Solidarity in Bioethics

Abstract

The concept of solidarity is frequently cited in discussions about distributive justice and what we owe to other people. In addition, solidarity is increasingly the focus of debates in bioethical theory and practice, where it is treated as a concept of fundamental importance, for example in public and global health contexts. Despite the attention that solidarity increasingly receives, however, an exact definition of the term and its role in bioethics remains elusive. Solidarity is understood as a commitment to accept costs to support others with whom people recognise relevant similarities, a definition that we consider particularly fruitful in using solidarity as a guiding principle for policy and practice. Key Concepts Solidarity has recently been gaining more prominence in bioethical, public health and global health debates. The history of solidarity is patterned. Throughout its history, the concept has been imbued with different meanings, with the common denominator being that solidarity is a prosocial notion. The authors define solidarity is as a (shared) commitment to accept ‘costs’ (in the wide sense of the word) to support others with whom people recognise relevant similarities. Defined in this manner, solidarity can be clearly distinguished from related concepts such as altruism or charity. The threat posed by global climate change demonstrates the importance of a solidaristic response by the governments and citizens of all countries. The risks of climate change also provide the catalyst for cooperative action by highlighting an important similarity that exists between all persons – common vulnerability to serious harm. In the context of bioethical policy and practice, solidarity has the potential to ground just, effective public policy and can motivate individuals and governments to participate in programmes intended to alleviate common threats.

¿Es defendible la objeción de conciencia institucional en el caso de aborto?

“…Restringir el ejercicio de la conciencia respecto de terceros identificados implica una sanción social a la práctica de la intolerancia 106 , ya que de lo contrario se abre una puerta a la "medicina basada en el valor" ("una caja de Pandora de medicina idiosincrásica, intolerante y discriminatoria") 107 basada en intereses privados en lugar de públicos. Las concesiones otorgadas a los objetores sugieren una ampliación de los límites de la esfera de conciencia privada en el ámbito público, donde objetar el cumplimiento de ciertos deberes de atención médica puede imponer cargas significativas a terceros y puede obstaculizar el disfrute de los derechos 108 .…”

“…Sin embargo, el ejercicio de la libertad de religión puede reducirse a ciertas instituciones que, en principio, tienen un propósito religioso claro (iglesias) 150 . El problema es que el caso Hobby Lobby ha demostrado que esto no es necesariamente así, ya que las organizaciones con fines de lucro no religiosas, pero estrechamente controladas, pueden ejercer la libertad de religión y evitar el cumplimiento de prestaciones 151 . Por eso, se requiere una perspectiva adicional.…”

Solidarity as a national health care strategy

“…47 53 This kind of 'tier three' solidarity is instantiated by the cooperative health care systems of wealthy countries like the U.K. and Germany. 47 53 This kind of 'tier three' solidarity is instantiated by the cooperative health care systems of wealthy countries like the U.K. and Germany.…”

“…In Susan's case, it can be argued that her general liberty would be promoted more effectively if she were to 'give up' this minor freedom in favour of mandatory participation in a cooperative health care system based on solidarity. There are, therefore, circumstances in which restrictions on personal liberty are justifiable, 84 and it is possible for restrictions on liberty in one area to promote liberty more generally, both for society as a whole and for those individuals whose initial liberties are constrained. Correlatively, participating in solidaristic systems which serve the health needs of all people minimizes the costs of protecting one's own health, thereby increasing the resources available to pursue one's own life goals and thereby promotes, rather than restricts, personal liberty.…”

From self‐interest to solidarity: One path towards delivering refugee health

“…85 Many refugees are resident in countries that lack the ability to provide health care to them (or even to citizens). However, the recommendations for AMR contained in the O'Neill report, although certainly self-interested, emphasized an overt willingness to incur costs to meet the needs and interests of persons outside the group with which wealthy nations were initially concerned, based on recognition of their shared vulnerabilities.…”