036. Cities

A discussion on our new environment.


Questions to ponder

  1. Who are you and where are you from?
  2. Dye (2008) notes that “urbanization is associated with falling birth and death rates and with the shift in burden of illness from acute childhood infections to chronic, noncommunicable diseases of adults”. With more than half the world’s population already living in urban areas, should we try to convince the other half to move to “the city”? Should there be more or less people(s) living “the city”? More or less people(s) living in the world?
  3. What fears do you have in the exasperation of differences between rich and poor individuals?
  4. “City dwellers”, Dye tells us, “are comparatively wealthy and lead more sedentary lives with easier access to low-cost, low-fiber, high-energy, high-fat food.” To what extent should the nutritional content of a city be regulated by city officials/representatives? What about other health surrogates (such as activity levels, vaccination schedules, etc.)?
  5. Traffic accidents kill over one million children and adults each year, mostly in urban centers. Along with the leveling of environments and the polluting of air, there are hazards to health by mere writ of cities’ existence. How can we mitigate their effects? How can maximize the benefits of the city (to both urban and rural residents)?
  6. Blustein & Fleischman (2004) identify three features – density, diversity, and disparity – affecting the health of urban populations.
    1. To what extent does the density of a population determine moral actions?
    2. “Is there an obligation to respect the cultural values of individuals even if the traditions and practices that give those values their content are in conflict with the dominant ethical norms” of a city in which the individual exists?
    3. Disparate outcomes of health/care correlate to poverty and its consequent lack of access. (“[R]acial and ethnic variations are also independent factors in determining disparate outcomes.”) How can we alleviate these disparities? When will we?
  7. Can a city get too big? Too small? Just right?
  8. Milgram (1970) suggests several “adaptive mechanisms” urban dwellers adopt to deal with the “overload” experienced in cities, including allocating less time to others, disregarding “low-priority inputs” (such as “the drunk sick on the street”), and social burden shifting (e.g., welfare departments, bus drivers no longer offering change, etc.). Given the superficiality, anonymity, and transitory nature of many urban interactions, do cities facilitate “the best of all possible worlds”? Are we our best selves in the city?
  9. When talking about “the city”, one is implicitly talking about “the country”. What is to be said about it, explicitly?
  10. Are cities “natural”?
  11. Are cities necessary for democracy? Does “Western liberalism” require cities?
  12. Many facets of bioethics get brought up in these discussions including clinical ethics (obligations of physicians, rights of patients), research ethics (responsibilities of researchers, protections of subjects), institutional ethics (organizations as moral agents), and public health ethics (populations as the dimension of interest). To this, for cities, we may consider further environmental ethics as issues, such as food safety, water filtration, and “waste” “disposal”, arise with regularity. Are inhabitants of cities in a position to ethically decide how their local environment is altered? What about the world’s? How shall we face our changing climate(s)?
  13. Quo vadis?

 


Essays to consider

  1. Health and Urban Living
  2. Urban Bioethics: Adapting Bioethics to the Urban Context
  3. The Experience of Living in Cities
  4. From the Urban to the Civic: The Moral Possibilities of the City