Hello, and welcome back to this Global Health YouTube channel.
My name is Greg Martin.
In this episode, we're going to talk about the idea of justice.
Now, this is a continuation of a series
that we started a little while ago,
and that series was looking at the application of philosophy
and ethics to global public health.
So far we've looked at a framework
for thinking about philosophy and global health.
We've also looked at deontological and utilitarian
ethics.
We've talked about two types of human rights.
We've defined the idea of exploitation.
Now we're going to take a look at the idea
of distributive justice and how it's
connected with the idea of inequality.
Here are one or two facts.
Firstly, about 1.2 billion people alive today
live in extreme poverty.
That's according to the World Bank.
That's living on less than $1.25 per day.
The world's poorest 3 billion people, cumulatively,
have as much wealth as the richest 300 people.
Now, I'm going to start off by introducing you
to another thought experiment.
This was developed by the late Jonathan Rawls in his paper,
"A Theory of Justice."
This is widely regarded as the single most influential
publication in political philosophy
over the last hundred years.
So I want you to imagine for a moment,
you are removed from the world, with all of its diversity
and all of its prejudice.
You and the rest of society find yourself behind a curtain.
This is what Rawls calls the veil of ignorance.
And behind this curtain, you've got no knowledge
of your position in society.
You've got no idea if you're rich,
if you're poor, if you're black, if you're white,
if you're male or female.
You know nothing about yourself.
So Rawls asks you a question.
Before you reenter your familiar civilian life,
he asks you to describe what kind of world
you would want to find on the other side of the curtain.
If you didn't know whether you were
going to be a city banker or a bricklayer,
what wage differential would you want
to exist between these two kinds of workers?
Rawls calls this the original position.
Now, we're going to come back to this thought experiment in just
a moment, and you'll see the point of it.
But for now, we're going to delve
into one of the many facets of justice,
and this is called distributive justice, which is really just
about the socially just allocation of goods
in a society.
Now, why is this important in the discussion
around global health?
Well, two reasons.
The first, and the most obvious, is
that people's health is hugely affected by the extent to which
they have access to treatment and care,
and this is something that we decide upon a society level.
The second is that health is also a function of your access
to other things like education, employment, housing,
fresh water, sanitation, food, security, information,
political freedom, and the like.
So to address this, Rawls poses a set of principles.
The first is called the liberty principle,
and this states that each person is entitled
to an equal and extensive set of liberties or rights.
And we've done an episode on human rights
and I encourage you to go back and watch that.
The second principle is really divided into two.
The first is the difference principle,
and the second is the fair opportunity principle.
The fair opportunity principle is reasonably straightforward.
Everybody's entitled to an equal set of opportunities.
It's the difference principle that's
particularly interesting, and this
is where our thought experiment comes into play.
So Rawls was grappling with the problem of the extent to which,
and the circumstances within which,
inequalities are justifiable in society.
Notice the connection between the word justifiable
and justice.
Using the thought experiment that we talked about,
about the veil of ignorance, and of course a set
of rational arguments that we can't get into in this video,
but you can read about if you go to his paper,
Rawls shows that a rational person
would allow for inequalities only in so much as they would
benefit the worst off as much as possible.
In other words Rawls could see that some inequality in society
may be beneficial.
For example, more productive people earning high wages
may lead to a richer economy.
But this is only justifiable where the worst off
benefit as much as possible.
He didn't support the argument that inequalities
are fine if the average income is improved.
This would be the position of your utilitarian.
There are many scenarios in which
the average income of a population has improved,
but the poorest people in society are left worse off.
Since Rawls' publication, there have
been a number of interesting studies,
and these have shown that an improvement in the well being
of the poorest socioeconomic strata
has significant benefit to society as a whole, not just
the poor.
And perhaps one of the more well-known
of these publications is a book called, "The Spirit Level-- Why
More Equal Societies Almost Always Do Better,"
and this is by Richard Wilkinson and Kate Pickett.
And this book looks at the impact of inequity
on other social indicators like physical health, mental health,
drug abuse, education, imprisonment, obesity,
social mobility, trust in community life, violence,
teenage pregnancies, and child well-being.
And what they found was that more equal societies almost
invariably do better against all of these measures, even
in the wealthier socioeconomic strata.
So it turns out that not only would
choosing a social structure in which the worst off are as well
off as possible be a rational choice, from behind the veil
where you don't know whether you're
going to be rich or poor, But a more equal society benefits you
even if you're lucky enough to be part of the wealthiest
socioeconomic strata.
I'd like to leave you with a quote from Robert F. Kennedy.
"Yet the gross national product does not
allow for the health of our children,
the quality of their educational,
or the joy of their play.
It doesn't include the beauty of our poetry
or the strength of our marriages,
the intelligence of our public debate
or the integrity of our public officials.
It measures neither our wit nor our courage,
neither our wisdom nor our learning,
neither our compassion nor our devotion to our country.
It measures everything, in short,
except that which makes life worthwhile."
I hope you enjoyed this video.
Remember to make comments below.
I'm interested in what you think.
And subscribe if you haven't.
We'll be making more content soon, so come back and watch.
Speak to you then.
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