Racial Groups, Distrust, and the Distribution of Health Care

Reconceptualizing solidarity as power from below

“…3 To this may be added Joel Feinberg’s ( 1968 ) conception of solidarity as involving vicarious pride and shame, integrated interests, and the experience of sharing a “common lot” (or “linked fate,” from the literature on racial identity). A substantial body of work also addresses issues of racial, gender, and other social identities, which is typically considered a key basis for group solidarity (Alcoff, 2005 ; Blum, 2007 ; McGary, 2012 ). Alison Weir ( 2013 ) has also argued that some kind of solidaristic perception is a necessary part of the process by which women are able to construct their interests and identities as women at all.…”

Racial Integration and the Problem of Relational Devaluation

“…Others have made such claims. For example, some critics of integration argue that it ‘deprives’ blacks of culture, and through this, of self-worth (McGary, 1999). 22 Other critics demand that blacks be respected as equals “from a distinct and valued subculture,” and reject integration as incompatible with this demand (Adams, 2006, p. 294) 23 .…”

“…24–25). Howard McGary (1999) has written: A crucial aspect of self-esteem is the fact that the opinions of others are crucial to a person's assessment of whether or not he feels that he is worthy of esteem. Self-respect, on the other hand, does not necessarily depend upon the assessment of others.…”

“… 22 McGary (1999) does not endorse this argument. Kwame Ture and Charles Hamilton (1992) make a version of it: “The racial and cultural personality of the black community must be preserved and that community must win its freedom while preserving its cultural integrity … No person can be healthy, complete and mature if he must deny a part of himself; this is what integration has required thus far” (p. 55).…”

Medicine and Contextual Justice

“…The difference principle reflects a broadly shared commitment to the idea that some people need more help than others, and because of that need, they should receive more help than others do. People who are poor, work several jobs, and have a hard time making ends meet, people who care for several children with little social support, people who live in environments that present special health challenges (e.g., pollution, violence, contamination), 33,34 people with mental or physical disabilities; 35,36 people who are old and frail, 37 people who are distrustful of medical professionals, 38 and people with limited medical literacy are likely to need more resources than others with similar medical conditions who are more able to manage on their own.…”