Assessing social equity of federal disaster aid distribution: A nationwide analysis.

In this study, we conduct the first comprehensive, nationwide assessment of social equity performance of multiple federal post- and pre-disaster assistance programs that differ in targeted recipients, project types, forms of aid, and funding requirements. We draw on the social equity and distributive justice theory to develop and test a set of hypotheses on the influence of program design and specificity on their aid distributional patterns and equity performance. The analysis uses panel data of about 3000 US counties to examine the relationship between a county's receipt of federal assistance and its recent disaster damage, socioeconomic, demographic, political, local government, and geographic characteristics in a two-stage random effects Tobit model. Expectedly, we find that post-disaster grants are largely driven by recent disaster damage, while damage is simultaneously influenced by local socioeconomic conditions. For all disaster programs, disproportionately more federal aid is allocated to populous counties. For programs geared toward state and local governments and targeting community recovery and mitigation, more aid is received by counties with better socioeconomic conditions. Conversely, for programs targeting individual relief and recovery, more aid is given to counties with lower incomes and greater social vulnerability. Results also indicate that counties located in high-risk regions receive greater outlays. These findings shed light on the varying degrees of social equity of federal disaster assistance programs tied to their cost-share requirement, funding caps, and inherent complexity of application procedures.

Unveiling the impact of school organizational justice on students' professional commitment through academic stress mediation.

Accurately understanding the critical elements influencing college students' professional commitment is both an urgent practical requirement and a critical theoretical proposition in today's intensely competitive job market. In order to provide new light on career development in the context of higher education, this study intends to investigate the complex interactions among college students between perceived organizational justice, academic stress, and professional commitment. Using descriptive statistics, correlation analysis, regression analysis, and structural equation modeling, we carried out a thorough investigation of H University's full-time undergraduate students in Central China in order to thoroughly examine our hypothesis. The results show that students' professional commitment is much lower when they view organizational justice to be lacking, and that there is a partial mediating role for academic stress in this relationship. Interestingly, organizational justice has a positive correlation with professional commitment and a negative correlation with academic stress. These findings provide educators and policymakers with insightful information, indicating that, in an increasingly competitive labor market, professional commitment is largely dependent on students' ability to manage their academic stress and develop a sense of organizational justice. This study adds a new understanding of career development in higher education settings by merging professional commitment research with organizational justice theory. It also has significant implications for educational practices and career support measures.

Reflections on being a Thai transman through the lens of the reproductive justice framework.

Transmen are a crucial gender group within the umbrella of transgender identities, yet there remains a lack of understanding regarding their gender identities and sexualities. Transmen often face challenges related to gender discrimination and inequalities, particularly in accessing government services such as healthcare and social welfare, and in securing legal recognition of their gender identity and rights. This article explores the challenges faced by transmen in Thailand. It through a discussion of the lived experiences and gender identities of Thai transmen by examining the societal context through existing literature and qualitative interviews of transmen on their own. The aim is to examine the specific local context of Thai transmen using a reproductive justice approach to examine how transmen experience gender discrimination when challenging the dominant cis-normative gender norms in Thai society. Understanding these challenges can contribute to creating fundamental knowledge for a better understanding of transmen's identities and inform recommendations for public policies that support greater gender diversity and a more inclusive environment. Importantly, supporting legal gender recognition based on self-identified gender can promote reproductive justice for transgender people.

Doing ethics with microbes: toward a queer feminist posthuman framework for bioethics.

