Diversity, equity, and inclusion (DEI) policies and programs are crucial tools for reducing social inequality within organizations. However, the recent decline in DEI practices and the inconsistencies found in existing research underscore the need for new theoretical approaches. This essay seeks to offer a fresh perspective on the strengths and limitations of DEI initiatives through the lens of granular interactions thinking theory. It posits that while DEI policies and programs generally create conditions conducive to greater value creation and improved adaptability (...) to changing environments and challenges, maintaining direction and operational certainty within an organization with high DEI demands significant energy investment. To sustain DEI and enhance its effectiveness, these policies need to go beyond simply increasing diversity and ensuring equal access to opportunities. They must also focus on empowering a diverse workforce to contribute to the organization’s success actively. Additionally, fostering a workplace culture that enhances members’ adaptive cognitive processing and skills can reduce the energy required to sustain DEI efforts, making these practices more sustainable in the long term. (shrink)

Equity in Early Modern Legal Scholarship takes the reader through the vast amount of legal writings on equity that were published in continental Europe in early modern times. The book offers the first comprehensive overview of the development of the legal concept of equity through the sixteenth and seventeenth century. During this time, equity scholarship broke with its medieval past and entered a lively debate on the nature and function of the concept. Lorenzo Maniscalco links these developments to the early (...) modern identification of equity with Aristotelian epieikeia, a conceptual shift that brought down the barrier that divided theological and legal writings on equity and led to its development as a tool for the interpretation and amendment of legal rules. (shrink)

The dominance of agency theory can reduce our collective scope to analyse private equity in all its diversity and depth. We contribute to theorisation of private equity by developing a contrasting perspective that draws on a rich tradition of virtue ethics. In doing so, we juxtapose 'private equity' with 'public good' to develop points of rhetorical and analytical contrast. We develop a typology differentiating various forms of private equity, and focus on the 'take private' form. These takeovers are where private (...) equity funds are used to buy all a firm's publicly listed shares. Take private deals reduce reporting requirements and lessen the amount of public scrutiny a firm comes under. They allow greater control of a firm's assets and resources but also have effects in terms of the wider social fabric. The 'public good' and virtue ethics offer an alternative basis for theorisation of these deals. This provides a needed contrast to accounts of private equity based on agency theory. (shrink)

Fish stocks, as common pool resources, are more and more managed by giving fishermen exclusive access rights as Individual Transferable Quotas (ITQ). These have been widely discussed, with focus on social, economic and ecological issues. While equity aspects have been of great concern, there is very limited analysis about how to assess issues of equity and fair distribution when introducing ITQs. This paper applies an existing framework for assessing equity in resource use systems to tradable quota systems in fisheries. The (...) framework defines the perspectives of distributive fairness, the stakeholders who are bound by fair practice rules, and instruments of fairness, and identifies metrics to assess equity in practice. We assess if the framework provides practical guidance for evaluating whether a given ITQ system operates under an equitable framework programme. (shrink)

Both intertemporal and intratemporal equity are central to the examination of policy towards climate change. However, many discussions of intertemporal issues have been marred by serious analytical errors, particularly in applying standard approaches to discounting; the errors arise, in part, from paying insufficient attention to the magnitude of potential damages, and in part from overlooking problems with market information. Some of the philosophical concepts and principles of Paper 1 are applied to the analytics and ethics of pure-time discounting and infinite-horizon (...) models, providing helpful insights into orderings of welfare streams and obligations towards future generations. Such principles give little support for the idea of discrimination by date of birth. Intratemporal issues are central to problematic and slow-moving international discussions and are the second focus of this paper. A way forward is to cast the policy issues and analyses in a way that keeps equity issues central and embeds them in the challenge of fostering the dynamic transition to the low-carbon economy in both developed and developing countries. This avoids the trap of seeing issues primarily in terms of burden-sharing and zero-sum games – that leads to inaction and the most inequitable outcome of all. (shrink)

Following the recommendations of the US National Academy of Sciences and the mandates of the 1987 Nuclear Waste Policy Amendments Act, the US Department of Energy has proposed Yucca Mountain, Nevada as the site of the world's first permanent repository for high-level nuclear waste. The main justification for permanent disposal (as opposed to above-ground storage) is that it guarantees safety by means of waste isolation. This essay argues, however, that considerations of equity (safer for whom?) undercut the safety rationale. The (...) article surveys some prima facie arguments for equity in the distribution of radwaste risks and then evaluates four objections that are based, respectively, on practicality, compensation for risks, scepticism about duties to future generations, and the uranium criterion. The conclusion is that, at least under existing regulations and policies, permanent waste disposal is highly questionable, in part, because it fails to distribute risk equitably or to compensate, in full, for this inequity. (shrink)

