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When solidarity turns bad: Misappropriated and exclusive solidarity as problematic forms of solidarity in healthcare

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Abstract

For a long time, scholarship on solidarity has primarily focused on its prosocial dimensions. Solidarity is typically seen as a socially, ethically, or politically desirable good—something that strengthens or expresses social cohesion. More recently, however, scholars have begun to examine the troubling aspects of solidarity. In this paper, we argue that problematic, or even harmful, forms of solidarity fall into two main categories. First, exclusive solidarity, where solidarity among a group deprives those excluded from access to essential goods or rights. Second, misappropriated solidarity, where the main benefits accrue to those performing solidarity—sometimes even at the expense of those ostensibly meant to benefit. Using two specific examples, we show how excluding migrants from public healthcare harms both the excluded and the included, weakening the broader solidaristic system. We also argue that using collective insurance contributions to fund unproven treatments, such as homoeopathy, can undermine trust and fairness. Finally, we revisit debates on linking healthcare entitlements to lifestyle choices to illustrate how exclusion and misappropriation can combine. We conclude that adopting an understanding of moral agents as shaped by their relationships to others can help prevent solidarity from becoming harmful.

Original languageEnglish
Article number119417
JournalSocial Science & Medicine
Volume403
DOIs
Publication statusPublished - Aug 2026

Austrian Fields of Science 2012

  • 506010 Policy analysis
  • 303019 Medical ethics

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