Justice Across Boundaries Whose Obligati

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978-1-107-11630-6 - Justice Across Boundaries: Whose Obligations?

Onora O’neill
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JUSTICE ACROSS
BOUNDARIES: WHOSE
OBLIGATIONS?
ONORA O’NEILL
© in this web service Cambridge University Press www.cambridge.org

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University Printing House, Cambridge cb2 8bs, United Kingdom
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O’Neill, Onora.
Justice across boundaries : whose obligations? / Onora O’Neill.
pages cm
Includes bibliographical references and index.
isbn 978-1-107-11630-6 (Hardback) – isbn 978-1-107-53817-7 (Paperback)
1. International relations–Moral and ethical aspects. 2. Justice (Philosophy) 3. Distributive justice.
4. Transitional justice. 5. Human rights. 6. Globalization–Moral and ethical aspects.
7. Globalization–Political aspects. I. Title.
jz1306.o64 2016
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isbn 978-1-107-53817-7 Paperback
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JUSTICE ACROSS BOUNDARIES
Who ought to do what, and for whom, if global justice is to progress?

In this collection of essays on justice beyond borders, Onora O’Neill
criticises theoretical approaches that concentrate on rights yet ignore
both the obligations that must be met to realise those rights, and the
capacities needed by those who shoulder these obligations. She notes
that states are profoundly anti-cosmopolitan institutions, and even
those committed to justice and universal rights often lack the com-
petence and the will to secure them, let alone to secure them beyond
their borders. She argues for a wider conception of global justice, in
which obligations may be held either by states or by competent non-
state actors, and in which borders themselves must meet standards of
justice. This rich and wide-ranging collection will appeal to a broad
array of academic researchers and advanced students of political
philosophy, political theory, international relations and philosophy
of law.
onora o’neill, baroness o’neill of Bengarve, is a former

Principal of Newnham College Cambridge, sits as a cross-bench peer
in the House of Lords and is Emeritus Honorary Professor of
Philosophy at the University of Cambridge. She has published widely
on Kant’s philosophy and her most recent publications include Acting
on Principle, second edition (Cambridge, 2013).

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Contents
Acknowledgements page vii
Introduction 1
part i hunger across boundaries 11

1 Lifeboat Earth 13
2 Rights, obligations and world hunger 29
3 Rights to compensation 43
part ii justifications across boundaries 59

4 Justice and boundaries 61
5 Ethical reasoning and ideological pluralism 79
6 Bounded and cosmopolitan justice 99
7 Pluralism, positivism and the justification of human rights 120
part iii action across boundaries 135

8 From Edmund Burke to twenty-first-century human rights:
abstraction, circumstances and globalisation 137
9 From statist to global conceptions of justice 151
10 Global justice: whose obligations? 160
11 Agents of justice 177
12 The dark side of human rights 193

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vi Contents
part iv health across boundaries 209
13 Public health or clinical ethics: thinking beyond borders 211
14 Broadening bioethics: clinical ethics, public health
and global health 225
Index 239

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Acknowledgements
I am deeply grateful to many friends, colleagues and students, and to wider

audiences, who have commented on and improved my thinking on justice
and boundaries across several decades.
vii

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Introduction
Do good fences make good neighbours?

In his simple and deep poem Mending Wall Robert Frost imagines a
dialogue with his New England neighbour about mending the crumbling
drystone wall that separates their farms, where cattle no longer run.
He points out that the wall is now not needed:
There where it is we do not need the wall:
He is all pine and I am apple orchard.
My apple trees will never get across
And eat the cones under his pines, I tell him.
His taciturn neighbour remains unconvinced:
He only says, ‘Good fences make good neighbours.’
Frost then poses questions that now animate many discussions of justice in
a globalising world:
Spring is the mischief in me, and I wonder
If I could put a notion in his head:
‘Why do they make good neighbours? Isn’t it
Where there are cows? But here there are no cows.
Before I built a wall I’d ask to know
What I was walling in or walling out,
And to whom I was like to give offence.
Something there is that doesn’t love a wall,
That wants it down.’
Are walls and fences, borders and boundaries, needed for good relations
and for justice? Or do they impose and perpetuate injustice? What
violations are likely if they are no longer maintained? Can the ‘walling
in or walling out’ that borders create and maintain be justified? Is
the ‘mischief ’ that tempts Frost to be rejected or embraced? Walls
have been built and mended to exclude and include since time

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2 Introduction
immemorial: walled cities and forts, garden walls and farm fences,
the Great Wall of China, Hadrian’s Wall, the Berlin Wall, the walls
of apartheid townships and the West Bank Barrier (its very name
disputed) all aim to ‘wall in and wall out’. But when and how do the
exclusions they maintain make for a more and when for a less
just world?
Boundaries and borders