The Centre for the Social Study of Microbes (CSSM) at University of Helsinki, Finland is a Wellcome-funded hub for creating new approaches to human-microbial relations. Most urgently, the complex relations between microbes, antimicrobial resistance (in its human-health centered definition, understood as infection and disease now uncurable by antibiotics, threatening human life and wellbeing), animals, environments and climate emergency require new theoretical and methodological approaches. These include a variety of research interest from global fermentation practices and cultures to microbial bioremediation techniques, from aquatic microbes to urban gardens. A key orientation of CSSM is also combining ethnography with artistic and performative practice such as felting, painting, installation, sculpture and audiovisual means, to gain a deeper, more sensory and embodied perspective of our shared lives with microbes. As their agency exists outside textuality, new experimental methodology is needed to engage with it. Thinking with microbes invites many ethical issues that often remain unaddressed in medical and scientific approach. As one of such contributions, we suggest a new framework for bioethics. In a conceptual analysis, a queer feminist posthuman framework aims for radical reorientation of human exceptionalism for more-than-human justice while keeping existing social justice issues between groups of people, such as vulnerabilities cascading around gender and sexual variance, in the same framework. Both a theoretical and practical initiative, seeking to forge solidarity between justice movements, this framework could ground policies relevant to a broader bioethical and philosophical research community, and social scientists studying microbes. This open letter discusses this work at the CSSM.

The Centre for the Social Study of Microbes (CSSM) at University of Helsinki, Finland is a Wellcome-funded hub for creating new approaches to human-microbial relations. These include a variety of research interest from global fermentation practices and cultures ­ the arts of rice beer and sake-making, for example ­ to microbial bioremediation techniques, from aquatic microbes to urban gardens. A key orientation of CSSM is also to explore microbes through artistic mediums such as felting, painting, installation, sculpture and audiovisual means. Thinking with microbes invites many ethical issues that often remain unaddressed in medical and scientific approach. Most urgently, the complex relations between microbes, antimicrobial resistance (in its human-health centered definition, understood as infection and disease now uncurable by antibiotics, threatening human life and wellbeing), animals, environments and climate emergency require new ways to think about these issues and aims to resolve them. As one of such contributions, we suggest a new framework for bioethics. Sudenkaarne's queer feminist posthuman framework for bioethics offers a platform to consider injustices caused by human action to environments and more-than-human animals and injustices between groups of people in the same framework. Hopefully, this framework is inspirational to other researchers and public policy initiatives. It has been inspired by the collective work at CSSM.

Reconstructing AI Ethics Principles: Rawlsian Ethics of Artificial Intelligence.

The popularisation of Artificial Intelligence (AI) technologies has sparked discussion about their ethical implications. This development has forced governmental organisations, NGOs, and private companies to react and draft ethics guidelines for future development of ethical AI systems. Whereas many ethics guidelines address values familiar to ethicists, they seem to lack in ethical justifications. Furthermore, most tend to neglect the impact of AI on democracy, governance, and public deliberation. Existing research suggest, however, that AI can threaten key elements of western democracies that are ethically relevant. In this paper, Rawls's theory of justice is applied to draft a set of guidelines for organisations and policy-makers to guide AI development towards a more ethical direction. The goal is to contribute to the broadening of the discussion on AI ethics by exploring the possibility of constructing AI ethics guidelines that are philosophically justified and take a broader perspective of societal justice. The paper discusses how Rawls's theory of justice as fairness and its key concepts relate to the ongoing developments in AI ethics and gives a proposition of how principles that offer a foundation for operationalising AI ethics in practice could look like if aligned with Rawls's theory of justice as fairness.

Ethical Frameworks and Global Health: A Narrative Review of the "Leave No One Behind" Principle.