This paper introduces this mini-series on vertical equity in health care. It reflects on the fact that by and large equity policies in health care have failed and that there is a need for positive discriminationto promote equity better in future. This positive discrimination is examined under the heading of`vertical equity'. The paper considers Varian's notion of 'envy' as a basis for equity in health care but concludes that this is not a helpful route to go down. Better it would (...) seem to pursue the idea from Sen of 'freedoms' and 'communitarian claims' (as raised previously by this author). While it is argued that procedural justice is to be preferred in the longer run as a basis for equity there are gains in adopting a short run goal of promoting distributive justice. Some preliminary evidence is presented on the weighting of health gains to reflect such vertical equity concerns. (shrink)

Surgery is an increasingly common and expensive mode of medical intervention. The ethical dimensions of the surgeon-patient relationship, including respect for personal autonomy and informed consent, are much discussed; but broader equity issues have not received the same attention. This paper extends the understanding of surgical ethics by considering the nature of evidence in surgery and its relationship to a just provision of healthcare for individuals and their populations.

Offering a new answer to an age-old problem: the meaning of a just or equitable distribution of resources, Julian Le Grand examines the principal interpretations of equity used by economists and political philosophers. He argues that none captures the essence of the term as well as an alternative conception relating equity to the existence or otherwise of individual choice. Le Grand shows that this conception is not only philosophically well-grounded but is also directly relevant to key areas of distributional policy. (...) His theoretical argument is complemented by detailed discussion of the application of the central idea to specific areas of policy, including the distribution of health and health care, central government grants to local governments and the measurement of income for tax purposes. Equity and Choice is written by an economist, but is intended for political philosophers and social policy analysts as well as economists. Hence the key chapters are written in a non-technical fashion, with specialized material relegated to appendices. This book is a unique combination of philosophical, economic and policy analysis and represents a major contribution in all three areas. (shrink)

Background: Equity in providing care is also a major value in the nursing profession. Equitable care aims to provide the entire population with safe, efficient, reliable, and quality nursing services at all levels of health. Objectives: This study was conducted to explain the process of the realization of equity in nursing care. Research design: This qualitative study uses Glaser’s approach to grounded theory. Participants and research context: Sample selection began with convenience sampling and continued with purposive sampling. A total of (...) 27 people were ultimately selected as the study subjects. Data were mainly collected through unstructured in-depth individual interviews plus observation and field notes. The data were then analyzed using the “Six C’s” coding family of Glaser. Ethical considerations: The study protocol was approved by the Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all subjects. Findings: According to the findings, participants’ main concern in providing equitable care is the rationing of nursing care. The identification of participants’ main concern led to the emergence of the core category of the study, that is, “nurses’ domination.” The other categories revolving around the core category were conceptualized according to the six C’s coding family: “nurses being dominated,” “nurses’ ineffective power in the health system,” “low attention to equitable care in health system,” “lack of clarity in measuring equitable care,” “the health structure’s inconsistency with equity,” and “the inefficiency of the care system.” Conclusion: There is a mutual relationship between providing fair care and nurses’ perceptions of equity. Nurses who have themselves experienced equity can provide their patients the experience of equity. This mutual relationship is actualized in a context in which fair care is clearly defined and demanded. (shrink)

The second edition of this volume is a comprehensive, practical and up-to-date analysis of the principles and rules of construction and post-probate issues, including how the courts interpret wills once they become the subject of litigation. This comprehensive work takes account of all recent case law-as well as new legislation such as the Land and Conveyancing Law Reform Act 2009-pertaining to trustees, trusts, trusts of land, and the amendments of the Rules of the Superior Courts by SI No 254 of (...) 2016 relating to the conduct of trials, and SI No 255 of 2016 which deals with pre-trial procedures. Part 1 provides the principles and rules of construction, and the rules of intrinsic and extrinsic evidence, which are applied by the courts when attempting to ascertain and give effect to a testator's intention from vague or uncertain language used by him or her in creating gifts. Part 2 deals with issues that may arise in construction suits concerning, not only uncertain language used in the creation of gifts, but also the actual legal validity of such gifts. Part 3 supplies a useful constructive and interpretative methodology that may be applied for construing and interpreting relevant statutory provisions. Part 4 deals with the forms and procedures required for instituting construction suits, and with issues involving the award of costs. This book is written primarily with legal practitioners in mind and will be of practical use in construction and probate litigation matters. It will also be a useful resource for academic lawyers, students engaged in professional courses, and those undertaking law degrees. [Subject: Wills & Trusts, Irish Law]. (shrink)