We live in a world of innumerable structures that ‘wall in and wall out’,
and in particular of countless boundaries and countless boundary cross-
ings. The boundaries that we often think of as borders usually separate
states or lesser jurisdictions, and for the most part form clear demarcations.
Other boundaries are fuzzier. They include boundaries between societies
and nations, between languages and religions, between ideologies and
cultures, between ecologies and economies.
Those who control well-defined borders may seek to regulate the
passage of people (especially of foreigners), of goods, of aid and trade, of
money and weapons, and even of ideas and information. Typically they
aim to control who and what will be allowed to cross, and who or what will
be detained, obstructed or prevented from crossing (at times with patchy
success). So a fundamental task for political philosophy is to consider
whether and how varying sorts of borders, and the inclusions and exclu-
sions they create, can be justified; and whether and how appeals to less
sharply defined boundaries – national and cultural, religious and ideo-
logical – may be relevant to justifications of state borders. Although many
accounts of justice insist that its principles are universal, this does not
determine the reach of justice: principles can combine universal form with
restricted scope.
So it is not surprising that both state borders and other boundaries
pose deep and interesting problems for discussions of justice. Borders can
be used to secure, alter, undermine or destroy justice, variously under-
stood. This is not generally because their location is disputed: although
that happens often enough, it is usually not philosophically interesting.
The deeper problems have less to do with the locations of borders,
than with their configuration, that is with the types of action they
permit or prevent, and with the justification of the inclusions and
exclusions that they impose. All justification is demanding, but the
justification of inclusions and exclusions often raises particularly
difficult demands: do arguments that seek to establish the scope of justice

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Introduction 3
have to address both those included and those excluded? Does it matter if
demarcations are not justified to ‘outsiders’?1
Aspirational versions of moral cosmopolitanism often claim that the
borders of states should be made more porous in more ways to more sorts
of people and to a greater range of activities. Some point towards a better
institutionalised cosmopolitan future, in which various sorts of differences
are not seen as justifying exclusions or inclusions, and so to a more
extensive institutional cosmopolitanism. Yet it is evident that many
would-be enthusiasts for cosmopolitan justice are reluctant to endorse a
monolithic world state, and are uncertain whether a world of fewer or
more porous boundaries could provide greater stability, or security or
justice.
Less ambitious, and seemingly more modest and realistic accounts of
global justice insist, on the contrary, that at least some of the demarcations
that are defined by state borders, and the inclusions and exclusions they
maintain, may be needed for justice. The old saying that good fences make
good neighbours expresses a wary anti-cosmopolitanism, that sees some
inclusions and exclusions as helpful, perhaps even as necessary, if justice
is to be realised or maintained. These themes animate claims both about
moral cosmopolitanism and about institutional anti-cosmopolitanism, and
have become central to philosophical and practical discussions of justice in
a globalising world. Here I aim to explore and hope to contribute to the
underlying arguments that matter for these debates.2
Part I Hunger across boundaries

With high hopes I decided in the mid 1970s that a focus on the rights of
the hungry would offer a useful approach to establishing at least some of
the basic claims of justice in a world where some suffer extreme yet
remediable deprivation. In the postwar world, appeals to rights – often,
but not always, specifically to the human rights proclaimed in the Univer-
sal Declaration of 1948 – were on the way to becoming the most salient
ethical vocabulary. While there were then few detailed philosophical
investigations of rights, I thought there was headway to be made.
1
Cf. Simon Caney, Justice beyond Borders: A Global Political Theory (Oxford University Press, 2005),
on borders as shaping justifications.
2
Several earlier essays on justice and borders are included in my Bounds of Justice (Cambridge
University Press, 2000).

