Union's inspiration: Universal health care and the essential partiality of solidarity.

Solidarity is commonly invoked in the justification of public health care. This is understandable, as calls for and appeals to solidarity are effective in the mobilization of unison action and the willingness to incur sacrifices for others. However, the reference to solidarity as a moral notion requires caution, as there is no agreement on the meaning of solidarity. The article argues that the reference to solidarity as a normative notion is relevant to health-related moral claims, but that it does not provide a convincing foundation of claims to universal health care. References to universal solidarity obliterate an important distinction between those moral demands that are founded on principles like justice, recognition, or humanity, and those demands that stem from partisan relations in communities. While there is no 'separate essence' of solidarity that could be referred to in order to argue for the conceptual necessity of solidarity's partiality, some features may reasonably be stipulated as being essential to solidarity with a view to its systematic function within moral philosophy. The normative and motivational force of the ties invoked by solidarity is particularly relevant when basic moral demands are not met, and societies are in need of significant forms of communal relatedness.

Money for Blood and Markets for Blood.

Ontario's Bill 178 proposing a Voluntary Blood Donations Act declares the offer or acceptance of payment for the donation of blood a legal offence and makes it subject to penalty. The bill reinvigorates a fundamental debate about the ethical problems associated with the payment of money for blood. Scarcity of blood donors is a recurring problem in most health systems, and monetary remuneration of the willingness to donate blood is regularly discussed--and sometimes practiced--as a means to overcome scarcity in blood. However, making blood an object of economic exchange has long aroused ethical concerns that often refer to the specific meaning of blood. From the perspective of a modern understanding of money as a metric of economic value, the exchange of money for blood--shed or given--is seen as ethically troubling, because it appears to imply a commensurability of the value of human life and economic wealth. In this paper, we begin with a general taxonomy of the types of arguments that speak in favour or against compensating donors for giving blood. We then describe the context in which the discussion about payment for blood arises, and of the specific aims and concerns that are brought forward in this context. This is used to reconstruct the normative background that supports the rejection of payment for blood as it is envisaged in Bill 178 and the aims of the proposal. We then argue that while a payment indeed changes the nature of a blood donation in an ethically considerable way, we do not believe that decisive arguments against the monetary remuneration of blood donations can be substantiated, at least not independently of assuming specific societal circumstances. Thus it may be possible to establish a stable and safe blood supply through just gratification while at the same time taking strong provisions against social disconnection, injustice, exploitation or heteronomy.

Ethical reasoning in pandemic preparedness plans: Southeast Asia and the Western Pacific.

The emergence of H1N1 in 2009 shows that it is a mistake to regard the scenario of having to implement pandemic plans as merely hypothetical. This recent experience provides an opportunity to inquire into the current state of pandemic preparedness plans with regard to their ethical adequacy. One aspect that deserves consideration in this context is the disclosure of ethical reasoning. Accordingly, the following is an analysis of examples of pandemic plans and drafts of plans from Southeast Asia and the Western Pacific. It is an analysis of the occurrence of explicit ethical reflection in these documents as well an inquiry into the related question of how ethical reflection can be understood as a constitutive element of ethical pandemic preparedness. In the analysis, different fields of ethical consideration concerning equity, personal rights and accountability are distinguished. There are both pragmatic and genuinely ethical reasons to explicitly address issues of these types in pandemic plans. The extent to which ethical language appears in the national plans in South East Asia and the Western Pacific suggests that there is limited awareness of ethical considerations, or at least insufficient ethical substantiation of pandemic action. The aim of the analysis is to show that further inclusion of ethical considerations into pandemic plans is ethically demanded. It is of particular significance that these considerations are formulated and remain discernible as instances of ethical deliberation.