_Advancing Equity and Achievement in America’s Diverse Schools _illustrates how educators, students, families and community partners can work in strategic ways to build on social, cultural, and ethnic diversity to advance educational equity and achievement. By drawing on the latest data on demographic change, constructions of culture and cultural difference, and the politics of school reform in urban, rural, and suburban school communities, this volume looks toward solutions and strategies for meaningful educational improvement. Contributors consider both the diversity of youth (...) and families served in public schools, and the culture of U.S. schooling, highlighting the influence of policy and reform agendas; students’ identities and agency; experiences and approaches of diverse educators; and the workings of effective school partnerships. Chapters also focus on those often overlooked in educational scholarship such as Native Americans, students experiencing poverty and/or homelessness, Muslim students, students with special needs, and students and educators who are lesbian, gay, bisexual, transgender, intersex, or queer. In all, this edited collection stresses the need for high quality education that is inclusive, culturally responsive and unifying so all students can experience academic success. This book is a meaningful resource for educators, policymakers, and community-based leaders interested in doing such transformative work. (shrink)

Menu labelling is a public health policy intervention that applies principles of nutrition labelling to the eating out environment. While menu labelling has received a good deal of attention with regard to its effectiveness in shaping food choices for obesity prevention, its premises have not yet been fully explored in terms of its broader applications to social equity and population health. In the following case, we focus on the example of menu labelling within the context of food policy at the (...) local level, a fruitful substantive area of consideration for public health ethics. (shrink)

Technology is often touted as a means for providing new opportunities for learning, economic development, and participation in digital-age citizenry—especially for those who have limited access to high-quality learning environments and who have historically been marginalized in decision-making processes. Unfortunately, these opportunities for advancement are inextricably linked to the possibility of continued disenfranchisement and oppression. Lack of access to technology—or an absence of informed guidance regarding its use—can actually magnify the inequities in students’ education and further limit their opportunities. For (...) these reasons, two of the most fundamental issues of cyber ethics in education are eliminating digital divides and promoting digital equity. In order to review the most recent trends in digital equity for elementary, secondary, and post-secondary education, this article analyzes 42 peer reviewed journal articles published in 2009-10 for trends in research and scholarly thought. (shrink)

This book sets out to defend the claim that Equity ought to remain a separate body of law; the temptation to iron-out the differences between neighbouring doctrines on the two sides of the Equity/Common Law divide should, in most cases, be resisted. The theoretical part of the book is argues that the characteristics of Equity, namely, appeal to conscience, flexibility, retroactivity and the use of morally-freighted jargon, are essential for the implementation of a legal ideal that has been neglected by (...) the Common Law: 'Accountability Correspondence'. According to this fundamental legal ideal, liability imposed by legal rules should correspond to the pattern of moral duty in the circumstances to which the rules apply. Equity promotes this ideal in the fields of property and obligations by disallowing parties to exploit the rule-like nature of Common Law norms in a way that breaches their moral duty to the other party. By reference to various equitable doctrines, it is argued that the faults identified by critics of Equity, especially from the perspective of the Rule of Law, are highly exaggerated, and that the criticism often reflects a political belief in the supremacy of individualism and free market over empathy and social justice. The theoretical part is followed by three chapters, each dedicated to an in-depth analysis of the equitable doctrines of fiduciary duties, proprietary estoppel, and clean hands. For each doctrine, it is shown how their equitable characteristics are indispensable for achieving their social, ethical and economic purpose. (shrink)

