Madison Powers and Ruth Faden here develop an innovative theory of structural injustice that links human rights norms and fairness norms. Norms of both kinds are grounded in an account of well-being. Their well-being account provides the foundation for human rights, explains the depth of unfairness of systematic patterns of disadvantage, and locates the unfairness of power relations in forms of control some groups have over the well-being of other groups. They explain how human rights violations and structurally unfair patterns of power and advantage are so often interconnected. Unlike theories of structural injustice tailored for largely benign social processes, Powers and Faden's theory addresses typical patterns of structural injustice-those in which the wrongful conduct of identifiable agents creates or sustains mutually reinforcing forms of injustice. These patterns exist both within nation-states and across national boundaries. However, this theory rejects the claim that for a structural theory to be broadly applicable both within and across national boundaries its central claims must be universally endorsable. Instead, Powers and Faden find support for their theory in examples of structural injustice around the world, and in the insights and perspectives of related social movements. Their theory also differs from approaches that make enhanced democratic decision-making or the global extension of republican institutions the centerpiece of proposed remedies. Instead, the theory focuses on justifiable forms of resistance in circumstances in which institutions are unwilling or unable to address pressing problems of injustice. The insights developed in Structural Injustice will interest not only scholars and students in a range of disciplines from political philosophy to feminist theory and environmental justice, but also activists and journalists engaged with issues of social justice.

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy.

The proliferation of Acquired Immune Deficiency Syndrome (AIDS) among women and children represents one of the gravest health issues confronting contemporary society. Women, most of childbearing age, now constitute 11 percent of all cases, and the U.S. Public Health Service has projected over 3,000 cases of pediatric AIDS by the end of 1991. In the face of these sobering statistics, experts have been called upon to grapple with a difficult, compelling question: under what conditions, if any, should HIV testing of women and children be required? Also at issue are the surreptitious testing for HIV antibodies as part of routine prenatal and neonatal examinations, and whether such testing should be performed on all women and infants, or only those who belong to groups judged at "high risk." In this unique contribution to the debate about HIV screening and testing, Ruth Faden, Madison Powers, and Gail Geller have assembled perspectives from experts in public health, medicine, law, and ethics. Their wide-ranging treatment examines the history of prenatal and neonatal screening programs; informed consent; legal issues and confidentiality; reproductive decision-making; and numerous other aspects of HIV testing. Alternative policy options for both now and the future are discussed in detail. This volume provides a comprehensive analysis of these pressing medical, public health, legal, ethical, and social issues, and is essential reading for AIDS researchers and clinicians, public health specialists, ethicists, health policymakers and analysts, obstetricians, and pediatricians.