The "Leave No One Behind" (LNOB) principle, a fundamental commitment of the United Nations' Sustainable Development Goals, emphasizes the urgent need to address and reduce global health inequalities. As global health initiatives strive to uphold this principle, they face significant ethical challenges in balancing equity, resource allocation, and diverse health priorities. This narrative review critically examines these ethical dilemmas and their implications for translating LNOB into actionable global health strategies. A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Semantic Scholar, covering publications from January 1990 to April 2024. The review included peer-reviewed articles, gray literature, and official reports that addressed the ethical dimensions of LNOB in global health contexts. A thematic analysis was employed to identify and synthesize recurring ethical issues, dilemmas, and proposed solutions. The thematic analysis identified 4 primary ethical tensions that complicate the operationalization of LNOB: (1) Universalism versus Targeting, where the challenge lies in balancing broad health improvements with targeted interventions for the most disadvantaged; (2) Resource Scarcity versus Equity; highlighting the ethical conflicts between maximizing efficiency and ensuring fairness; (3) Top-down versus Bottom-up Approaches, reflecting the tension between externally driven initiatives and local community needs; and (4) Short-term versus Long-term Sustainability, addressing the balance between immediate health interventions and sustainable systemic changes. To navigate these ethical challenges effectively, global health strategies must adopt a nuanced, context-sensitive approach incorporating structured decision-making processes and authentic community participation. The review advocates for systemic reforms that address the root causes of health disparities, promote equitable collaboration between health practitioners and marginalized communities, and align global health interventions with ethical imperatives. Such an approach is essential to truly operationalize the LNOB principle and foster sustainable health equity.

Police legitimacy and procedural justice for children and youth: a scoping review of definitions, determinants, and consequences.

Introduction: Understanding police legitimacy among children and youth is important for building a just and democratic society. Although the volume of studies on police legitimacy among underaged persons has grown in recent decades, the findings on the relationships between police legitimacy and procedural justice and their definitions, associated determinants, and consequences remain heterogeneous across studies and across political and legal contexts. Given these heterogeneities, the conclusions and implications generated by this research are far from comprehensive. Method: This scoping review offers readers a comprehensive and comparative understanding of this topic by answering the following questions. (1) How can we define police legitimacy and procedural justice for children and youth? (2) What are the determinants of police procedural justice and legitimacy for children and youth? (3) What are the consequences of police procedural (in)justice and (il)legitimacy for children and youth? (4) Among children and youth, who are the vulnerable groups receiving less legitimate and unjust treatment from the police? A scoping review of the literature published between January 1, 1990 and May 31, 2022 was conducted based on four databases: PubMed, Web of Science, Scopus, and ProQuest. Guided by the scoping review screening framework proposed by Arksey and O'Malley, that is, the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and the checklist provided by the Joanna Briggs Institute for quality assessment, 47 publications, consisting of 38 quantitative studies and 9 qualitative studies, were retained in the final sample. Results: The results synthesize the operational and subjective interpretations of police legitimacy offered by the respondents in the studies reviewed which is followed by the discussion of conceptual and measurement issues. The key correlates of police legitimacy identified in these studies were police procedural justice and behavior, followed by experience and contact with the police, relationships with other authority figures, and personal competence in moral reasoning and self-control. In addition to compliance and cooperation, cynicism, trust, and health were related to police (il)legitimacy. Discussion: We argue that in addition to building and maintaining police legitimacy, it is vital to remedy the negative consequences of injustice in police-youth encounters. Systematic Review Registration: https://inplasy.com/inplasy-2024-9-0064/, INPLASY202490064.

Moving towards transformative justice for black women survivors of intimate partner violence: an intersectional qualitative study.

BACKGROUND: Intimate partner violence (IPV) disproportionately affects Black women, yet the current IPV justice response, relying on the criminal legal system, often fails them due to racialized, sexist stereotypes that disrupt Black women's claims to survivorship. Transformative justice, a community-based approach designed to repair harm between the survivor and person who caused harm and transform the social conditions that perpetuate violence, may be a promising alternative approach to facilitate justice and accountability for IPV. However, little is known about the justice preferences of Black women IPV survivors. This qualitative study sought to understand Black women IPV survivors' experiences interacting with police and their justice preferences following IPV. METHODS: Semi-structured interviews with 15 Black women IPV survivors were conducted between April 2020 and April 2022. Inductive analytic techniques derived from grounded theory were used to contextualize Black women IPV survivors' experiences. RESULTS: One theme was identified that aligned with Black women IPV survivors' experiences interacting with the police: 1) fear and distrust. Four themes were identified that aligned with justice preferences: (1) resolution through dialogue, (2) therapy and counseling services, (3) resource support, and (4) protection and prevention for children. Fear and distrust of the police was mainly driven by anticipated discrimination. Survivors' justice preferences encompassed solution-based dialogue between the survivor and person who caused harm mediated by family and trusted individuals in the community, therapy services, housing support, and attention to preventing the intergenerational cycle of IPV for children as part of a community-based, holistic justice response. CONCLUSIONS: Police interactions as part of the current justice response were counterproductive for Black women IPV survivors. Black women IPV survivors deserve alternative forms of justice and accountability for IPV. As an alternative justice response to IPV, transformative justice can encompass their justice preferences and promote equity and center Black women IPV survivors and their communities.