The concept of the "unlevel playing field" is critiqued for its tendency to take the prevailing masculinist managerial paradigm for granted. Rather than assume that both men and women should assimilate to corporate masculinity, feminist alternatives are suggested. The pervasiveness of the masculine ethic and the "myth of meritocracy" in organizations are reviewed, with the space shuttle Challenger disaster serving as a focal point to demonstrate the dysfunctionality of masculine management and the rationale for feminist-based organizational transformation to promote not (...) only gender equity, but more effective and ethical organizational behavior. (shrink)

Access to education for undocumented migrant children in South Africa remains a significant challenge. While the difficulties related to their inability to access education within the country have been highlighted elsewhere, there remains a lack of clarity on an approach to how this basic human right can be achieved. In this conceptual paper, we draw on the distinction between equality and equity, and describe the various ways in which education has been conceptualised in the South African Constitution – which in (...) part contributes to the existing confusion on education for various groups, including undocumented migrant children. In this paper, we critically reflects on the need to develop an integrated approach for creating a platform that allows all undocumented migrant children access to education in South Africa. We argue that an integrated approach – which entails ways through which access to education can be delivered through the lens of equity – will enhance the right to education for undocumented migrant children in South Africa. We conclude that the South African government must urgently consider this integrated approach to enable access to education for undocumented migrant children, so that they can achieve their full educational potential. (shrink)

The tension between equity and excellence is fundamental in science policy. This tension might appear to be resolved through the use of merit-based evaluation as a criterion for research funding. This is not the case. Merit-based decision making alone is insufficient because of inequality aversion, a fundamental tendency of people to avoid extremely unequal distributions. The distribution of performance in science is extremely unequal, and no decision maker with the power to establish a distribution of public money would dare to (...) match the level of inequality in research performance. We argue that decision makers who increase concentration of resources because they accept that research resources should be distributed according to merit probably implement less inequality than would be justified by differences in research performance. Here we show that the consequences are likely to be suppression of incentives for the very best scientists. The consequences for the performance of a national research system may be substantial. Decision makers are unaware of the issue, as they operate with distributional assumptions of normality that guide our everyday intuitions. (shrink)

We wholeheartedly agree with Schmidt and colleagues’ efforts to promote equity in intensive care unit triage. We also take issue with their characterisation of the New Jersey allocation framework for ICU beds and ventilators, which is modelled after the multi-principle allocation framework we developed early in the pandemic. They characterise it as a two-criterion allocation framework and claim—without evidence—that it will ‘compound disadvantage for black patients’. However, the NJ triage framework—like the model allocation policy we developed—actually contains four allocation criteria: (...) the two criteria that the authors mentioned and two criteria that they failed to mention which we included to promote equity: giving priority to frontline essential workers and giving priority to younger patients. These omissions are problematic both for reasons of factual accuracy and because the two criteria they failed to acknowledge would likely mitigate rather than exacerbate racial disparities during triage. (shrink)

This chapter contains sections titled: Distributive Justice Nanotechnology and the Developing World Water Purification Solar Energy Medicine Nanotechnology, the Developing World, and Distributive Justice.

This book returns the reader to an agenda for addressing equity in schools, emphasizing the need to reexamine past reform efforts and the work ahead for educational leaders in reshaping schools and schooling.

This paper is a book review of the volume Bărbatul și femeia. Imaginea unei polemici cu privire la echitatea de gen [The man and the woman. The image of a controversy over gender equity], authored by Iulian Apostu and Cristina Petrescu and published by Lumen Publishing House from Iași, Romania, in 2017. The book addresses issues like the psycho-social dynamic of the marital couple, the emancipation of women within the couple, solidarity and conflict between men and women, while placing the (...) debates at the crossroads of modernity and postmodernity, as social paradigms marking the couple’s formation, evolution and separation. (shrink)

Achieving equity in international research is one of the pressing concerns of the twenty-first century. In this era of progressive globalization, there are many opportunities for the deliberate or accidental export of unethical research practices from high-income regions to low- and middle-income countries and emerging economies. The export of unethical practices, termed “ethics dumping,” may occur through all forms of research and can affect individuals, communities, countries, animals, and the environment. Ethics dumping may be the result of purposeful exploitation but (...) often arises from lack of awareness of good ethical and governance practice. This chapter describes the work of the TRUST project toward counteracting the practice of ethics dumping through the development of tools for the improvement of research governance structures. Multi-stakeholder consultation informs all of TRUST’s developments. Most importantly, this gives voice to marginalized vulnerable groups and indigenous people, who have been equal and active partners throughout the project. At the heart of the TRUST project is an ambitious aim to develop a Global Code of Conduct for Research in Resource-Poor Settings. Uniquely, the Code provides guidance across all research disciplines in clear, short statements, focusing on research collaborations that entail considerable imbalances of power, resources and knowledge and using a new framework based on the values of fairness, respect, care, and honesty. The code was recently adopted by the European Commission as a reference document for Horizon 2020 and Horizon Europe. (shrink)