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4 Introduction
There were certainly problems to be addressed: the news at that time
was full of reports of famine and extreme poverty in many parts of the
world, including Biafra, Cambodia and Ethiopia (few knew about the
great Chinese famine of 1958–62); of hurtling population growth; and of
the effects of the 1973 oil crisis on the poorest. Despite the ongoing green
revolution, there was scant evidence of any demographic transition, of any
end to the Cold War, of the surging economic growth later achieved in
some (but not other) poor states, or of the mushrooming of cross-border
activities that fuelled not only greater prosperity for many, but rampant
global corruption and the emergence of a peripatetic class of the super-rich.
All these profound changes lay far ahead: indeed many of them emerged
only because of changes in the effectiveness and effects of border controls
that came about with the end of the Cold War and the spread of various
forms of economic liberalisation.
Unsurprisingly, much of the ethical literature on poverty and develop-
ment before these changes focused on the extreme case of hunger and
famine. The most widely accepted ethical approach was utilitarian, and the
most discussed contribution was Peter Singer’s ‘Famine, affluence and
morality’.3 I admired his work, but thought that utilitarian approaches
depended on extravagant assumptions that could not do the required
heavy ethical lifting. I aspired to do more with less, and hoped that an
appeal to rights would provide a more economical and plausible starting
point to address ethical questions about hunger and famine. The first three
chapters in the collection start from considerations about rights. But they
also reveal difficulties in that starting point, and put forward reasons for
locating rights in a wider framework in which obligations and agency are
seen as more basic. In these papers, as in most of the later chapters here,
I relied on traditional conceptions of rights – of natural rights, moral
rights, fundamental rights – rather than appealing only and specifically
to human rights. However, in some of the later chapters I consider both
the justification and some of the practical implications of human rights as
set out in the Universal Declaration of 1948.4
In Chapter 1 ‘Lifeboat Earth’ I tried to show that we can do without
either utilitarian or broader consequentialist assumptions, and argued that
robust conclusions could be established by starting with rights. However,
3
Peter Singer, ‘Famine, affluence, and morality’, Philosophy and Public Affairs 1 (1972), 229–43.
4
Chapter 7 ‘Positivists, pluralists and the justification of human rights’, below, 120–33, focuses on the
justification of human rights; Chapter 12 ‘The dark side of human rights’, below, 193–207, considers
what has to be added to human rights if they are to guide action.

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Introduction 5
I deliberately did not invoke the temptingly capacious yet amorphous
‘right to life’5 that has been central to so many ethical debates, particularly
in bioethics. I hoped that starting from a more modest, widely accepted
assumption that everyone has (at least!) a right not to be killed unjusti-
fiably would beg fewer questions, and would be enough to show that
action violates rights if its distributive effects unjustifiably lead to add-
itional deaths. ‘Lifeboat Earth’ has probably had more readers than any
other paper I have published, and I have been persuaded to include it
unamended in this collection, despite the fact that I soon reached the
disappointing conclusion that a minimal right not to be killed unjustifiably
does not provide a sufficient ethical basis for an approach to the ethical
questions raised by hunger and famine, let alone for a wider view of global
justice. The reasons that led me to this conclusion are developed in other
papers in this collection.
Although I remain convinced that utilitarian arguments are inadequate
for guiding action, I came to think that appeals to rights could have bite
only if combined with arguments to show who should act, and what they
should do. Rights could be realised only if the counterpart obligations were
held by competent agents. The second paper, Chapter 2 ‘Hunger, rights
and obligations’, was written as something of a ‘manifesto piece’ for this
line of thought, which it sets out in plain and direct terms. During the
1980s I developed this approach in more detail in a number of other
articles, and in a book.6
The third chapter in Part I, ‘Rights to compensation’, examines a
different, perennially popular, rights-based approach. Rights to compen-
sation seek to assign obligations to address poverty and famine to those
whose action caused them. An apparent advantage of the approach is that
it provides clarity about who is to carry the counterpart obligations. With
some regret, I concluded that this approach too does not offer a convincing
way of responding to distant hunger or destitution, and may indeed be a
distraction. Rights to compensation are relevant where hunger and poverty
and hunger have demonstrably arisen from the wrongdoing of identifiable
5
Disagreements about the right to life became and remain central in philosophical and more popular
discussions of the legalisation of abortion, and of other novel reproductive technologies.
6
They include ‘The moral perplexities of famine relief ’ in Tom Regan (ed.), Matters of Life and Death
(New York: Random House, 1980), 260–98; extensively revised editions, 1986, 1993 (with the title
changed to ‘Ending world hunger’ and pagination to 235–79 in the latter); ‘Rights, obligations and
needs’, Logos 6 (1985), 29–47, most recently reprinted in Thomas Pogge and Keith Horton (eds.),
Global Ethics: Seminal Essays (St. Paul, MN: Paragon, 2008); and Faces of Hunger: An Essay on
Poverty, Development and Justice (London: George Allen & Unwin, 1986).

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6 Introduction
others. While it is all too true that there have been great historic injustices,
it is also all too often uncertain whose unjust action contributed to whose
present poverty, and all too clear that much present poverty and hunger
has multiple causes, and is often in large part unattributable to any
competent agents who could be required to compensate. Appeals to rights
to compensation gesture towards competent agents who are to shoulder
obligations to compensate, but they do so with a wavering finger.
I concluded that only a clearer focus on action and obligation could
support a convincing and broader account of obligations of justice.
Part II Justifications across boundaries

