Amplified Solidarity with Future Generations

Abstract

A recent trend in bioethics has highlighted the decisive role that solidarity plays in global health. However, given the impact and extent of the effects of climate change, which reach beyond present generations, it is important to consider whether this concept can be applied intergenerationally. Does it make sense to talk about solidarity with future generations? The objective of this article is to explore ‘amplified solidarity’, a new concept of solidarity that explains our obligations towards the health and quality of life of future generations. The analysis of this concept is structured as follows: I first establish the moral relevance of future people and then investigate the traits of amplified solidarity, its challenges, and its relationship with other key principles. I propose that amplified solidarity needs both a critical imagination to be projected towards the future and an institutional framework to correct health injustices across an intergenerational timescale. Solidarity forms a potent triangular constellation with responsibility and justice to fight against global and intergenerational injustices.

1. Introduction

“The way in which snails excited our sister’s macabre fantasy drove my brother and me to a rebellion that was at once one of solidarity with the poor mangled beasts, disgust at the taste of cooked snails, and discontent with everything and everyone, so much so that it was not surprising that Cosimo matured from there and what followed” [1] (pp. 93–94)¹.

What followed is that Cosimo Piovasco di Rondò decided to climb a tree in the garden at home and vowed never to set foot on the ground again. Cosimo dedicated his life to living in trees so that what seemed a wild whim of a 12-year-old boy became a promise until the end of his days.

Years later, elsewhere and at a different juncture, Olivia and Nick decide to climb into the branches of Mimas, a giant sequoia, in order to prevent its imminent felling. The desperate performance to protect the tree turns into a months-long protest and criminal convictions for environmental terrorism. At the same time, seven other people are fighting resolutely for both the conservation of the forests and the respect for nature’s wisdom; a dispersed, heterogeneous community that forms an army of insurgents united by the same goal: to save the trees [2].

Though they have very different endings—one sudden and tragic, one drawn out—both ‘tree stories’ have the common denominator of solidarity. Solidarity is part of the way we relate to each other and see the world; it is linked to hope and the rejection of injustice. Biagio, in recounting this eschewing of the consumption of snails, is very clear that his brother’s feat of arboreal ascension has a sense of solidarity with the poor creatures. Olivia and Nick resist threats, violence, and pressure from logging company workers and the government for their ‘crime’ of protecting the trees. Perhaps neither of them would be able to define in detail what solidarity is, but even so, it is very clear to them that they are there, standing up for the conservation of nature, protesting an injustice.

Although solidarity is part of our everyday language and is manifested in social relations and practices, it has not always received the conceptualisation and the place it should occupy in relation to other classical values in the ethical and political sphere, in the same way that ‘justice’ or ‘freedom’ have. In the field of bioethics, i.e., in studies dealing with the life of human beings, non-human animals, and other forms of life, it has only recently acquired a distinct and well-formed identity. Numerous contemporary studies concerned with the problems of public health are exploring the potential and limits of a concept of solidarity with a global character [3,4,5,6,7,8,9], so we are witnessing the birth and consolidation of an ‘emerging concept’ in bioethics [10]. Without seeking to provide a complete approach, bioethicists understand solidarity from different angles in terms of its axiological place, its epistemological range, and its role in public health. In the latter, according to Anca Gheaus, it appears as a non-excludable ‘political relational good’, understood as public and with a sense of it as instrumental [3] (p. 179). Barbara Prainsack and Alena Buyx define solidarity as “shared practices reflecting a collective commitment to carry ‘costs’ (financial, social, emotional or otherwise) to assist others […] with whom a person recognises sameness or similarity in at least one relevant respect” [10] (p. xiv). Angus Dawson and Bruce Jennings prefer to treat solidarity “like concepts such as community and trust, as necessarily involving both normative and descriptive components, and as being essential requirements for the very possibility of ethical decision-making”, without offering a more detailed definition [5] (p. 74).

The most obvious reason for such an epistemological and ethical shift towards solidarity is the threats and impact of the effects of climate change on global health. This is the understanding of Peter G. N. West-Oram and Alena Buyx when they state that “[t]he threat posed to rich and poor alike by emerging global health threats should motivate wealthy nations to expand the range of persons with whose interests they are concerned” [4] (p. 214).