In this age of information technology, it is morally imperative that equal access to information via computer systems be afforded to people with disabilities. This paper addresses the problems that computer technology poses for students with disabilities and discusses what is needed to ensure equity of access. particularly in a university environment.

Equity in health and health care is animportant issue. It has been proposed that thepursuit of equity in health care is beinghampered by the dominance of individualism inhealth care practices. This paper explores theway in which communitarian ideals and practicesmight lend themselves to the pursuit of equity.Communitarians acknowledge, respect and fosterthe bonds that unite and identify communities.The paper argues that, to achieve equity inhealth care, these bonds need to be recognisedand harnessed rather than ignored. The notionof individual autonomy in (...) the context of thecommunity is examined. Alternative concepts ofautonomy – social autonomy and communityautonomy – are seen to be more respectful andnurturing of both the individual and thecommunity. Moreover, these concepts appeardesirable for the pursuit of health care equitygoals. The paper concludes with some thoughtsabout how equity in Australia's health caresystem can reasonably progress within acommunitarian vision. Disadvantaged communitiesare discussed throughout, in particular,Australian Aboriginal communities. (shrink)

The allocation of critical care resources and triaging patients garnered a great deal of attention during the COVID-19 pandemic, but there is a paucity of guidance regarding the ethical aspects of resource allocation and patient prioritization in ‘normal’ circumstances for Canadian healthcare systems. One context where allocation and prioritization decisions are required are surgical waitlists, which have been globally exacerbated due to the COVID-19 pandemic. In this paper, we detail the process used to develop an ethics framework to support prioritization (...) for elective surgery at The Hospital for Sick Children, Toronto, a tertiary pediatric hospital. Our goal was to provide guidance for the more value-laden aspects of prioritization, particularly when clinical urgency alone is insufficient to dictate priority. With this goal in mind, we worked to capture familial, relational, and equity considerations. As part of our institution’s concerted efforts to ethically and effectively address our surgical backlog, an ethics working group was formed comprising clinicians from surgery, anesthesiology, intensive care, a hospital bioethicist, a parent advisor, and an academic bioethics researcher. A reflective equilibrium process was used to develop an ethics framework. To this end, the same methodology was used to create a support for patient prioritization that identifies clinically and morally relevant factors for prioritization among medically similar surgical cases, with a substantive goal being to identify and redress health inequities in surgical prioritization, inasmuch as this is possible. While further steps are needed to validate several aspects of the framework, our research suggests that an ethics framework grounded in the practical realities of hospital operations provides consistency, transparency, and needed support for decisions that are often left to individual clinicians, as well as an opportunity to reflect upon the presence of health inequities in all domains of healthcare delivery. (shrink)

An enduring concern for educational policy in many affluent countries is the endemic nature of educational inequalities that are predominately located in poor urban contexts. Given the inabilities of school reform per se to deal with these inequalities, the paper focuses on issues of scarcity and spatial processes that are implicated in the formation of young people's educational identities – identities that then mediate the conversion of educational resources into educational attainments or achievements.

We report the results of a vignette study with an online sample of the German adult population in which we analyze the interplay between need, equity, and accountability in third-party distribution decisions. We asked participants to divide firewood between two hypothetical persons who either differ in their need for heat or in their productivity in terms of their ability to chop wood. The study systematically varies the persons’ accountability for their neediness as well as for their productivity. We find that (...) participants distribute significantly fewer logs of wood to persons who are held accountable for their disadvantage. Independently of being held accountable or not, the needier person is partially compensated with a share of logs that exceeds her contribution, while the person who contributes less is given a share of logs smaller than her need share. Moreover, there is a domain effect in terms of participants being more sensitive to lower contributions than to greater need. (shrink)

