I think both these answers are off the mark. The first focuses too narrowly on what we owe people based on legal rules and formal citizenship. The other answer focuses too broadly, on what we owe people qua human beings. We need a perspective that is in between, that adequately responds to the phenomenon of illegal immigration and adequately reflects the complexity of moral thought. There may be important ethical distinctions, for example, among the following groups: U.S. citizens who lack health insurance, undocumented workers who lack health insurance in spite of working full time, medical visitors who fly to the United States as tourists in order to obtain care at public hospitals, foreign citizens who work abroad for subcontractors of American firms, and foreign citizens who live in impoverished countries. I believe that we-U.S. citizens-have ethical duties in all of these situations, but I see important differences in what these duties demand and how they are to be explained.

"a job without overtime pay, health insurance, or sick leave-and usually without recourse against the abuses of one's employer, which can include being required to have sex without a condom and being forced to turn tricks in order to work off crushing debts."5

I have suggested that the issues should be framed in terms of social justice and social responsibility. I realize that I did not fully justify my view, and that other people may give a different account of what social justice requires. But I had a different aim. I did not want to convince everyone of the rectitude of my account, but to shift the discussion into the realm of social justice and responsibility.

I believe that societies that attract illegal immigrants should pursue policies and practices that (1) improve the pay for and conditions of the worst forms of work; (2) structure and organize work so as to give workers more voice, power, and opportunity to develop their capacities; and (3) connect labor to unions, associations, and communities in ways that increase social respect for all workers. I cannot justify these claims in this paper, but I want to note how they are connected to health care. Providing health care for all workers and their families is a very good way to improve the benefit that workers receive for the worst forms of work, to render workers less vulnerable, and to express social and communal respect for them. These are good reasons for providing health care for all workers, documented and undocumented alike. And they express ethical concerns that are not captured by talking about human rights, public health, or the rights of citizens.

Rather than claiming an essentially limitless right, it makes more sense to recognize a modest core of human rights and to supplement those rights with a robust account of social responsibility, social justice, and international justice. I do not know if there is a principled way to delineate exactly what should be included in the core of human rights.18 But even a short list of circumscribed rights would have important consequences if societies took responsibility for trying to protect everyone from violations of these rights. Illegal immigrants are sometimes killed in transport, physically or sexually abused, held as slaves, kept in indentured servitude, forced to work in occupations, and denied petsonal property. These are clear violations of what should be tecognized as human rights. But this core of recognized rights should be supplemented with an account of social justice and responsibility.

The claim might also mean that the selection of patients should be based only on medical need, never on such factors as nationality, residency, immigration status, or ability to pay. This is a very strong claim. It means that all private practice is morally wrong. It means that most national health care systems are too restrictive. It means that transplant lists for organs donated in a particular country should be open to everyone in the world. It might even mean that physicians have an ethical responsibility to relocate to places where the medical need is the greatest. I shall say more about the strong claim in the next section. Here I just want to note one point. This claim goes well beyond professional ethics. It is an ethical claim that seems to be based on a belief about the nature of human needs and human rights.

The abstract ethical question of whether societies have a responsibility to provide health care for illegal immigrants sometimes becomes a concrete political issue. Rising health care costs, budget reduction programs, and feelings of resentment sometimes transform the ethical question into a political debate. This has happened several times in the United States. In 1996, the Congress debated and passed the "Illegal Immigration Reform and Immigrant Responsibility Act." This law made all immigrants ineligible for Medicaid, although it did allow the federal government to reimburse states for emergency treatment of illegal immigrants.

In the global economy, in which a company can shift its manufacturing base with relative ease to a country with cheaper labor, illegal immigrants often perform work that cannot be shifted overseas. Toilets have to be cleaned, dishes have to be washed, and children have to be watched locally. This local demand may help to explain a relatively new trend: the feminization of migration. Migrants used to be predominantly young men, seeking work in areas such as agriculture and construction. But that pattern is changing. More and more women migrants are employed in the service sector as, for example, maids, nannies, and health care aides.

About 30-40 percent of these people entered the country legally, but overstayed their visas. Of all the immigrants in Europe, about one third are probably illegal immigrants. A small country like Israel has about 125,000 foreign workers (not counting Palestinians). About 50,000 of these are in the country illegally.2

But while human migration is not new, illegal immigration is, since only recently have nation-states tried to control and regulate the flow of immigration. Societies have always tried to exclude people they viewed as undesirable: criminals, people unable to support themselves, people with contagious diseases, and certain ethnic or racial groups. But only in the last hundred years or so have states tried in a systematic way to control the number and kinds of immigrants.

In this paper, I want to focus on the situation of illegal immigrants. I will discuss several different answers to the question about what ethical responsibility we have to provide health care to illegal immigrants. (I shall simply assume that societies have an ethical obligation to provide their own citizens with a reasonably comprehensive package of health benefits.) The answers that I shall discuss tend to conceptualize the ethical issues in terms of individual desert, professional ethics, or human rights. I want to discuss the limitations of each of these approaches and to offer an alternative. I shall approach the issues in terms of social responsibility and discuss the moral relevance of work. In doing so, I tend to pull bioethics in the direction of social ethics and political philosophy. That's the direction I think it should be heading. But before I begin the ethical discussion, I need to say more about the phenomenon of illegal immigration.

Illegal immigrants form a large and disputed group in many countries. Indeed, even the name is in dispute. People in this group are referred to as illegal immigrants, illegal aliens, irregular migrants, undocumented workers, or, in French, as sans papiers. Whatever they are called, their existence raises an important ethical question: Do societies have an ethical responsibility to provide health care for them and to promote their health?