Allyship, authenticity and agency: The Triple A Model of Social Justice Mentoring.

This conceptual review explores the full potential of mentoring for diversity initiatives. Using a positive relationships lens, I describe how focusing on average relationships obscures the benefits of high-quality mentoring and how traditional views of mentoring as hierarchical, one-way relationships limit our understanding of its role in advancing social justice. Addressing these limitations, I extend relational mentoring and diversified mentoring theories to introduce the Triple A Model of Social Justice Mentoring. This model holds that the effects of high-quality mentoring extend beyond the relationship to influence social justice outcomes. Both members can learn about diversity and experience relational dynamics that foster allyship, agentic empowerment and authentic identities. Implications for formal mentoring, diverse friendships, mentoring episodes and high-quality connections are discussed.

Mobilizing Critical Occupational Therapy Praxis to Promote Structural Justice, Equity, and Rights[Formula: see text].

BACKGROUND: Societal structures and systems compel occupational therapists, at times, to behave in ways that perpetuate injustices. Justice theorists have described how Global North social structures have created the conditions for oppression of some groups while enabling additional groups to have unearned privileges. Mobilizing critical occupational therapy praxis is an essential response. PURPOSE: This lecture addresses three questions: why should occupational therapists integrate structural justice, equity, and rights into their everyday practices?; what gives occupational therapy the potential to be a structural justice-, equity-, and rights-oriented profession?; and, how can occupational therapy mobilize critical praxis that will promote structural justice, equity, and rights? KEY ISSUES: Occupational therapy's embeddedness in structures of injustice and therapists' obligations to integrate justice, equity, and rights into their everyday practices are increasingly evident. A focus on occupational participation, growing critical consciousness, socially transformative practices, and capacity for collective action position occupational therapy to be a structural justice-oriented profession. Critical reflexivity and reflection; justice-, equity-, and rights-based lenses; and acts of resistance and disobedience to oppressive systems can help mobilize critical praxis. IMPLICATIONS: Occupational therapists have individual and collective opportunities for exercising the moral imagination and moral courage to mobilize critical occupational therapy praxis.

The Critical Case File Approach: A Novel Tool for Critically Analyzing Mixed-Method Data as Exemplified in a Juvenile Legal Setting.

Current criminology and corrections research is limited in its ability to fully conceptualize and analyze inequities in the legal systems' response to young people, particularly those with multiple marginalized identities. This article presents a novel methodological framework-the Critical Case File (CCF) approach-to advance methodological innovations in criminal and juvenile legal system research. Specifically, the CCF approach leverages the rich multisystem information available within case file data and analyzes it through a critical lens to examine (a) the structural factors (e.g., economic and housing precarity) undergirding legal system contact and (b) how the legal system responds to these structural factors to perpetuate the well-documented disparities that exist across the legal continuum. In this article, we present the CCF approach, which systematizes best practices for capturing the breadth of information available within case files. We first propose a six-step methodological process to describe how information from legal system-impacted people's case files can be extracted, analyzed, and disseminated with an equity-oriented lens. We then exemplify how the CCF approach differentiates from other methods typically used in social science and criminology research. Practice and policy implications are presented to demonstrate the ways that the CCF approach can leverage case file data to generate novel, meaningful, and data-driven solutions that illuminate structural factors that may drive and exacerbate legal system contact and delineate the potential of research-practice-policy partnerships to reduce structural disparities.