Organs for transplantation are a scarce resource. Markedly, the transplant community’s primary challenge is the stark disparity between the number of patients awaiting deceased donor organ transplants and the rate at which organs become available. However, the allocation of a limited number of organs poses another constant challenge: maintaining an equilibrium between renal transplant utility and equity, that is, striking a balance between the utilitarian argument of medical efficiency and the principle of equity. In this comprehensive overview, the authors delve (...) into the challenge of maintaining an acceptable balance between equity and efficiency and elaborate on some of the factors that might inform a decisionmaker’s evaluation of the extent to which a given allocation scheme is efficient or equitable. (shrink)

Recent calls to address racism in bioethics reflect a sense of urgency to mitigate the lethal effects of a lack of action. While the field was catalyzed largely in response to pivotal events deeply rooted in racism and other structures of oppression embedded in research and health care, it has failed to center racial justice in its scholarship, pedagogy, advocacy, and practice, and neglected to integrate anti-racism as a central consideration. Academic bioethics programs play a key role in determining the (...) field’s norms and practices, including methodologies, funding priorities, and professional networks that bear on equity, inclusion, and epistemic justice. This article describes recommendations from the Racial Equity, Diversity, and Inclusion (REDI) Task Force commissioned by the Association of Bioethics Program Directors to prioritize and strengthen anti-racist practices in bioethics programmatic endeavors and to evaluate and develop specific goals to advance REDI. (shrink)

Based on the concept of shareholder primacy, many scholars have argued that it is more important for businesses to earn profits for their shareholders than to provide benefits to society at large. Corporate social responsibility is often regarded as an investment that comes at the expense of shareholders. In contrast, research analyzing the connections between the equity ownership structure of a company and its level of CSR engagement suggests that CSR offers benefits to shareholders that go beyond direct financial returns (...) from investments. This study provides a comprehensive review and systematic assessment of theoretical considerations and approaches regarding different forms of equity ownership and their relationships to CSR, and it discusses the relevant benefits and motivations of shareholders. The perceived value of these CSR benefits varies among different types of shareholders, as they assign unequal values to short-term financial or to rather long-term CSR benefits. Based on a literature sample of 146 publications, this review demonstrates central problems inherent in previous analyses. Given the ambiguous and partially contradictory findings of prior research, this study identifies potential moderating influences that help clarify empirical evidence. A contingency approach is suggested in future research, as this can help resolve the problem of contradictory empirical findings and theoretical arguments. (shrink)

Aristotelian equity has often been relegated to scholarly discussions of retributive justice. Recently, however, political theorists have recast equity as the virtue of a sympathetic democratic citizen. I build on this literature by offering a more precise explanation of equity’s internal structure and political significance. In particular, I reveal equity’s deliberative dimension. For Aristotle, equitable citizens, statesmen, and legislators correct or go beyond the law, as appropriate, not only when they render retrospective judgments about matters of punishment or distribution, but (...) also when they deliberate about future-oriented questions of legislation or political action. In addition, I show, more concretely, the role of equity in democratic citizenship. Drawing upon the Aristotelian Constitution of the Athenians, I argue that the Athenian demos exemplified equity when it brought about the reconciliation and the amnesty of 403 BC. Attention to this episode clarifies the conceptual linkages between equity, deliberation, sympathy, and democracy. (shrink)

Since the onset of the COVID-19 pandemic, a controversial criterion for allocating scarce medical treatment has been defended and incorporated into policy: the criterion of equity. Equity-included allocation schemes prioritize, to some degree, patients from marginalized or historically disadvantaged racial/ethnic groups, or patients with low socioeconomic status, for scarce treatment. The use of such criteria has been most prominently defended in two ways: (1) as reflecting a risk factor for severe COVID-19, and thus as a way of tracking medical need, (...) and (2) as a form of remedial justice, viz. a way of redressing disparities in COVID outcomes that are caused by underlying unjust social conditions. Here, we delineate and critique those arguments. We argue that not only are such arguments unconvincing but also that there are compelling moral reasons to reject the sort of equity-included allocation schemes at issue. (shrink)