From the early 1980s my understanding of global poverty was transformed
by reading Amartya Sen’s wonderful Poverty and Famines.7 Once I had
fully grasped how deeply hunger and deprivation are shaped both by
institutional structures and by everyday economic transactions, the idea
that rights to compensation can make a major contribution to global
justice seemed unconvincing, although it remains perennially popular.
From then on I tried to take a strictly forward-looking and practical view
of just responses to hunger and destitution. A practical approach cannot
assume that culprits can generally be identified and made to compensate
for all injury or harm suffered. Yet if justice is to be secured it is necessary
to specify the obligations of competent agents of change.
The chapters in Part II address questions that arise if justifications are to
reach across boundaries. Western political philosophy has been deeply
shaped by the thought that justice is internal to communities, cities or
states, so may and perhaps must be bounded. Although versions and
elements of ius gentium, and of international justice and law, have been
with of us since antiquity, they have generally been seen as applying only
in limited ways to justice between bounded communities, cities or states, or
to ways in which bounded communities, cities or states deal with outsiders.
Until recently, few have thought through the institutional and practical
implications of abandoning these limited claims in favour of institutional-
ised forms of cosmopolitanism.
Arguments for instituting a more cosmopolitan system of justice across
boundaries are not merely arguments that the scope of justice should be
enlarged, in the ways in which it may be when a state adds to its territory
7
Amartya Sen, Poverty and Famines: An Essay on Entitlement and Deprivation (Oxford: Clarendon
Press, 1981).

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Introduction 7
or extends the franchise. They are more often arguments for making
borders more porous in specific ways – and thereby perhaps less effective
in other specific ways. Interestingly, many of the political arguments
invoked for making borders more porous, even during the present era of
globalisation, appeal to state interests: free trade may increase national (i.e.
state) prosperity; free movement of ideas could improve understanding
between states and national security; free movement of (some) people
would improve national prosperity. Such arguments, it seemed to me,
would not be adequate to justify a more complete opening of borders,
which would dissolve or undermine the very conceptions of national and
state interest to which they appealed. So I proceeded more circumspectly.
Chapter 4 ‘Justice and boundaries’ considers whether the claim that
principles of justice are universal provides enough to show that they should
stretch across boundaries. I concluded that this move is unconvincing
because universal form and universal scope are different matters. The mere
fact that principles of justice are universal in form does not entail any
specific view about their proper scope, or about the merits or failings of any
form of institutional cosmopolitanism. In Chapter 5 ‘Ethical reasoning and
ideological pluralism’, I considered some difficulties that can arise where
the beliefs and conceptual capacities of those who are separated by various
sorts of boundaries differ, with the consequence that they may not follow
or be persuaded by reasoning that seems adequate to others on the far side
of various boundaries, who do not share their outlook. Chapter 6
‘Bounded and cosmopolitan justice’ continues these themes and compares
communitarian justifications that ostensibly work within certain boundar-
ies (or ‘spheres’), that are seen as limits of justice, and the ‘semi-cosmopol-
itan’ positions supported by the conceptions of public reason defended by
John Rawls and many others.
The last chapter in Part II, ‘Positivists, pluralists and the justification of
human rights’, turns to the prospect of justifying the human rights
declared and widely accepted in the post-World War II world. Human
rights are but one version of the idea that human beings have rights: a
uniquely successful and assertive version, but not immune from philo-
sophical investigation, criticism or (if possible) justification. A number of
distinguished political philosophers have done penetrating work on the
justification of human rights, especially since the millennium, but all too
much discussion and advocacy of human rights is still conducted (and
accepted) on the basis of arguments from authority. The agreement of
states, of the international community, of the bien pensants, is all too often
taken as sufficient warrant, even by those who would reject arguments

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8 Introduction
from authority in many other contexts. Here I consider a possible way of
justifying the rights set out in the Universal Declaration without either
arguing from authority, or building on contentious metaphysical or theo-
logical claims.
Part III Action across boundaries

The chapters in Part III turn from justifications to some of the precondi-
tions for respecting and realising rights. They argue that appeals to abstract
rights are never enough, yet are indispensable. The indeterminacy of
rights – like the indeterminacy of other ethical principles – is essential if
agents and agencies are to enact obligations of justice in varying circum-
stances. Many of the problems said to arise because rights are ‘too abstract’
reflect no more than unsustainable views both of abstraction and of what it
would be to respect rights. These chapters also discuss a range of consider-
ations that matter if rights are to be respected and realised, including the
task of assigning the necessary counterpart obligations, the capacities of the
agents and agencies to whom they are assigned, and the circumstances in
which they act. And once again the final chapter addresses questions about
enacting human rights.
Chapter 8 ‘From Edmund Burke to twenty-first-century human rights’
discusses Edmund Burke’s classical criticisms of abstraction, and suggests
that his line of thought neither targets nor undermines the prospect of
institutionalising abstract rights, but rather allows for their varied enact-
ment in differing circumstances. Burke saw abstraction neither as avoid-
able nor as fatal, but rather as indispensable yet insufficient.
Chapter 9 ‘From statist to global conceptions of justice’ argues that the
practical tasks of enacting and securing justice should not question specific
borders, but should focus on the capacities for action of the agents and
agencies that are to respect or realise justice. In particular, a practical
approach to rights needs to take account both of the specific powers and
of the diversity of non-state actors, many of them not intrinsically territor-
ial, whose activities often cross state and other boundaries. Chapter 10
‘Global justice: whose obligations?’ argues that rights are not taken ser-
iously unless they are anchored in obligations, and that obligations are not
taken seriously unless they are anchored in realistic accounts of the
capabilities and vulnerabilities of the agents and agencies that are to carry
them, and that doing so requires attention to the highly variable nature of
boundaries and borders, and the specific inclusions and exclusions they
maintain.