Satellite data for environmental justice: a scoping review of the literature in the United States.

In support of the environmental justice (EJ) movement, researchers, activists, and policymakers often use environmental data to document evidence of the unequal distribution of environmental burdens and benefits along lines of race, class, and other socioeconomic characteristics. Numerous limitations, such as spatial or temporal discontinuities, exist with commonly used data measurement techniques, which include ground monitoring and federal screening tools. Satellite data is well poised to address these gaps in EJ measurement and monitoring; however, little is known about how satellite data has advanced findings in EJ or can help to promote EJ through interventions. Thus, this scoping review aims to (1) explore trends in study design, topics, geographic scope, and satellite datasets used to research EJ, (2) synthesize findings from studies that use satellite data to characterize disparities and inequities across socio-demographic groups for various environmental categories, and (3) capture how satellite data are relevant to policy and real-world impact. Following PRISMA extension guidelines for scoping reviews, we retrieved 81 articles that applied satellite data for EJ research in the United States from 2000 to 2022. The majority of the studies leveraged the technical advantages of satellite data to identify socio-demographic disparities in exposure to environmental risk factors, such as air pollution, and access to environmental benefits, such as green space, at wider coverage and with greater precision than previously possible. These disparities in exposure and access are associated with health outcomes such as increased cardiovascular and respiratory diseases, mental illness, and mortality. Research using satellite data to illuminate EJ concerns can contribute to efforts to mitigate environmental inequalities and reduce health disparities. Satellite data for EJ research can therefore support targeted interventions or influence planning and policy changes, but significant work remains to facilitate the application of satellite data for policy and community impact.

Incorporating multiracial and multiethnic experiences into genetic counseling practice and research: A necessary opportunity.

The conflation of race and genetic ancestry can have harmful consequences. Biological conceptualizations of race have long been used to justify inequities and distract from social structures that afford opportunities to some that are unjustly denied to others. Despite recent efforts within the scientific community to distinguish between the sociopolitical constructs of race and ethnicity and the biological constructs of genetic ancestry and genetic similarity, their conflation continues to influence genomic research and its translation into clinical care. One overlooked aspect of this problematic conflation is the extent to which discrete monoracial and monoethnic categorization systems persist and perpetuate unequal benefit-sharing in the clinical translation of genomic technologies. In genetic service delivery, reliance on discrete racial and ethnic categories undermines the clinical translation of genomic technologies for large segments of the global population. For multiracial and multiethnic individuals, who have complex identities that defy discrete categorization systems, the potential benefits of genomic discoveries are especially elusive. Scholars have recently begun to call for the inclusion of multiracial, multiethnic, and admixed individuals in race, ethnicity, and ancestry frameworks in genetics and genomics. However, little work has been done to explore and address the unique challenges and opportunities posed by multiracial/multiethnic individuals in genetic counseling specifically. We discuss how conceptualizing diversity along discrete racial and ethnic lines perpetuates inequitable patient care and limits efforts to increase inclusion and belonging within genetic counseling. Moreover, we argue that ongoing efforts to mitigate racial inequity must actively challenge the paradigm of monoracial and monoethnic categories to accomplish their goal.

Education as oppression.

In assessing leverage points to promote educational equality, this paper examines Freire's concept of education as oppression to highlight the potential of reclaiming resources currently dedicated to oppressive education. Harel Ben-Shahar's concepts of education as a positional good as well as the potential lack of instrumental value in contributing to students' social, health, relational, and other holistic aspects of wellbeing are mobilized to disentangle varying forms of education. Practitioner experience with students living with disabilities in a postcolonial global south establishes the foundational context to consider how education has capacity to challenge the following: economic domination; restraint on traditional Indigenous knowledge; limited basic livelihood; and media stereotypes on effort committed by the marginalized-yet often chooses not to. Disentangling what precisely constitutes education as oppression emerges as a challenging task, since Freire's conceptualization of conformity is often required of students if they wish to meet essential survival needs. Lisu case studies in rural agricultural economies, traditional ecological knowledge, and postcolonial curriculum demonstrate that education as oppression can emerge naturally with or without intent, and that education mobilized to gatekeep social resources or justify the inequitable distribution of life opportunities can reinforce existing systematic inequalities. Notably, resources and opportunities in disadvantaged communities can already be stratified by preexisting racist; sexist; ableist; classist; or colonial discrimination, and suggest that the intersection between education and basic survival of students should not be viewed as too tangential or basic for future policy discourse. Four forms of education as oppression are preliminarily considered, toward supporting future discourse on eliminating inadvertent oppressive impacts via funded pedagogy.