Indeed, in recent years, globalised societies have faced two major global challenges: climate change and an increase in antibiotic resistance. These phenomena make us redefine who is vulnerable in such a way that they are now conceived as threats to which all individuals, united in their vulnerability, are exposed [4]. Climate change has been associated with profound systemic shocks that are affecting life on the planet, altering the fundamentals of human and non-human health and well-being to a previously inconceivable degree. As we continue to be almost completely dependent on the energy generated by solid fuels (fossil fuels account for 80% of the global primary energy supply [11]) and on the consumption of carbon-intensively produced food like meat and dairy, anthropogenic greenhouse gas emissions continue to rise [12]. Heat waves increasingly affect both the physical and mental health of individuals, the security and quality of water and food supplies are in danger, and problematic mass population movements to safer and more economically prosperous areas occur more and more [12]. At the same time, the risk of contagious diseases increases, and we are witnessing an “accelerated evolution of antimicrobial resistance” [4] (p. 212). These are the unprecedented characteristics of our time.

In this context, bioethics has put on the table the need to appeal to international solidarity as a driving mechanism—sometimes at the level of justification, sometimes as a motivational instance—with a view to global health, deemphasising (but not banishing) the classical principles of the discipline². Solidarity is the call to act collectively in the design and implementation of measures to ensure good health for all people on the planet. This would mean assuming costs so that basic health goods can be ensured for everyone in the world, regardless of where they live. However, without drastic measures to keep it in check, the human action facilitated by advances in science and technology will continue to produce changes and transformations on a planetary scale, which will have an irreversible negative impact on climate and therefore health, not only in the immediate present but also for thousands of years to come.

An essential question emerges from this: does it make sense to talk about intergenerational solidarity? If we answer affirmatively, then we must specify what solidarity with future generations is. We must ask whether solidarity ought to not only contribute to the well-being of present generations but also be extended as a necessary moral and political good that encompasses the well-being of future generations. In other words, in the face of the global threats of climate change, can the duties we have to future generations be conceived in terms of solidarity?

There is currently far from a homogeneous definition and position on the nature and status of solidarity in the field of global health among contemporaries. Furthermore, studies that aim to extend analyses to the intergenerational terrain by applying and reconceptualising the principle of solidarity appear to be scarce and in need of revision and discussion [13]. A notable exception is the 2013 Report of the United Nations Secretary General Ban Ki-Moon, which is worth highlighting for its clarity and relevance, and which states that the need for intergenerational solidarity must be implemented and promoted through the analysis of sustainable development, and respect for the actions and treaties already in force [14]. However, while the report shows the UN’s concern for future generations as illustrative and important, we do not find a detailed and satisfactory definition and analysis of solidarity in its pages. Solidarity appears as a sentiment (a ‘strong empathy’), at other times as a ‘value’, on occasions as ‘social cohesion’, or as a ‘principle’, overstretching the concept and blurring its frontiers, intertwining it with the concept of sustainable development—a concept itself not free of controversy [15].

On the other hand, strictly speaking, in bioethics studies, this is an almost unexplored problem when concerning future and remote generations.

Faced with the increasingly urgent question of what our obligations and rights are when considering health from an intergenerational perspective, the central hypothesis is based on the premise that health is a fundamental and irreplaceable good for individuals and societies. Here, I take health in its extended and comprehensive sense, as a condition for the possibility of achieving objectives and living valuable lives, based on the assumption that every human being has the right to the capability to be healthy and the right to live a life of a ‘normal’ duration³, and that a ‘just’ or ‘good’ society will be one that ensures a healthy life from a perspective that respects the same right of future generations [17].

I defend that we have relations of solidarity with future generations, and that solidarity is an instrumental and substantial moral and political good crucial to motivating the practice of acting with consideration for the life of future generations. Solidarity in its normative sense also stands as a principle that explains the reasons why we care and carry out sacrifices considering future generations—but is it sufficient per se, or does it need to be accompanied by other principles to be effective in the long term?

2. The Moral Relevance of Future People

Is a life in the future worth the same as a life today? Why should we stand in solidarity with the people of the future? When we consider these questions carefully, we find ourselves at one of the stumbling blocks facing intergenerational ethics (as opposed to thinking in the intra-generational sphere, i.e., in the relationships and obligations of people living contemporaneously). In addition to the uncertainty and lack of cooperation between non-overlapping generations, there is the problem of what reasons and motives people have to act in solidarity and responsibly considering the lives of the people of the future [18].

I will offer two compelling reasons to support the idea that people’s lives have equal moral relevance regardless of their distance from us in either space or time.

