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Asylum Seekers and Public Health Ethics

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Ethics in Public Health and Health Policy

Part of the book series: Public Health Ethics Analysis ((PHES,volume 1))

Abstract

I discuss the case of asylum seekers in Germany and hence identify ethical questions that are relevant from a public health perspective. First, I describe the situation asylum seekers face currently in Germany. Next, I assess this particular case by explaining and applying Powers and Faden’s theory of social justice in public health and health policy. At the core of their sufficientarian approach lies the assumption that social justice is the foundational moral justification of public health. Finally, I identify and briefly comment on a central question that remains open, namely, what moral obligations governments have towards citizens and non-citizens.

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Notes

  1. 1.

    Asylum and protection as refugee are two slightly different categories, according to which law is the basis for the decision (§60 Aufenthaltsgesetz or Art. 16a Grundgesetz), see for example Hailbronner 2008.

  2. 2.

    In the following I will use the term “asylum-seekers” to refer to all three groups mentioned above.

  3. 3.

    Health care for social welfare recipients is generally as good as for any other publicly insured German citizen, and social welfare consists mainly of financial aid instead of non-cash benefits.

  4. 4.

    In his study Pieper presents material from altogether 40 long interviews, 86 short interviews, 2 group interviews, visits of 42 camps and a questionnaire study (Pieper 2008: chapter 1.4). Behrensen and Groß present material from 31 participatory observations, 39 long interviews, 2 group interviews, 22 questionnaires and the analysis of 87 documents (Behrensen and Groß 2004: chapter 2.1).

  5. 5.

    Even though Powers and Faden’s theory is intended to be an alternative to other theories of justice, it does have many affinities with the capabilities approach of Amartya Sen or Martha Nussbaum (Powers and Faden:37). The main difference compared with Sen’s and Nussbaum’s capabilities approaches is that Powers and Faden’s theory is interested in actually and directly achieving a sufficient level of the six dimensions of well-being – instead of merely achieving the freedom or the capabilities to achieve well-being if one so chooses.

  6. 6.

    See also O’Neill who argues for a richer understanding of justice in public health beyond questions of distributable goods and their just allocation (2011).

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Acknowledgments

I would like to thank Angus Dawson, Carina Fourie, Kalle Grill, Alison Thompson and the two anonymous reviewers for their very valuable comments on earlier drafts of this paper. The work has been partially funded by Swiss National Science Foundation.

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Authors and Affiliations

  1. Institute of Biomedical Ethics, University of Zurich, Zurich, Switzerland

    Verina Wild

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  1. Verina Wild
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Correspondence to Verina Wild .

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Editors and Affiliations

  1. Carl-Neuberg-Str. 1, Hannover, 30625, Niedersachsen, Germany

    Daniel Strech

  2. Carl-Neuberg-Str. 1, Hannover, 30625, Niedersachsen, Germany

    Irene Hirschberg

  3. Ludwig-Maximlians-University Munchen, Lessingstr 2, Munchen, 80336, Germany

    Georg Marckmann

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Wild, V. (2013). Asylum Seekers and Public Health Ethics. In: Strech, D., Hirschberg, I., Marckmann, G. (eds) Ethics in Public Health and Health Policy. Public Health Ethics Analysis, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6374-6_13

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