Local environment perceived in daily life and urban green and blue space visits: Uncovering key factors for different age groups to access ecosystem services.

Inequality in access to green and blue spaces is a major issue in the field of environmental justice. Various factors significantly influence visitations to these spaces, including residential, commuting, and shopping areas. However, studies have mainly focused on residential environments. Analyzing the coupling of environmental and socioeconomic factors, including age, income, and childhood experience, and examining the direct and indirect effects of these factors for different age groups are needed to better understand the detailed context of inequalities in access to ecosystem services. We conducted a questionnaire survey and analysis to address these needs in an urban setting. The results demonstrate that several land use categories (i.e., agricultural lands in residential areas, grasslands near shopping areas, and deciduous forests near commuting destinations) positively correlated with visitation frequency, suggesting the lack thereof may be the cause of access inequalities. In particular, the perimeter per unit area of some land cover types, which shows the complexity of the form of each land cover category, was found to be a significant factor. We identified inequality in nature experience to be the key factor correlated with inequality in nature visits among the young age group. For the middle-aged and old age groups, nature-relatedness was positively correlated with visitation frequency. Proper design of the local environment, such as through land use planning, can be an effective measure for all age groups. For instance, long-bordered green areas in the Monsoon Asian region are an attractive traditional landscape, with high accessibility and a comfortable thermal environment. The key factors for each age group should be considered in spatial design and inclusive information-sharing to reduce inequality in access to ecosystem services.

The meaning of obstetric violence experiences: A qualitative content analysis of the Break the Silence Campaign.

BACKGROUND: Obstetric violence involves the mistreatment, disrespect, and abuse of birthing people and the problem has been recognized in healthcare systems worldwide. Obstetric violence is a gendered, sex-specific form of violence against women that is a public health problem and a violation of human rights. There are an unknowable number of online posts and social media messages that describe obstetric violence experiences. There are no known studies about self-published experiences of obstetric violence in the US maternity care system. OBJECTIVE: To understand the meaning of obstetric violence experiences in the US maternity care system from a naturally occurring, purposive sample. DESIGN: A secondary analysis of the textual data from the original Break the Silence social media campaign using qualitative content analysis. The theory of social justice in nursing provided a theoretical framework. A healthcare systems approach was used for a wide-angle view of the multidirectional structure, processes, and outcome of obstetric violence. SETTING: The study setting is the public Facebook page where the Break the Silence social media campaign can be seen. Break the Silence was an online activism response to the problem of obstetric violence in the US maternity care system with signboard messages posted from 31 known US states. The setting is bounded by the digital page where the campaign is published. PARTICIPANTS: There were 139 participants, and 11 of them posted more than one signboard message. Most participants were birthing people (n = 125) followed by doulas (n = 10). METHODS: Krippendorff's methodology for qualitative content analysis was applied to 156 signboard messages posted on Break the Silence from 2014 to 2016. Qualitative content analysis was supported by Atlas.ti 23. RESULTS: Four themes illustrated the meaning of obstetric violence in US maternity care: 1) pregnancy and birth as a battle with healthcare providers and the healthcare system, 2) sacrifice of the maternal body normalized and assumed as a gender stereotype, 3) disrupted rites of passage from childbirth, and 4) abuse of fiduciary power by healthcare providers. CONCLUSIONS: This study demonstrated thematic meanings for the experience of obstetric violence in US maternity care with a healthcare systems approach that included structural and organizational considerations to increase understanding. Categories and forms of obstetric violence from the existing literature were expanded and strengthened by findings from this study. Themes were validated in principle with consistency in findings across the international evidence base on obstetric violence. TWEETABLE ABSTRACT: The meaning of #obstetricviolence experiences is interpersonal and structural with thematic consistency across international studies.