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Introduction 9
Chapter 11 ‘Agents of justice’ returns to the lurking statism of many
accounts of the practical implications of rights and explores ways in which
a wider range of non-state agencies may contribute to justice. It argues that
states are not invariably the primary agents of justice, and that, even where
they are primary, other non-state agents and agencies may have obligations
that go beyond complying with the just requirements of states.
The final chapter in this part, like the last chapter in Part II, turns
specifically to human rights. Chapter 12 ‘The dark side of human rights’
looks at some ways in which assigning obligations to respect and realise
human rights to states have shaped discussions of their realisation, and
discusses some of the costs of linking human rights too closely to state
actors. It is unclear how far the scope of justice can be extended if
obligations to respect and realise rights are assigned primarily to intrinsic-
ally anti-cosmopolitan intuitions.
Part IV Health across boundaries

The essays in the final part address some questions that arise in thinking
about health and justice in a globalising world. Health is one of several
areas (climate and technological change are others) in which the role of
state borders in defining the scope of justice can be particularly problem-
atic. I argue that a great deal of work in bioethics has taken too little
account of this reality, usually not because it explicitly relies on statist
assumptions (they are often implicit), but because it takes an individual-
istic approach that is often appropriate for clinical ethics, but not for the
ethics of public health, which is always affected by disparities in global
health.
Chapter 13 ‘Public health or clinical ethics: thinking beyond borders’
examines some of the costs of the intense focus of much contemporary
bioethics on doctor–patient relationships, on informed consent, and on
the just distribution of health care to individuals. This focus has often
marginalised public health issues, and the importance of sustaining and
improving the health of poorer populations, and other global health issues.
An adequate public health ethics needs to be anchored in political philoso-
phy rather than in ethics, and to take a realistic view of ways in which both
state and non-state actors can affect population health. In consequence
neither individual autonomy nor informed consent can be seen as funda-
mental to the ethics of health.
Chapter 14 ‘Broadening bioethics: clinical ethics, public health and
global health’ asks whether public health measures are genuine ‘global

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public goods’, in which everybody has an interest. It argues that while
many public health measures, including many targeted health interven-
tions, may have beneficial externalities, they are not genuine global
public goods.
––––––––––
The papers in this collection criticise certain views of human rights, but
maintain that those rights matter for justice. I am critical, in the main, of
discussions of human rights that are silent or vague about the agents of
justice, or about their specific duties, and assume without argument that
the relevant duties all fall on states. In my view we do not take rights
seriously unless we seek to show who ought to do what for whom, and the
duties that do fall on states are typically second-order duties to enable and
require other agents and agencies to act. I am all too aware that the many
colleagues, students and audiences on whom I have pressed these thoughts
may have become weary of my refrain, but I remain unrepentant.

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Index
abortion, 25 blame, 166, 175, 207