First of all, many of our actions reveal that the more distant people are, the less moral importance we attach to them. At first glance, this may make sense: human beings prefer to receive the benefits or rewards that their actions can bring as immediately as possible, prioritising the present and the short term over the long term, a tendency that becomes, in economic theory, a very sinister machine. This is fundamentally the hypothesis in welfare economics called the ‘social discount rate’, which allows us to discount the effects of our actions at a rate of n percent per year. By using this rate, it is possible to tackle the expansion of obligations by claiming that the more distant the effects of our actions are, the less we should be concerned about them. Our moral responsibility for the well-being of future people decreases as time goes on, or, in other words, we are more morally justified in caring less about more distant future generations than about those nearer to us. The conclusion reached by this view of intergenerational justice could not be more alarming: ‘At a discount rate of five percent, one death next year counts for more than a billion deaths in 500 years’ [19] (p. 357). This method, when adopted politically, has become a way of operating in public policies where immediate or near-future benefits are sought. It also responds to a utilitarian filter that favours short-term utility.

However, these strategies applied in critical and difficult circumstances point to the dangers of prioritising a presentist, economistic, results-based, profit-driven, and calculating way of conceiving life. This is what Roman Krznaric conceives of as a “weapon of intergenerational oppression disguised as rational economic methodology” [20] (p. 91). However, if we stop to analyse its theoretical assumptions, the pitfalls begin to appear, as Derek Parfit highlights:

“The present moral importance of future events does not decline at a rate of n per cent per year. Remoteness in time has, in itself, no more significance than remoteness in space. Suppose that I shoot some arrow into a distant wood, where it wounds some person. If I should have known that there might be someone in this wood, I am guilty of gross negligence. Because this person is far away, I cannot identify the person whom I harm. But this is no excuse. Nor is it any excuse that this person is far away. We should make the same claims about effects on people who are temporally remote” [19] (p. 357).

This argument coincides with the idea of global justice theorists who claim that our intergenerational duties should be understood as a special area of application of extended global justice. For our purposes, if there is solidarity with people spatially distant from us (with people that we do not know and who live in other parts of the world), then there can be solidarity with people who do not coincide temporally with us.

In short, it seems difficult to argue from a moral point of view that some lives are more valuable than others simply because of a feeling rooted in emotional closeness and our knowledge of the particularities of that life due to temporal or spatial proximity. The task of defining these obligations across the temporal arc is enormously difficult because of the uncertainty that weighs heavily on our thinking; the uncertainty about the changes that techno-scientific advances will bring to both living conditions and human beings (such as genetic enhancement) in the future, coupled with the events that escape our predictive abilities and the unknowability of the future of the human race.

The second compelling argument for the moral relevance of spatially and temporally distant lives comes from luck egalitarianism, insofar as it is conceived as a duty of justice when people are disadvantaged not as a product of their conscious choices but rather due to the effect of luck [21,22]. In the historical epoch in which we find ourselves, it is clear that threats to global health have amplified this luck factor. Thus, our duties should be amplified accordingly. If we take into account the structural injustices resulting from our systems of production and consumption, and from our systemic economies and relations, what we may call brute luck seems to be in need of revision, as human beings are exposed to a greater number of risks resulting from the widening of the radius and the deepening of the impact of the effects of our actions linked to advances in contemporary science and technology⁴.

Human action has created, with the help of technoscience, a vulnerability that goes beyond that which is linked to the natural cycle of life, as Paul Ricoeur noted in his reading and borrowing of Hans Jonas’ principle of responsibility [23] (pp. 75–76). In the past, the range of human action was short, and its effects were therefore also limited in space and time; they were reparable. But, if we consider the ecological and climate crisis,

“for the first time, we are discovering that our actions can have harmful effects on a cosmic scale and in an irreversible way. For millennia, nature has been seen as an invulnerable environment while our cities have grown as safe enclosures. Today, on the other hand, nature is threatened by man” [23] (p. 75).

This vulnerability does not distinguish between economically prosperous societies and low-income societies, although its consequences are being felt even more severely by already vulnerable populations [24]. The phenomena of globalisation and the interconnectedness in which we live, coupled with climate change, have turned health into a global public problem that requires coordinated and transnational strategies to be properly addressed with future generations in mind. This does not mean that local approaches are of no use. Rather, I understand that solidarity must take place at different levels (and local solidarity actions are fundamental). However, the priority here is to point to the need to adopt a global and intergenerational perspective for the health of individuals in view of our increasingly interconnected societies and the consequences of the ecological and climate change crisis that have a global radius of impact. This is not such a far-fetched idea, although some theorists have doubts about its concrete and sustainable implementation due to the lack of a global contract between countries⁵. Vaccination plans and distribution—to return to the case of the COVID-19 pandemic—are a powerful example of a long-term plan that takes into account several generations. The pity is that many of these mechanisms are put in place when the danger is already in our homes.