Health equity is increasingly identified as a principal goal to be achieved through public health policies and activities. However, what is to be measured in the assessment of health equity and how inequities in health ought to be redressed are among the pressing questions that must be answered if health equity is to serve as a meaningful and consistent ethical guide for measurement and intervention in public health. In this article I argue that the concept of health equity, in the (...) form it is predominantly found in public health, suffers from normative indeterminacy and is therefore unlikely to provide actionable normative guidance to public health policy-makers, practitioners and researchers. I argue that the concept of health equity, as it is commonly defined in public health, ultimately rests upon assumptions of a more fundamental, yet tacit, conception of justice to do its normative work. In this vein, I expand upon a critique of Margaret Whitehead’s oft-cited definition of health equity made by James Wilson to raise additional reasons not explored by Wilson, or others, as to why Whitehead’s definition remains inadequate in providing normative guidance to policy-makers, practitioners and researchers in public health. (shrink)

Inequities in health and health care are one of the greatest challenges facing the international community today. This problem raises serious questions for health care planners, politicians and ethicists alike. The major world religions can play an important role in this discussion. Therefore, interreligious dialogue on this topic between ethicists and health care professionals is of increasing relevance and urgency. This article gives an overview on the positions of Islam and Christianity on equity and the distribution of resources in health (...) care. It has been written in close collaboration and constant dialogue between the two authors coming from the two religions. Although there is no specific concept for the modern term equity in either of the two religions, several areas of agreement have been identified: All human beings share the same values and status, which constitutes the basis for an equitable distribution of rights and benefits. Special provisions need to be made for the most needy and disadvantaged. The obligation to provide equitable health services extends beyond national and religious boundaries. Several areas require intensified research and further dialogue: the relationship between the individual and the community interms of rights and responsibilities, how to operationalize the moral duty to decrease global inequalities in health, and the understanding and interpretation of human rights in regard to social services. (shrink)

Health equity matters, but there is no universally accepted definition of this or associated terms, such as inequities, inequalities, and disparities. Given the flexibility of these terms, investigating how policymakers understand them is important to observe priorities and perhaps course correct. Accordingly, this study analyzed the perceptions high-level policymakers within the WHO African Region. An online survey was distributed to attendees of the WHO’s Fifth Health Sector Directors’ Policy and Planning Meeting for the WHO African Region by email. After responses (...) were collected, both inductive and deductive coding were applied. Inductive coding was undertaken to glean central concepts from free-form responses on understandings of health equity and deductive coding was used to assess alignment with four theories of distributive justice using a coding framework. In analyzing central concepts, three became apparent: access to health services and/or health care, financial protection, and recognizing subgroups. And when we investigated alignment with theory, most respondents’ understandings of health equity aligned with Rawls’ ‘Theory of Justice’ (95%). Of these responses, 70% were exclusively aligned with Rawls’ ‘Theory of Justice’ and 30% aligned also with another theory (this 30% was split 55% utilitarianism and 45% Sen’s Capabilities Approach). Respondent understandings of health equity showed limited alignment with other theories of distributive justice, which were: utilitarianism (n = 7/39; 17.95%), Sen’s Capabilities Approach (n = 5/39; 12.82%), and libertarianism (n = 2/39; 5.13%). Our study demonstrates that alignment with certain theories is tied to specific themes (i.e., theoretical underpinnings may guide policymakers to favour certain policy approaches). For instance, a utilitarian-minded policymaker may be focused on a widespread vaccination campaign, whereas a Rawlsian-aligned policymaker may focus on a targeted approach to reach communities that have lower vaccination rates, and a Senian-aligned policymaker may focus on health literacy programs targeted at addressing vaccine-hesitant individuals within communities with lower vaccination rates. These findings can guide high-level policymakers and international organizations to optimize decision-making by clarifying ethical alternatives. (shrink)

Can the institutional systems that prepare Black nurse researchers question the ways their systemic pathways have impacted health equity knowledge development in nursing? We invite our readers to keep this question in mind and engage with our conversation as Black nurse researchers, scholars, educators, and clinicians. The purpose of our conversation, and this article, is to explore the transactional impact of knowledge development pathways and Black faculty retention pathways on the state of health equity knowledge in nursing today. Over a (...) series of conversations, we discuss the research exploitation of communities of color, deficit research funding, knowledge capitalization, the marginalization of diversity as a continuous process, a lack of sociocultural authority, and our thoughts on solutions. We conclude by using the wisdom of a generation to answer our initial question. (shrink)

