 Chapter Notes - Chapter 9: Jeremy Bentham, Thomas Pogge, Global Health
RGH Ch. 9 Values and Global Health Part 1
Moral Frameworks and Global Health
Utilitarianism
• Greatest happiness principle
• Jeremy Bentham and Stuart Mill (19th century philosophers) – actions were deemed good
if they maximized utility (defined as happiness, pleasure, or well-being) for as many
people as possible
• Approach inspires progressive reform – women’s rights, welfare, inclusive democracy,
penal reform
• May lead to tyranny of majority
• How do we measure utility?
• A more equitable distribution of medical care and spending would allow the world to lead
full lives in good health for the same cost; moves towards equity
• Peter Singer – argument has 4 premises
o Suffering and death from lack of food, shelter and medical care are bad
o If it is within our power to prevent something bad from happening without
sacrificing anything nearly as important, it is wrong not to do so
o By donating to aid agencies, you can prevent suffering and death from lack of
food, shelter, and medical care, without sacrificing anything nearly as important
o Therefore, if you do not donate to aid agencies, you are doing something wrong
• Peter Singer
o Emphasizes targeting “the poorest” and those “most in need” focusing on South
Asia
o His approach leads to helping everyone live a slightly less miserable life, without
letting anyone live well
o What is the value of life?
• Global income equality is greater today than it was during the 20th century
• Cost-effectiveness – maximizing the impact of global health outlays; doing the greatest
good for the greatest number
o Maximizes utility after assuming scarce resources
o Can lead to pitfalls of “appropriate technology” – long-term substantial
investments required to strengthen health systems might be written off because
they are too expensive
Liberal Cosmopolitanism
• Cosmopolitanism – “the idea that all human beings, regardless of their political
affiliation do belong to a single community, and that this community should be
cultivated”
• John Rawls – “veil of ignorance” – individual doesn’t yet know the circumstances of the
life that awaits them
o “difference principle” – massive redistribution from rich to poor
o restricts argument to nation-state
• Thomas Pogge – Rawlsian political liberalism
o Critiques global institutional order – says economic and political systems exploit
the poor to the advantage of the rich
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