But then, if people’s lives, both now and in the future, matter, questions arise as to whether the people of the future should bear the consequences of our actions, which will have a more serious impact in the time to come, and what our obligations are with respect to them. In other words, if our obligations towards justice and ensuring a healthy life for all people extend both spatially and temporally, and if solidarity, in view of the recent bioethics literature, is a touchstone in the face of the present challenges in global health linked to the consequences of climate change, then can we also talk about solidarity in our relationships with future generations? Can this concept extend beyond the obligations between generations that coexist in the present?

3. Elongating the Waves of Intergenerational Solidarity

Much of bioethicists’ language of solidarity comes from its flourishing and popularity in political and social discourse. It becomes explicit in social movements and real practices from both the right and the left. The notion has travelled a long road full of detours and obstacles in the political arena and political thought since the 19th century—the solidarism of Léon Bourgeois is often cited as the ultimate political expression, as it became the doctrine of the Third Republic [27]. Its etymological root, from ‘united’ (from ‘solide’), as an association or communion of interests or responsibilities can be traced, for example, in the First International: solidarity as the emancipation of the working class (which some say did not eventuate, in that case precisely because of a lack of this solidarity). For the sociologist Émile Durkheim, solidarity is what makes society function and what holds it together, promoting the freedom and well-being of its members. A disjointed society is one in which self-interest and individualism prevail and solidarity dissolves, and where the fetishisation of individual rights and freedoms abounds over collective interests—a pathology that is very present in today’s societies.

With the help of bioethics, solidarity undergoes its metamorphosis from a social practice into a normative idea that claims its place alongside other well-established principles such as autonomy, beneficence, equity, or justice. Many elements coincide in these two readings of solidarity from an analytical point of view, such as the idea of inter-relationality, the communion of interests, and the struggle for a common goal. However, this concept, even when reviewed from a bioethical perspective, is insufficient and limited in its capacity to embrace the consideration of future and remote generations.

The most obvious fact is that the distant descendants of our descendants in hundreds (or thousands) of years do not yet exist. In other words, solidarity is usually towards a subject with a more or less known identity, even if it is not perfectly demarcated. One is in solidarity with someone (a people, a group, a person, a non-human animal, a tree) because of something (destruction, poverty, inequality, disease). We cannot give the people of the future names and surnames; they are not yet agents, but they will not be wholly and completely different from us, no matter how much technobiological and cyborg revolutionary arguments may object. It will be highly unlikely that the people of the future will not have feelings of love or compassion, flee from death, and enjoy sensory experiences and a landscape rich in opportunities to live flourishing lives, to use Martha Nussbaum’s terms.

What does make a colossal difference is that we now stand in solidarity not only as a result of events that have happened but also in anticipation of the future consequences of events that are happening and that it is foreseen will happen. Additionally, from the perspective of intergenerationality, the blunt trigger is the global threat unleashed by human-induced climate change, the solution to which finds its greatest obstacle in the very structure of capitalism itself. It also implies that we are all responsible for the Earth and the living conditions we are passing from one generation to the next—and beyond.

This is a new idea of solidarity, which is not comfortable with the traditionally rigid framework conceiving only of interactions between cohabiting generations. I call this ‘amplified solidarity’: like boosted sound waves emanating outwards across both space and time, solidarity has the potential to resonate across generations.

But what does this amplified solidarity consist of? What is its relationship to other fundamental ethical principles?

4. Amplified Solidarity with Future Generations

With a view to providing a solution to the issues that emerge from considering solidarity in this way, I will address this notion along five analytical axes.

Dawson and Jennings propose that solidarity it is not just another concept to add to the list of ethical principles, but that it needs to be considered as embedded into a semantic network, included in a web of concepts such as ‘community, compassion sympathy, and empathy’. They do not necessarily conceive of it as a separate concept and competing principle but, rather, as a ‘shaping sensibility’ and a ‘standing up beside’, with the task of informing other normative instances [6] (p. 32).

My reading of amplified solidarity, however, is that it should be conceived of as an ethical principle in that it obliges certain human behaviour. It gives us reasons to act, and sits in a space between sentiments such as empathy or altruism and broader principles such as justice. It is important to see that if it does not translate into an obligation, it falls into the void of voluntary action, so that no one can be forced to act in solidarity. However, our empirical and historical reality is full of examples showing how, in exceptional cases, measures are imposed that force people to act in accordance with the restriction of some of their basic freedoms in favour of solidarity. The most blatant and recent case is the COVID-19 pandemic, when governments around the world restricted citizen’s movement and imposed the use of masks in order to prevent the most vulnerable people from dying. A brilliant analysis of this obligatory nature of solidarity can be found in Angel Puyol’s study on the role of solidarity in a pandemic. One of the virtues of such an analysis is that it understands solidarity on three levels: the first is linked to individual affection and moral experience, where sentiment clearly plays a crucial motivating role; the second corresponds to joint action of support for the common good of a group or community of people; and the third occurs when solidarity is so normatively and socially embedded and ‘solidified’ that it is transferred to the field of law and obligation, impose by the state [9] (pp. 7–8).