Today, with sea-surface temperatures on the rise, the oceans are acidifying, and some shelled animals are already showing signs of their shells dissolving.

As the planet warmed, the oceans absorbed more and more carbon dioxide. This caused waters to acidify to the point that organisms like corals would have dissolved, explained Hana Jurikova, a biogeochemist at the University of St. Andrews in Scotland who led the study. Dr. Jurikova and her team discovered spikes of the element boron — a proxy for acidity levels — in fossil brachiopod shells found in

One potential issue with coronene, says Henrik Svenson, a geologist at the University of Oslo who was not involved in the work, is that it forms only at temperatures exceeding 2,100 degrees Fahrenheit, and to reach such temperatures, the fossil fuels would have had to be enveloped inside the magma, not just sitting next to it.

Dr. Kaiho and his team retrieved samples from rock deposits in south China and northern Italy that formed around the time of the extinction, and they detected spikes of a molecule called coronene. That substance, Dr. Kaiho explained, is produced only when fossil fuels combust at extremely high temperatures — like those you might find in magma.

“There was lots of oil, coal and carbonates formed before the extinction underground near the Siberian volcanism,” said Kunio Kaiho, a geochemist at Tohoku University in Sendai, Japan, and the lead author of one of the studies, published this month in Geology, which presented evidence for the burning of ancient fossil fuels by magma. “We discovered two volcanic combustion events coinciding with the end-Permian land extinction and marine extinction.”

But volcanism on its own didn’t cause the extinction. The Great Dying was fueled, two separate teams of scientists report in two recent papers, by extensive oil and coal deposits that the Siberian magma blazed through, leading to combustion that released greenhouse gases like carbon dioxide and methane.

The smoking gun was ancient volcanism in what is today Siberia, where volcanoes disgorged enough magma and lava over about a million years to cover an amount of land equivalent to a third or even half of the surface area of the United States.

Paleontologists call it the Permian-Triassic mass extinction, but it has another name: “the Great Dying.” It happened about 252 million years ago, and, over the course of just tens of thousands of years, 96 percent of all life in the oceans and, perhaps, roughly 70 percent of all land life vanished forever.

"Assuming complete removal, aerosols at most will cause warming of about 1 K," said Allen. "However, aerosol-induced warming, as well as the associated ocean circulation changes, can be moderated by rigorous cuts in greenhouse gases including methane and carbon dioxide.

Humans have already increased carbon dioxide levels by almost 50% since the 1850s, and it continues to increase worldwide. Stabilizing carbon dioxide at current levels would require zero net emissions before the year 2070, which is ambitious, but critical.

Allen explained the study did not attempt to rigorously identify the mechanisms by which aerosol reductions weaken the AMOC. Those mechanisms will be the focus of future studies.

In addition, the researchers said a rise in sea level w

n particular, the Atlantic meridional overturning circulation, or AMOC, would be disturbed as aerosols are removed from the atmosphere, the study found. The AMOC pulls warm water further north and pushes colder water south, ensuring the climate on land areas at higher latitudes, such as Europe, are relatively mild.

"The first scenario leads to the surprising result that fewer aerosols in the atmosphere could shift the region where most of the ocean is taking up heat, from the Southern Ocean toward the North Atlantic," Allen said. advertisement googletag.cmd.push(function() { deployads.push(function() { deployads.gpt.display("adslot-mobile-middle-rectangle") }); });

The research team created detailed computer models to determine the impact on oceans under two different scenarios -- one in which there is only a reduction in aerosols, and another scenario in which greenhouse gases like carbon dioxide and methane are also reduced.

Much research has examined aerosol impacts on air quality and land surface temperatures. Less explored is the way aerosols might impact the oceans, which is the focus of a UC Riverside study now published in the journal Science Advances.

"The conundrum," explained UC Riverside climate scientist and study co-author Robert Allen, "is that aerosols cause poor air quality and lead to premature deaths. However, these particles have a net cooling impact on the climate, so when you cut them that leads to a net warming effect."

Aerosol pollution refers to particles in the air emitted by vehicles and factories that burn fossil fuels. This pollution contributes to asthma, bronchitis, and long-term irritation of the respiratory tract, which can lead to cancer.

“All states have been at a disadvantage in their response to C-19 because the federal government has failed to adopt a unified, nationwide strategy.

White told the Howard Center he moved on to another plan after city officials gave him “kind of a non-response” that didn’t show support for the project.

Many have criticized the federal government for not providing a coordinated response to the pandemic’s impact on homeless people, as well as more resources for testing and tracing.

Cities and counties can access the funds directly or seek reimbursement for approved expenditures after signing grant agreements with HUD.

reporters filed 140 public records requests to the vulnerable counties and their major cities to learn more about their responses to the crisis.

San Francisco, Los Angeles, New York City, Washington, D.C., Seattle and Phoenix -- and found at least 206 deaths nationwide by early August.

The administration’s homelessness czar told Congress in July there had been just 130 homeless deaths, noting that was “significantly lower than had been originally projected.”

That’s despite the fact that unlike other high-risk, congregate-living groups, such as nursing home residents or prisoners, homeless people interact more with the public.

But residents complain that hygiene supplies have become scarce, and measures meant to contain the spread of COVID-19 are not enforced.

Despite 12-foot-square sections painted in the gravel, there is little social distancing for Phoenix’s homeless population.

That’s despite the fact that unlike other high-risk, congregate-living groups, such as nursing home residents and prisoners, homeless people interact more with the general public.

But residents complain that hygiene supplies have become scarce, and measures meant to contain the spread of COVID-19 are not enforced.

Despite 12-foot-square sections painted in the gravel, there is little social distancing for Phoenix’s homeless population.