abstract individualism, 81 borders, 61. See boundaries
abstraction, 80, 84–8, 94, 96, 137–50, 155 boundaries, 62, 79, 99–119, 160, 216–19, 224
accountability, 204 action across, 137–50
affluence, 17 justification of, 61
agency, perspective of, 56 of states, 104, 151
agents political, legitimacy of, 71
idealised, 87 porous, 147, 165, 217
institutional, 167 boundaryless concepts, 70
non-state, 159, 171, 174–6, 188–92, 203, 207. bounded society, 99. See society, bounded
See non-governmental organisation; bribery, 172
transnational corporation Burke, Edmund, 8, 84, 86, 137–50, 193, 203
obligation-bearers, 196, 205 Reflections on the Revolution in France, 137, 139,
of justice, 118, 167, 177–92, 217, 223–4 141
primary, 160, 164, 178–80, 188
secondary, 164, 173, 178, 190 capabilities, 41, 165, 167–74, 186–8
state, 158, 166, 217–23 artificial, 167
aid policies, 22, 32 institutional, 168, 175
Annan, Kofi, 147, 191, 230 of state, 175
antiretroviral therapy (ART), 231 Categorical Imperative, 113–14
assisted reproduction, 227 charity, 33, 37, 54
attitudes, reactive, 167 circumstances
authority, arguments from, 110, 116 cultural, 144
autonomy, 35–6, 38, 40–1, 112–13 international, 144
individual, 112, 211–16, 218, 224, 226 of justice, 73. See justice
Kantian, 112, 213 citizens, 151–9, 184
patient, 212, 216, 222 citizenship, 66–7, 77, 82–3, 89, 91, 104
exclusive, 182
beneficence, 14, 30, 42, 163. See also duties of clinical
beneficence care, 216
benefits ethics, 211, 225–38
dispersed, 228–34, 236 medicine, 214–16
targeted, 229–33 coercion, 39, 95, 98, 115, 214–15, 218, 222, 224,
Bentham, Jeremy, 31, 86 237
Berlin, Isaiah, 2, 68, 108, 120, 122, 125–6, 128, 132 Coleridge, Samuel Taylor, 138
Bill of Rights, 141. See also international covenants colonialism, 44, 51–2, 90
bioethics, 211–24. See also clinical ethics; public commonwealth, ethical, 68
health ethics communitarianism, 61–2, 65, 72, 102–3, 105,
individualistic, 235 122
medical ethics, 211, 213, 216–17 community, communities, 65, 67, 71
individualism, 226 compensation, 43–57, 206
239

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240 Index
complainant, 206. See victims externalities, 233. See health intervention,
compulsion, 214, 216, 221, 224 targeted
conceptions of the good, 120, 219
consent, 214–15, 236 famine, 28. See hunger
informed, 213, 226, 235 foreign investment, 20–2. See also corporations
consequentialism, 163. See utilitarianism formalism, 80. See abstraction
constitution fraud, 237. See deception
and tradition, 142, 148 free rider, 229
patriotism, 68 freedom
constructivism, 91 lawless, 111
copyright, 232 of expression, 127, 129
corporations, 20–1, 147, 192. See also institutions of movement, 161, 182
responsible, 190 Frost, Robert, 1
rogue, 191
corruption, 32, 165, 191 General Will, 67. See Rousseau
cosmopolitan scope, 162 global compact initiative, 147, 191
cosmopolitanism, 75, 99–119, 177–92 globalisation, 75, 137–50
abstract, 155, 162–6. See cosmopolitanism, goods, 234. See public goods
moral distribution, 229–33
institutional, 62, 178
institutional anti-, 99, 155 Habermas, Jürgen, 68, 101, 121, 177
justice, 117, 153, 160, 218 happiness, 31–3
moral, 62, 99, 153–5 Hardin, Garrett, 31
rhetoric, 161, 180–6 health, 211. See also bioethics; public health
counterpart obligations, 155. See obligations beyond borders, 217
covenants, 146, 196, 198–203. See also ethics, 219
international covenants global, 225–38
intervention
death, 14. See also endangering life non-targeted, 229–33
allowing to die, 16, 19, 21 targeted, 227–9, 231, 233–7
causes of, 19 justice, 211–24
causing, 13 policies, 211–24
killing, 13–28, 43 promotion, 215, 231, 237
deception, 40, 95, 98, 222, 237 health care, 211–24
declarations, 198. See covenants costs of, 214
deliberation, 95–7 just, 216
development, 13–28, 33, 40–1 systems, 211, 216, 226
discrimination, 44 Health Impact Fund, 232
diseases of poverty, 230 Hegel, Georg, 80, 86, 90, 142
distribution, 19, 22, 52, 227 Hegelianism, 81
diversity, 93. See pluralism historicism, 68
duties, 14. See also obligations HIV/AIDS, 231, 234
allocation of, 131, 145 Hobbes, Thomas, 64, 115, 151, 158
counterpart, 130 horizon, 81, 89
of assistance, 105 human needs, 33, 35–6, 40–1
of beneficence, 14, 36 human rights, 37–8, 41, 48, 63, 107, 137–50, 161,
second-order, 145–6 193–207
interpretation of, 128–9
emergency relief, 40–1 justification of, 120–33
endangering life, 14 movement, 207
ethical pluralism, 93. See pluralism realisation of, 149
ethics, 225. See bioethics; pubic health states and, 181
ethics violations, 77
Ethiopia, 29 humanitarian interventions, 161
exclusion, 66, 69, 75, 100, 102, 115, 117 Hume, David, 73, 120

