ACTA UNIVERSITATIS UPSALIENSIS Uppsala Studies in Social Ethics 51
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ACTA UNIVERSITATIS UPSALIENSIS Uppsala Studies in Social Ethics 51 Ville Päivänsalo Justice with Health Faith in Support of Progress across Contexts Uppsala 2020 Päivänsalo, Ville, 2020. Justice with Health: Faith in Support of Progress across Contexts. Acta Universitatis Upsaliensis, Uppsala Studies in Social Ethics 49. 347 pp. Uppsala. ISBN 978-91-513-0971-2. Abstract This book combines a religiously non-confessional approach to justice with health to- gether with an analysis of the faith-based promotion of justice with health and focuses mainly on the time period beginning from the mid-1960s. Here “justice with health” means a particular reasonable conception of socio-political justice that includes health-related capabilities among its central components. The faith-based heritage in question is Protestant, especially Lutheran, Christianity. Drawing on some of the most prominent theories of justice from the past few decades, primarily those by John Rawls and Amartya Sen, the constructive part of the study defends a moderately structured account of reasonable justice identified through ten guidelines. Although these guidelines are first defended in terms of religiously non-confessional theories, it is argued that they could be properly supported by in- sights of faith as well. The guidelines—concerning the foundations, principles, and goals of justice—allow comparatively flexible variation across contexts. Yet they are intended to help achieve a firmer consensus in the promotion of health-related justice than the status quo among various responsible agencies usually indicates. A broad historical review of the Protestant promotion of social justice and health, from the Reformation era onwards, illuminates the importance of this faith-based heritage. Insights inspired by a holistic theology of human dignity, faith in freedom, a calling to serve one’s neighbor, the two kingdoms doctrine, natural law theology, and advocacy for the sick and the poor have functioned as highly significant reasons to assume responsibilities for justice and health long before the era of secular wel- fare states and explicit programs for global health. Concentrating on the mid-1960s to the early 2010s, the review serves as a basis for confirming that, despite important counter-examples, it is possible to identify an abundance of insights regarding both reasonable and practical health-related social justice among Protestant-Lutheran faith perspectives. Keywords: global health, global justice, political justice, human development, Protestant Christianity, medical mission, faith-based organizations, holistic health, Lutheran theology. Ville Päivänsalo, ThD, Adjunct Professor (Docent) in Theological and Social Ethics (University of Helsinki 2010); culturesethics.wordpress.com, [email protected] © AUU and Ville Päivänsalo 2020 ISSN 0346-6507 ISBN 978-91-513-0971-2 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411572 Printed in Sweden by DanagårdLiTHO AB, Ödeshög Contents List of Tables ....................................................................................... 7 Preface ................................................................................................. 9 1. Introduction: Supportive Compatibility for Progress .................. 13 2. Non-Confessional Ideas and Guidelines ...................................... 49 2.1 Reasonably Universal Justice ............................................... 49 2.2 The Ideas of Justice and Capabilities ................................... 67 2.3 Towards Justice with Health ................................................. 84 2.4 Between Constitutional and Distributive Justice ............... 103 2.5 Justice with Health: A Quest for Non-Confessional Guidelines ........................................................................... 123 3. A Tradition of Service in Freedom ............................................ 130 3.1 Luther and the Emerging Political Liberalism ................... 130 3.2 Expanding Earthly Responsibilities ................................... 153 3.3 Medical Missions and Globalizing Politics ........................ 170 3.4 Churches for Human Rights and Healing .......................... 187 3.5 Fragile Progress across Contexts ........................................ 205 4. Fragile Justice and Practical Faith ............................................. 219 4.1 Foundations and Principles ................................................. 219 4.2 Prophetic Justice for Societal Healing ................................ 239 4.3 Communities in Broad Cooperation for Health ................. 256 4.4 Non-Confessional and Faith-based Visions ........................ 267 4.5 Goals in Context: Toward Wholeness/Shalom ................... 285 5. Conclusions: Compatibility with a Vision ................................. 302 6. Sources and Literature ................................................................ 318 6.1 Sources (since 1965): Authors ............................................. 318 6.2 Sources (since 1965): Organizations .................................. 319 6.3 Literature ............................................................................ 326 List of Tables Table 1. The Foundations of Justice with Health ............................ 223 Table 2. The Principles of Justice with Health ................................ 231 Table 3. The Central Goals of Justice with Health ......................... 286 7 Preface This book complements a kind of trilogy. Balancing Reasonable Jus- tice: John Rawls and Crucial Steps Beyond (2007) counts as its first part. In that book, I outlined the theoretical foundations of my own approach to socio-political justice and showed how we can address the key weaknesses of Rawlsian, American political liberalism, and move on to discuss topical issues of justice in a balanced way. Looking at the divided American political debates through the 2010s, progress in this respect has not appeared to be easy to achieve for anyone! Thus, if you find that the theoretical foundations of the present “justice with health” account are somehow not defended carefully enough, further analysis can be discovered in Balancing Reasonable Justice. But surely, I have done my best to present these foundational issues here as clearly as possible and as comprehensively as useful (see especially Chapter 2). The second book in my trilogy on socio-political justice is Maal- linen oikeudenmukaisuus [Earthly Justice] (2010), written in Finnish. I do not regret my choice of language, for I was particularly interested in developing my approach in the contexts of the traditions in my proxim- ity. In religious terms, that meant the Lutheran heritage from the 16th century up to the age of globalization. At the same time, the challenge there was to enter into the discussion of global justice and human devel- opment more fully from a Western background (European-American) than what was possible in Balancing Reasonable Justice. Finally, in Justice with Health: Faith in Support of Progress across Contexts, I develop the theoretical approach explicitly in a cross-con- textual manner (utilizing e.g. Bengali-born Amartya Sen’s work), I thoroughly analyze one very important aspect of justice and human development (health), and I combine the theoretical approach to an even broader array of historical (see Chapter 3) and contemporary (see Chapter 4) examples from the evolving Protestant-Lutheran heritage. 9 Of course, the discussion could always be more comprehensive. Yet, the idea of writing a broad monograph like this has been to show the coherence as well as the justifiability and feasibility of the present ap- proach in comparison to a number of relevant alternatives. The con- clusions (Chapter 5), I dare to say, sum up all this more systematically than what is usual even in rather profound academic monographs in the field! The discussion will definitely continue. There is no way I could have predicted the emergence of the terrible corona virus while writing this book. However, the pandemic urges us to develop, in addition to im- mediate practical responses, as complete an understanding as possible of the underlying historical, ideological, and religious patterns across contexts. Indeed, the world has suddenly entered into an age of fragile global health in a more comprehensive way than hardly anyone could have foreseen! I have used abbreviations sparingly and explained their meaning anew in each chapter and, when needed, in each subchapter. Therefore, no separate list of abbreviations or acronyms would have been useful. Regarding my way of structuring the sources and literature, please see the section titled “Four Types of Material” in the Introduction (Chapter 1). Publications by the same author are listed in chronological order. When it comes to acknowledgements, I must first mention the Facul- ty of Theology at the University of Helsinki, which I served for most of the time during this book project, first as Assistant Professor of Glob- al Theology, Worldviews, and Ideologies (Feb 2012 – Dec 2016), and then as Acting University Lecturer in Systematic Theology, especially theological and social ethics (2017). The Ethics and Society project of this faculty supported my six-month period as a visiting scholar at The University of Heidelberg in the Research Center for International and Interdisciplinary Theology (Forschungszentrum für Internationale und Interdisziplinäre Theologie, FIIT), a period that was very useful for research on the European Lutheran heritage