The everyday harms of structural racism and discrimination, perpetuated through institutions, laws, policies, and practices, constitute social determinants of health, but measures that account for their debilitating effects are largely missing in genetic studies of complex diseases. Drawing on insights from the social sciences and public health, we propose critical methodologies for incorporating tools that measure structural racism and discrimination within genetic analyses. We illustrate how including these measures may strengthen the accuracy and utility of findings for diverse communities, clarify (...) elusive relationships between genetics and environment in a racialized society, and support greater equity within genomics and precision health research. This approach may also support efforts to build and sustain vital partnerships with communities and with other fields of research inquiry, centering community expertise and lived experiences and drawing on valuable knowledge from practitioners in the social sciences and public health to innovate biomedical and genomic study designs aimed at community health priorities. (shrink)

Orthodox ideas of ownership tend to depict property as a private domain that expresses the owner?s formal rights. Yet equity does much to resist this outlook, deploying ethically-loaded ideas such as conscience and articulating an interpersonal and distinctly duty-driven character to property relations. Focusing on English case law, this article suggests that we can gather various strands of equitable property norms, particularly those derived from the constructive trust, around relationships of responsibility and vulnerability. Furthermore, the article asks what such equitable (...) ideas about property might therefore tell us about the purportedly possessive character of human subjectivity. Rather than constructing people as sovereign, autonomous proprietors, we might read equity as tracing an ethical quality to the way we perceive ourselves and others through property-related ideas. (shrink)

There is consistent and strong empirical evidence for social inequalities in health, as a vast and fast growing literature shows. In recent years, these findings have helped to move health equity high on international research and policy agendas. This paper examines how the empirical identification of social inequalities in health relates to a normative judgment about health inequities and puts forward an approach which embeds the pursuit of health equity within the general pursuit of social justice. It defends an indirect (...) approach to health equity, which views social inequalities in health as unjust in so far as they are the result of an unjust basic structure of society in Rawls’ sense. (shrink)

This paper focuses on the potential of “equitech”—AI technology that improves equity. Recently, interventions have been developed to reduce the harm of implicit bias, the automatic form of stereotype or prejudice that contributes to injustice. However, these interventions—some of which are assisted by AI-related technology—have significant limitations, including unintended negative consequences and general inefficacy. To overcome these limitations, we propose a two-dimensional framework to assess current AI-assisted interventions and explore promising new ones. We begin by using the case of human (...) resource recruitment as a focal point to show that existing approaches have exploited only a subset of the available solution space. We then demonstrate how our framework facilitates the discovery of new approaches. The first dimension of this framework helps us systematically consider the analytic information, intervention implementation, and modes of human-machine interaction made available by advancements in AI-related technology. The second dimension enables the identification and incorporation of insights from recent research on implicit bias intervention. We argue that a design strategy that combines complementary interventions can further enhance the effectiveness of interventions by targeting the various interacting cognitive systems that underlie implicit bias. We end with a discussion of how our cognitive interventions framework can have positive downstream effects for structural problems. (shrink)

Achieving gender equity in clinical trials requires that women be included in sufficient numbers to carry out analysis, that sub-sample analyses be performed, and that results be communicated in such a way as to expand medical knowledge, inform policy decisions, and educate patients. In this article, we examine the extent to which Canada promotes gender equity through its laws and guidelines, viewed within the context of its drug safety system and its research ethics board structure. We analyze the structuring of (...) information by the pharmaceutical industry and consider the impact of its promotional activities on the state of gender knowledge and health. In the final section, we propose ways to improve the structuring of health information to promote gender equity. (shrink)

This book presents a clear, carefully-analysed picture of the operation of equity today, across the common law world. Rather than revisit the abstract debate as to whether or not equity has 'fused' with the common law, it focuses on specific equitable principles and doctrines. Expert contributors step back and take a wider view of those doctrines, examining how they can best be understood today, and how they might develop in the future. This will prove invaluable to practitioners and courts (at (...) first instance as well as appellate level), allowing them to navigate the constantly-growing mass of case law. Drawing on expertise from across the worlds of academia, practice and the bench, this seminal collection provides the most illuminating picture available of how equity operates. (shrink)

In this response, I reiterate my argument that price gouging undercuts the goal of equity in access to essential goods whereas Zwolinski emphasizes the importance of the efficient provision of essential goods above all other goals. I agree that the efficient provision of essential goods is important as I argue for the goal of equitable access to sufficient of the goods essential to living a minimally flourishing human life. However, efficiency is a means to this goal rather than the end (...) itself. Finally, I offer additional arguments against the non-worseness claim. (shrink)