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Index 241
hunger, 13–28 principles of, 71, 93, 95, 104, 177
famine deaths, 24 private, 49
famine policies, 24–8, 31 republican, 115
starvation deaths, 26 rights-based accounts of, 221
scope of, 63, 72, 75–7, 99, 216
idealisation, 74–5, 84–9, 93, 142 statist conceptions of, 151–9
idealism, 186
transcendental, 108 Kant, Immanuel, 38–9, 86, 100–1, 104, 107–20, 213
identity, 63–70, 103. See also communities; conception of autonomy, 213
nations; peoples Perpetual Peace, 101, 108, 115, 117
dual, 66
formation of, 69 lawlessness in thinking, 111
multiple, 68 lawlike form, 113
national, 70 liberalism
sense of, 65 abstract, 142
immunisation, 228, 230 deontological, 98
indeterminacy, 127 libertarianism, 36, 44, 49, 84
indifference, 41 justice, 154
informed consent, 213. See consent political, 84
institutions, 164. See also corporations; political, 150
obligations; states social or welfare, 44, 48, 53–4
anti-cosmopolitan, 182 utilitarian, 84
international, 167, 218 liberty, liberties
networking, 157–8 largest set of, 55
non-state, 172, 224. See also non-governmental maximal human, 38
organisation lifeboat situations, 13–28
transnational corporation, 147, 165, 169–74, Locke, John, 19, 48–51, 54, 120
190
non-territorial, 156 MacIntyre, Alasdair, 62, 80, 83
intellectual property, 232 Malthus, Thomas, 31
international covenants, 35, 123 Marx, Karl, 86, 89
Declaration of the Rights of Man and of the medical paternalism, 212
Citizen, 138, 142, 194 metaphysics of the person, 73
European Convention on Human Rights, 123, Mill, John Stuart, 84
126, 139 monism, 125–6. See value monism
International Covenant on Civil and Political Moralität, 80–1, 83, 88, 93
Rights, 140, 195 morality system, 166, 207
International Covenant on Economic, Social and
Cultural Rights, 140, 195, 198, 200 nations, nationalism, 65, 67–9, 71
international relations, 52, 160, 184. See also realism natural law, 48, 54
interpretation of rights, 127. See rights natural rights, 54. See rights
intervention, 152, 161 needs, 33. See human needs
Nietzsche, Friedrich, 206
judgement, 126. See deliberation non-governmental organisations (NGOs),
justice, 57. See agents, of justice; health; human 169–74. See also institutions, non-state
rights; natural law; obligations; Nozick, Robert, 48–51, 63
rectificatory justice; rights; states Anarchy, State, and Utopia, 15, 44, 48, 50, 63
beyond boundaries, 99–119
circumstances of, 73–4, 76, 93, 95, 98, 120 obligation-bearers, 196. See agents; institutions
domestic, 113–16, 162, 218 obligations, 29–42, 53, 151–9, 169–74, 176, 197,
economic, 105 220–1
enforcement of, 49 allocation of, 154, 160, 162, 165, 169, 171–2, 181,
global conceptions of, 151–9 194–5, 198, 201, 223
international, 107, 116–17, 151–2, 155, 218 counterpart, 155, 194, 197, 199, 201
political conception of, 81 first-order, 194, 201, 203–5

Onora O’neill
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242 Index
obligations (cont.) A Theory of Justice, 81–3, 184
imperfect, 40, 54, 197 conception of justice, 183–6
institutional, 167 Political Liberalism, 99–100, 103–4, 163, 184
of justice, 38–40, 160–76 The Law of Peoples, 99–101, 103, 105, 107, 162,
of states, 160–76 184
overload of, 82 realism, 107, 117–18, 164, 166, 186, 190
perspective of, 54 conceptions of state, 184
second-order, 164, 200–1, 203 in international relations, 158, 160, 218
state, 200–3 political, 64, 101, 106, 116, 158, 174–6
statist view of, 183 reason
to secure univeral rights, 161 abstract, 85
off-shoring, 147 non-public, 104
original position, 81–2, 87 practical, 102–3, 108, 112–14
overload of obligations, 82. See obligations private uses of, 108–9
public, 100, 103
Paine, Tom vindication of, 111
The Rights of Man, 34 recipience, 49, 56
patents, 232 perspective of, 55–6, 180
patient autonomy, 211. See autonomy rectificatory justice, 43–57
patriotism, 68. See constitution reflective equilibrium, 82. See also Rawls
peoples, 106, 162, 184 relativism, 61–2, 72, 121
persons, stateless, 152, 182 religion, civil, 68–9
pluralism, 82, 93, 103, 120–33, 149 reproduction, assisted, 227
empirical, 120 research ethics, 226
ethical, 79–98, 219 research subjects, 226
of values, 120–1, 125 resources, 19, 27
political, 123 responsibility, 166
plurality, 74, 94 restitution, 44–8
political realism, 101. See realism retrospective attitudes, 166
population, 13–28, 227 rights, 29–42, 151–9, 193–207, 220.
growth, 24–5 See also obligations
health, 227–8. See public health abstract, 137, 140, 143–4, 193, 195
policies, 26–7 cosmopolitan rights (Kantian), 160–76
positional goods, 129 cosmopolitan view of, 183
positivism, 120–33 counterpart obligations, 153
poverty, 17, 29–42, 44, 56, 77, 161–2 cultural, 154
diseases of, 230 democratic political, 34
power, 226 duties and, 145
property rights, 17, 19 economic, 19, 34–5, 154
public goods, 231 human, 38. See human rights
global, 229–33 implementation of, 126–33, 144–8
non-excludable, 229 institutional, 154
non-rivalrous, 229 interpretation of, 126–33, 144–8
public health, 211, 218, 225–38. See also bioethics; justiciable, 176, 193
health legal, 43
ethics, 211–24 liberty, 34–6, 128–31, 145, 155, 164, 181, 193–6,
measures, 234 198–9, 202–3
non-targeted, 235–6 maximal, 56, 129
policies, 215 natural, 54, 143
population, 227 obligation to secure rights, 148, 161
public reason, 100, 103–19. See also peoples; of man, 137. See also international covenants
vindication of reason of self-preservation, 19
punishment, 44–50 positive, 199
right-holders, 196, 205
Rawls, John, 7, 62, 73, 81–5, 87–8, 91–3, 95, social or welfare, 34–7, 154, 193
99–109, 117, 120–2, 151, 162, 177, 217 special, 196

