Infectious disease outbreaks primarily affect communities of individuals with little reference to the political borders which contain them; yet, the state is still the primary provider of public health capacity. This duality has profound effects for the way disease is framed as a security issue, and how international organisations, such as the World Health Organization, assist affected countries. The article seeks to explore the role that domestic political relationships play in mediating the treatment of diseases as security issues. Drawing upon an analysis of the securitisation of avian influenza in Vietnam and Indonesia, the article discusses the effect that legitimacy, competing referents and audiences have on the external and internal policy reactions of states to infectious diseases, specifically in their interpretation of disease as a security threat. In doing so, we extend upon existing debates on the Copenhagen School's securitisation framework, particularly on the impact of domestic political structures on securitisation processes in non-Western, non-democratic and transitional states.
Do unknown and unrealized risks of harm diminish an individual’s well-being? The traditional answer is no: that the security of prudential goods benefits an individual only instrumentally or by virtue of their subjective sense of security. Recent work has argued, however, that the security of prudential goods non-instrumentally benefits an individual regardless of whether or not they enjoy subjective security. In this paper, I critically examine three claims about the way in which unknown and unrealized risks of harm might diminish individual well-being: (i) it frustrates a desire to be secure, (ii) it frustrates the enjoyment of modally-robust goods, and (iii) it undermines the ability to make reasonable plans. Ultimately, I argue that all three of these hypotheses are mistaken, but that they deepen our understanding of the ways in which subjective security is an important constituent of individual well-being.
This paper discusses the views of 17 healthcare practitioners involved with transplantation on the ethics of live liver donations (LLDs). Donations between emotionally related donor and recipients (especially from parents to their children) increased the acceptability of an LLD compared with those between strangers. Most healthcare professionals (HCPs) disapproved of altruistic stranger donations, considering them to entail an unacceptable degree of risk taking. Participants tended to emphasise the need to balance the harms of proceeding against those of not proceeding, rather than calculating the harm-to-benefits ratio of donor versus recipient. Participants' views suggested that a complex process of negotiation is required, which respects the autonomy of donor, recipient and HCP. Although they considered that, of the three, donor autonomy is of primary importance, they also placed considerable weight on their own autonomy. Our participants suggest that their opinions about acceptable risk taking were more objective than those of the recipient or donor and were therefore given greater weight. However, it was clear that more subjective values were also influential. Processes used in live kidney donation (LKD) were thought to be a good model for LLD, but our participants stressed that there is a danger that patients may underestimate the risks involved in LLD if it is too closely associated with LKD.
Many instances of scientific research impose risks, not just on participants and scientists but also on third parties. This class of social risks unifies a range of problems previously treated as distinct phenomena, including so‐called bystander risks, biosafety concerns arising from gain‐of‐function research, the misuse of the results of dual‐use research, and the harm caused by inductive risks. The standard approach to these problems has been to extend two familiar principles from human subjects research regulations—a favorable risk‐benefit ratio and informed consent. We argue, however, that these moral principles will be difficult to satisfy in the context of widely distributed social risks about which affected parties may reasonably disagree. We propose that framing these risks as political rather than moral problems may offer another way. By borrowing lessons from political philosophy, we propose a framework that unifies our discussion of social risks and the possible solutions to them.
The frequent and swift emergence of new and devastating infectious diseases has brought renewed attention to health as an issue of international importance. Some states and regional organizations, including in Asia, have begun to regard infectious disease as a national and international security issue. This article seeks to examine the Vietnamese government's response to the epidemics of avian influenza and Human immunodeficiency virus. Both diseases have been recognized at different times as threats to international security and both are serious infectious disease problems in Vietnam. Yet, the character of the central government's response to these two epidemics has been starkly different. How and why this disparity in policy approaches occurs depends largely on the epidemiological, economic and political context in which they occur. Although epidemiological factors are frequently explored when discussing disease as a security issue, seldom are the political, social and economic characteristics of the state invoked. These dimensions, and their interaction with the epidemiology of the disease, are central to understanding which diseases are ultimately treated by states as security issues. In particular, the role of economic security as a powerful motivator for resistance to control measures and the role that local implementation of policies can have in disrupting the effect of central government policy are explored. In exploring both the outcomes of securitization, and its facilitating conditions, I suggest some preliminary observations on the potential costs and benefits of securitizing infectious disease and its utility as a mechanism for protecting health in Asia.
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