Secondly, regarding the ambiguity found in some studies as to whether the idea of solidarity is an ideal or a fact, in an intergenerational context, I argue that it is both. Were it just a fact, we would not have direction or aspiration—we may well fall into the perpetuation of the status quo. Solidarity is transformative and is critical to changing structures of domination and the exploitation of life in its different manifestations: violence against women and girls, non-human animals, LGTBIQ+ communities, racialised people, etc. It is the struggle to face the risks produced by human activity on a worldwide scale in the anthropogenic era that compels us to take this stand together. But also, that we engage in action to ensure healthy lives in both the present and the future seems to me to be one of the least disputed facts. We are, at least on some level, aware that we should protect and transmit our common goods. However, whether these measures are taken effectively or whether instead they are often propagandistic, manipulative manoeuvres aimed at private interests is a very different question.

Thirdly, it is important to decipher whether we are talking about solidarity in a political, social, or moral sense. Since its origin is a sentiment of injustice, its root has a moral dimension. Durkheim says, “[e]verything that is a source of solidarity, everything that forces human beings to rely on others, to regulate their movements independently of the impulses of their selfishness, is moral” [28] (p. 394). This solidarity has a projective force that can take many forms, but which mobilises us to action, awakened by concerns about how our world should be and how we should live with each other. In the field of global health, it implies a solidarity that encompasses these three dimensions (social, political, and moral) in that it is a value and a good—but it also relates to the field of praxis and to socio-historical context. Solidarity calls for action. There is no contemplative solidarity; there is only solidarity that instils and produces change.

Moreover, the fourth analytical axis involves recognising that amplified solidarity has its own unique characteristics. One of the most fundamental of these is that it is asymmetrical, despite what some studies seem to claim. West-Oram and Buyx, for example, affirm that “agents who recognize solidarity with others stand in symmetrical relationships as between equals, at least regarding the shared situation, interest or goal. Solidarity is not enacted in unilateral, top down or charitable relationships” [4] (p. 213).

Solidarity in its amplified version cannot be between equals in two senses. Firstly, with our contemporaries, there are already profound inequalities that must be taken into account when weighing solidarity, applying sensitivity to the context and the particular position of the actor. The magic of amplified solidarity is that in our differences, we stand with our contemporaries and with all future (and past) generations. Secondly, the scale of power to affect life and introduce profound transformations (both positive and negative) tips spectacularly in favour of the present generations—those able to act now. We are thus inextricably involved in an intergenerational framework in which there is, without doubt, an unbridgeable imbalance of power. Iris Marion Young has very aptly picked up on this idea:

“As a term and a concept, solidarity need not connote homogeneity or symmetry among those in relation. Some people use the term to imply identification with other or the unity of a group, but such usages can and should be challenged. As I am understanding it, solidarity is a relationship among separate and dissimilar actors who decide to stand together, for one another. Moreover, unlike brotherhood, which appeals to a natural origin in the unspoken mother, already there to be counted on, solidarity must always be forged and reforged. Solidarity is firm but fragile. It looks to the future because it must constantly be renewed” [29] (p. 120).

I have saved for the fifth and final analytical aspect in this physiognomy the one I consider to be the thorniest: the with of solidarity. Solidarity with future generations (as it appears in the title of this work) is problematic. Doubts have been raised as to whether the idea of solidarity can be applied to relationships and obligations that are not reciprocal. For example, imagine the possibility of enlarging the concept to embrace solidarity with the natural environment or with non-human animals. There is a sense that the concept would be lost: we would not act with them but for or on behalf of them. The question of who forms part of the ‘we’ concerns the metaphysical problem of belonging and reciprocity. It could be argued that future generations are not yet agents and we cannot benefit from a scheme of mutual reciprocity. But I think we have to be careful with the temptation to write off the with quite so soon, as in the case of Sally Scholz’s work [30], and instead understand the idea of solidarity from a much broader and more flexible perspective than what has been understood according to political solidarity [30].

It should be said, first of all, that I consider the question of intergenerationality to be a continuum⁶. This view allows us to talk about both compensations for events committed in the past that have caused damage or harm to people or groups (justice that is reparative to the victims of past injustices), as well as our present obligations to ensure that the people of the future will have a good quality of life, with real opportunities to flourish and to live a life worth living⁷.