Clinical research vehicles as a modality for medical research education and conduct of decentralized trials, supporting justice, equity, and diversity in research.

Current clinical research lacks diversity in those that participate. This lack of diversity is concerning given its importance for successful drug development. The frequency and severity of many diseases, along with the pharmacological properties of therapies, can display significant differences based on patient diversity. A clinical trial population that is more reflective of these differences will help researchers better understand the therapeutic profile of the treatment and provide generalizable knowledge to the medical community. The advent of decentralized clinical trial designs is meant to help address this lack of diversity by using portable digital health technologies and virtual interactions to enhance clinical trial access and broaden participation. By leveraging these technologies, trial conduct can occur at locations other than traditional research sites. This shift in trial location may help address some of the logistical, educational, engagement, and trust barriers that have historically prevented enrollment of diverse populations. However, these types of trials still have limitations. Ethical concerns around justice, equity, and diversity will still exist with decentralized clinical trials, which could be mediated using clinical research vehicles. When utilized, this modality may enhance the scientific design and conduct of clinical trials and better follow these ethical principles. These enhancements and improved ethical direction could be accomplished through increasing community involvement, improving health literacy, supporting more diverse trial sites, creating community-based research footholds, fostering connections with researchers, limiting technical challenges, and preventing data security issues.

Addressing the COVID-induced healthcare backlog: How can we balance the interests of people and nature?

The COVID-19 pandemic created healthcare backlogs of routine primary and preventive care, elective procedures, dental care, and mental healthcare appointments across the world. So far, governments are responding by enacting pandemic recovery policies that expand their healthcare sector activity, without much, if any, consideration of its effects on the environmental crisis that is (among other things) worsening human health and health equity. This study argues that, as a matter of health and social justice, governments have an ethical responsibility to equitably reduce the backlog with minimal environmental damage. To do so, a first key action is to give priority to policy options that minimise negative human impacts on the environment. Yet these policies alone will not be sufficient to address the backlog, particularly in relation to elective procedures. The study therefore contends that a second key action for governments is to enact the policy options that are best able to equitably reduce the remainder of the backlog, while accelerating the transition to sustainable health care in ways that are best able to reduce the specific environmental costs of those policy options. It concludes by considering whether limits apply to governments' ethical responsibilities that ultimately mean accelerating the transition to sustainable health care is not required when addressing the backlog.

Public health, pluralism, and the telos of political virtue.

In the ethics of public health, questions of virtue, that is, of what it means for public health to act excellently, have received little attention. This omission needs remedy first because achieving improvements in population-wide health can be in tension with goals like respect for the liberty, self-determination, or non-oppression of various individuals or groups. A virtue-ethics approach is flexible and well-suited for the kind of deliberation required to resolve or mitigate such tension. Public health requires practically wise and careful thinking, which virtue ethics brings with it. Furthermore, too tight a focus on delivering outcomes in determining how public health should act has, in some cases, actually undermined its ability to achieve those consequences. However, the main concern about incorporating virtue into public health in a pluralistic society is likely to be that virtue is generally teleological, and we would surely need some widely agreed upon idea of something like flourishing or the common good for this to work. In this paper, I propose that for public health to express virtue in its work, it must express a commitment to justice as it goes about its business promoting and protecting the health of the population. Justice is both a contributor toward better health for groups in society, and a worthwhile goal in its own right. I will sketch an argument that justice as non-oppression - not merely health equity - is the right telos toward which excellent public health should aim in a pluralist society.