Onora O’neill
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Index 243
states and, 146. See states imperial, 160
to a nationality, 152, 181 league of, 116
to asylum, 152, 182 minimal, 50
to compensation, 43–57 plurality of, 66
for ancient and distant wrongs, 51–3 power of, 207
to fair trials, 129 quasi- 179. See states, weak
to food, 34–5, 129–30, 195 republican, 101, 116–17
to goods and services, 155, 181, 194, 196, 199, rogue, 165, 179
203 sovereign, 64
to health, 34, 195, 221 sovereignty of, 64
to life, 26, 127, 129 state boundaries, 61–78
to marry, 127 system of, 177, 186
to not be enslaved, 128 unjust, 164
to not be killed, 13–28 weak, 147, 165, 169, 174, 179, 187, 189, 202, 220
to not be tortured, 128 world state, 63, 76, 101, 155, 177
to privacy, 127, 129–30 statism, 151–3, 157, 161–2, 164, 175, 183.
to secession, 61 See also justice
to security, 127, 129 sufficiency situations, 18–23
to self-determination, 76 supererogation, 37, 54
to subsistence, 36
to work, 127 tasks, 176. See obligations
universal, 126, 162–3, 183 territories, 63–70, 105–7, 155–8, 184–5, 217.
Rousseau, Jean-Jacques, 67, 69, 83 See also states
Ruggie, John bounded, 162
Protect, Respect and Remedy Framework, 147 tradition, 103, 142. See constitution
shared political, 141
safety standards, 237 transnational corporations (TNCs) 165. See
Sandel, Michael, 80–1 institutions, non-state
SARS, 230
scarcity, 13–28 underdevelopment, 20. See development
scope of ethical principles, 61 United Nations (UN), 101, 105, 123, 147, 153, 164,
self-defence, 13–16, 20–1 169–70, 172, 183, 218, 230
self-determination, 61 Universal Declaration of Human Rights, 34, 99,
self-interest, 185 122–8, 137, 139, 152–3, 155, 161, 177, 180–3,
self-legislation, 112 195, 198, 220. See also international
Sen, Amartya, 6, 123, 187 covenants
Singer, Peter, 4, 17, 31, 84, 162 Universal Principle of Justice, 113–16
Famine, Affluence, and Morality, 17 universal principles, 100
Sittlichkeit, 80–98 universal rights, 61, 161. See rights
slavery, 51, 53 universal scope, 71, 79, 83, 114, 126, 148, 162
social contract, 113 universalisability, 213
socialism, 79 utilitarianism, 30–4, 37, 41, 50, 55, 84, 162–3
society, 121
bounded, 99, 104, 184, 217–18 value monism, 121–2, 125–6, 132–3
civil, 106 value pluralism, 121. See pluralism
sovereignty, 77, 107, 158–9, 170, 185–6 victims, 43–57, 206
starvation, 17, 29. See hunger
state of nature, 115 Walzer, Michael, 62, 80, 152
states, 63–7, 79, 99–119, 137–50, 156, 160–1, 165, Weil, Simone, 37, 42
177–92, 218. See also agents Westphalian, 146–7
agents, 158 Williams, Bernard, 80, 166–7, 207
bounded, 64, 70, 152, 160, 182 World Health Organization (WHO), 195, 218,
dependent, 179 230. See also United Nations
failing, 165. See states, weak world state, 155. See states

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