Amplified solidarity means honouring the wishes of our ancestors while acting in the present and nurturing a concern for the health and well-being of future generations. It means listening, taking time, and committing to reviewing those wishes, endorsing the ones we consider fair and just, and passing them on to future generations. But, just as the wishes and legacy of our ancestors might now seem parochial to us, we must also admit that our views and wishes may be considered parochial to future people⁸. This does not mean, however, that we should abandon the enterprise of solidarity or critical review of our respective heritages.

Reciprocity usually implies mutual benefit, so if we in the present stand to gain from the hard work and forward thinking of past generations, how do we repay the favour? I argue that respecting the wishes of past generations and carrying them into both present and future retroactively provides those generations with the ‘benefit’ of a lasting legacy—of having the seeds planted by their wishes bear fruit through our actions.

This idea may seem strange from a Western hermeneutical and epistemological point of view, but it is not so far from what the thinker and activist Günther Anders envisioned in his seventh thesis for the atomic age: an alliance of generations.

“The distinction between the generations of today and of tomorrow has become meaningless; we can even speak of a League of Generations to which our grandchildren belong, just as automatically as we ourselves. They are our ‘neighbors in time’ By setting fire to our house, we cannot help but make the flames leap over into the cities of the future, and the not yet-built homes of the not-yet-born generations will fall to ashes together with our homes. Even our ancestors are full-fledged members of this League: for by dying we would make them die, too—a second time, so to speak; and after this second death everything would be as if they had never been” [32].

This sense of continuity and solidarity is also evident in Māori philosophy:

“Each generation […] is part of a never-ending series of new beginnings—each born in the imaginations of generations past, with the responsibility to set the course for the journeys that follow. To embed this idea, Indigenous philosophies emphasize the importance of nourishing relationships—embedding the importance of cultivating intimate connections to a past that we were not part of and a future we will not live to realize ourselves. To this end, rich and diverse social practices facilitate our remembering […] of hundreds of thousands of relationships across vast distances in time and space. […] [M]ost urgently, it reminds us that we need to find the courage to profoundly change our story, to be bold enough to set a new course, and to inspire the will to hold the course toward a just future” [33]⁹.

Solidarity is therefore an ‘intergenerational journey’ [33]. It is the deep understanding that we are part of the same world and that our existence is interdependent on others, dead, living, and yet to be born—the recognition of the value of different lives. We are part of a web that extends intergenerationally. The principle of amplified solidarity is a value and a moral good that implies mutual obligations insofar as we are in solidarity with our contemporaries and with past and future generations, in pursuit of a common destiny and against a common threat. This solidarity forces us to abandon the citadel of selfishness and to count on others to pass on a healthy quality of life to future generations, correcting the inequalities and injustices in health in our contemporary world.

5. Is Intergenerational Solidarity Enough?

With the way that solidarity has been described so far, we could be tempted to say that we have found the panacea to all our problems, and know how to save the planet and the future of humanity. However, although it has value and is beneficial as a good to cultivate for our shared future, solidarity is not enough. I will focus in particular, but not exhaustively, on the triad of solidarity with justice and responsibility.

First of all, it is important to notice that the principle of justice—of social justice as it is understood here—is a broader principle than that of solidarity. The sentiment of injustice, as noted above, is the spark that ignites the flame of solidarity. And injustices in the area of bioethics can wear many faces, which do not always require the response of solidarity, but instead, for example, the response of recognising a patient’s freedom and autonomy, differences in cultural and religious beliefs and practices, or the need for equity in the distribution of and access to health resources. Not all health problems and not all demands for justice require solidarity, although it cannot be denied that the aim of solidarity is justice.

The case of responsibility is more intricate. Solidarity would be previous to responsibility. A thought solidarity without its corresponding action could only dubiously be called solidarity at all. Therefore, when solidarity makes us responsible, makes us take responsibility, that is when, in some way, solidarity takes on all its meaning. But what is responsibility? The concept of responsibility has been well sealed into the legal framework since the 19th century—both in civil and criminal law—while philosophy seems to have forgotten until recent times about this incorporation into its musings. But, when we consider the vulnerability that we have created through our actions in the advances of science and technology, in the terms that Hans Jonas and Paul Ricoeur conceived, “where human intervention creates power, it also creates new forms of vulnerability and, consequently, responsibility” [23] (p. 75).

Now, responsibility is not taking on guilt, as if one had committed an identifiable crime towards a person or collective that one knows; the object is no longer that which is located at the juridic and legal levels, where responsibility refers to the harmful effects of our activities on damage that has been already inflicted. Rather, taking responsibility is (both etymologically and in practice) responding to a systemic and ecological vulnerability that results from the human action linked to technoscientific advances.

Responsibility is responding to a debt that is shared by all and that calls for action and the transformation of the world. But in amplified solidarity, this duty takes the form of responsibility by living in a society and having a legacy—it transforms from a moral debt into an obligation¹⁰.

Focusing on the domain of health, the most obvious danger is the dilapidation of public in favour of private healthcare due to a lack of institutional and governmental responsibility, leaving the ill to bear the cost of their care [35] (pp. 11–12). Therefore, a public good such as health cannot be conditioned to a variable such as the purchasing power of each person, but, as our interconnectedness and interrelatedness reflect, it is a public and democratic responsibility. We need only mention the COVID-19 pandemic again, which has hit our societies hard and from which we are still recovering.

However, being responsible does not always entail solidarity. A person can be responsible by sorting their waste very well and have no inclination to show solidarity. Or, imagine a person who is responsible for the care of an elderly person. Care shows our sense of interdependence with people and other forms of life and, in a personal way, we involve ourselves with our bodies in it¹¹. In our duties of care, there is a relationship of dependence of one being on another. This is not so in solidarity, which calls for collective or individual action to change structures and the state of things, motivated by a feeling of injustice.

Solidarity, on the other hand, can have varying degrees of involvement and action. Moreover, if amplified solidarity obliges responsibility for global threats, responsibility can be unevenly shared. In a world dominated by relations of oppression and power, it is clear that while the construction of a healthy and just world both now and in the future is a task for all individuals (and institutions), to paraphrase Paul Ricoeur [37] (p. 69), the sphere of responsibility expands as far as the sphere of power extends.

Therefore, solidarity bereft of responsibility and justice is not enough.

6. Forging Solidarity in Spite of the Challenges

The vagueness that accompanies solidarity’s very nature is prone to making the concept overstretched or dissolving its boundaries so that it overflows into both sentiments (empathy, compromise, altruism) and other moral goods (fraternity, sorority, charity, benevolence). As necessary as amplified solidarity is in our societies in the age of anthropogenic crisis and climate change, five major dangers nevertheless lie in wait for this principle.

The first danger is the tension between precaution and security. In the ‘Age of Inability to Fear’, as Anders called it in our own time, it is appropriate if we ‘don’t fear fear’, but instead ‘have the courage to be frightened’ [32] (p. 498). In practical terms, it is necessary to implement the precautionary principle, and be jointly responsible not only for the immediate effects but also for the foreseeable ones, since they are the consequences of our actions in spite of ourselves. However, when precaution becomes an over-stimulated imperative and insensitive to reality, the risk of hypersecurity appears, which builds walls, separates territories, and discriminates against populations. Solidarity is petrified and becomes prevention and separation, a security alert. Others put us at risk, while we (a new, shrinking we) have to defend ourselves and live safely¹². A safe society is established in our times with the face of a few rich in front of a precarious and endangered multitude.

Secondly, the problem of solidarity cannot be only a local problem, especially when it comes to dealing with the effects on the health of the population linked to climate change. There are some distributional issues, such as the allocation of kidneys, that demand a local response¹³. However, climate change is responsible for the increase in “weather and climate hazards [that] affect health both directly and indirectly, increasing the risk of deaths, noncommunicable diseases, the emergence and spread of infectious diseases, and health emergencies” [39], which calls for a global solidarity response with an intergenerational justice perspective.

Next, the concept of solidarity, with its tendency to be universal, needs to create links between people who do not or will not know each other, which also means, fourthly, addressing the difficult question of strengthening the links between people and the motives they have for solidarity beyond a vicarious, familiar solidarity based on emotional and spatial closeness.

Finally, there is no doubt that the most pressing challenges in forging and reforging solidarity arise from facing an objective problem: the economic and political dynamics of our societies that generate structural injustices and foster egocentric and particularistic subjectivities. This then becomes a subjective problem: how to cultivate more than self-interest.

So, at this point, it is worth asking what makes solidarity possible and how we can amplify its waves, sending them out to people across places, societies, and generations.

Dr. Séverine Caluwaerts, a gynaecologist and obstetrician who works for Doctors Without Borders, explains in one of her testimonies:

“Today, more women die worldwide of cervical cancer than of complications of pregnancy and delivery. In 2018, 311,000 women died of cervical cancer and these were mainly women living in low-income settings with limited financial, cultural or geographical access to quality medical care. The figure is projected to increase in coming years, yet the world is largely silent about these deaths. The worst part is that preventive tools including human papillomavirus (HPV) vaccination and treatment like cryotherapy (freezing of the cervix) are available and, in the case of the latter, affordable” [40].

The difference in access to resources and medical care between rich and low-income countries puts the latter at a huge disadvantage, and is a paradigmatic picture of the injustice suffered by many of the world’s people in the area of health. In July 2019, Caluwaerts carried out a cervical cancer screening and treatment programme, set up an HPV school vaccination for 9–10-year-old girls, and supplied vaccines to 1000 HIV-positive girls and young women aged 15–26 as a joint action with the Zimbabwean Ministry of Health and Child Care. The results have been as expected. The programme has been scaled up so that more and more women and girls are now able to prevent the development of uterine cancer and avoid this deadly disease [40].

Hope is also a very important component of the capability to weave solidarity and concern for present and future generations. This hope lies in our capability to imagine and to act in prevention of future risks. There is a need to imagine things in a way that takes a step back from everyday life, production, and alienation—so much so that imagination becomes the only ‘organon of truth’ in Anders’ terms [32] (p. 497). When human incursion into nature and the increasing virtualisation of experience seem to suggest a reality (and a human power) without limits, the imagination finds itself in an abyss, without the capacity to transform the world around it into a feasible future conducive to positive collective action. In this sense, there is a certain emotional stupefaction in that, faced with the horror of the apocalypse or the salvation of technology, we are unable to critically imagine alternative futures¹⁴. We must instead expand our imaginations and cultivate a critical attitude, while also putting some limits on the traditional neoliberal concept of freedom in favour of justice. Freedom means being free to put the brakes on our desires and needs, in accordance with our circumstances and position in the world, because others must always be treated first and foremost as ends in themselves, as Immanuel Kant strongly and movingly reminds us.

There is potential for the obliging nature of amplified solidarity and its connectedness with responsibility within a framework of democratic freedoms and rights to help it to become a habit—hopefully in terms of a second nature, as Aristotle saw virtue—so that we work together for a better world where the individual obligation of solidarity is embedded into a shared responsibility as part of the network of life and its intergenerational legacy.

It is obvious that people who already start from vulnerable circumstances and a fragile position cannot be forced equally to be responsible in solidaristic terms, so our task always comes back to an old problem of social justice: the institutional framework. There is a relationship between historical and global injustices and intergenerational justice. We are interdependent and our resources are not fairly divided. It is difficult to see how to think about our duties towards future generations without considering present global inequalities, as well as historical injustices. The factors that are endangering and impoverishing life in many parts of the world today are closely related to the patterns of inequality derived from colonialism. The reality is that only rich countries can afford the costs of adaptation and/or mitigation in the face of climate change; therefore, these countries have vastly more responsibility to act in solidarity.

7. Conclusions

We have some reasons to congratulate ourselves. Although solidarity is not immune to problems and practical obstacles, the long overdue attention it is receiving from bioethicists and its reconceptualisation for intergenerational application are cause for celebration. There is an increasing awareness and will to rebuild our common world, bolstering the principle of solidarity.

In this article, I have proposed amplified solidarity as a normative concept that can be applied in relation to our obligations, and which is therefore part of the field of ethics. By including not only solidarity among living generations but also that with future generations, it is placed as the focus of bioethics and intergenerational obligations. It also has a social and political dimension in that it is situated in our commonality, pointing to our social aspirations to transform society and build meaningful relationships, while honouring the legacy of the past and passing on healthy living conditions to the people of the future. To definitively show my perspective on solidarity, I formulate five claims.

Firstly, when applying an amplified solidarity, we must shift the priority to the long-term view over mere presentism and vested personal interests. This does not mean forgetting the urgent actions to carry it out in the present, but it does mean adapting to and reconciling ourselves with this idea of continuity.

Secondly, solidarity is a concept that is necessary, is previous to responsibility, and emerges from a sense of injustice. At the same time, it needs responsibility according to the position of power of people, governments, institutions, and collectives, so that it does not remain passive or merely emotional. Solidarity harnesses a sense of belonging and motivates us to act to change the world. The call to action of Dr. Caluwaerts is clear: prevention and access to health resources for all.

Thirdly, we need an institutional frame that enables transformation to correct intergenerational health injustices—just as, fourthly, to face these challenges, solidarity must form a triangular constellation with responsibility and justice.

Finally, amplified solidarity needs hope, and to be projected with imagination, so that it is oriented towards the future.

With these lines, I aspire to contribute to the debate on solidarity in the field of bioethics. Far from being resolved, this debate will give rise to many more insights. Nevertheless, in practice, the essence of amplified solidarity is already being carried into fruition by many of those who fight for a fairer and healthier future.