When Misfortune Becomes Injustice: Evolving Human Rights Struggles for Health and Social Equality by Alicia Ely Yamin (review)

"When is a disaster a misfortune and when is it an injustice?" begins Judith Shklar in her Storrs Lecture from 1988:

Intuitively the answer seems quite obvious. If the dreadful event is caused by the external forces of nature, it is a misfortune, and we must resign ourselves to our suffering. Should, however, some ill-intentioned agent… have brought it about, then it is an injustice and we may express indignation and outrage.¹

It is injustice, not misfortune, that defines a human rights concern, and the authors of the books under review would no doubt agree. And yet as Shklar admits, the distinction between misfortune and injustice, however productive and generative it may be, is fundamentally unstable. In actual experience, the clung-to distinction does not mean very much. As is obvious to any observer of human rights and their multiple infringements, from colonialism, long-standing repressions, foreseeable corporate calamities, the climate crisis, digital imperialism, and the current path of, and responses to, the Covid-19 pandemic, the line between misfortune and injustice shifts through history. What infringements are treated as misfortune—"unavoidable or natural"—and what are treated as injustice—"controllable and social"—is itself under our control. It is a matter "of technology and of ideology or interpretation" states Shklar.² Moreover, it is easier to conclude that adversity reflects misfortune rather than injustice when it happens to other people; not so when one must experience it directly oneself.³

Three decades ago, Shklar applied this distinction to a series of human sufferings, including those caused by gender and those caused by markets. Is being born a woman a misfortune or an injustice, she asked, and could this be rooted in the control of women's reproductive functions?⁴ What about being a loser in the invisible hand of the market?⁵ Both configurations of injustice—but particularly gender—are addressed in these two important new books, one on health and social inequalities by Alicia Ely Yamin, and one on sexual and racial violence and its aftermath by Alison Crosby and M. Brinton Lykes.

Yamin, who frames her book around this distinction,⁶ yields quite different conclusions to the ones reached by Shklar. Yamin, Lecturer on Global Health and Population at the Harvard T.H. Chan School of Public Health, and Senior Fellow at the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at Harvard Law School, sets out to document the various successes and failures in feminist and human rights advocacy in sexual and reproductive health and rights (SRHR) over the last three decades. These are shifts that can be understood as occurring in technology as well as in ideology and interpretation, and Yamin's book addresses each. Yet her book is very much focused on interpretation, particularly on efforts made to advance an understanding of human rights that includes women's health rights and SRHR more explicitly.⁷ Health, as she acknowledges, is perhaps the most "complex" subject to address through human rights law, given the way economic, political and scientific paradigms all put pressure on what should be treated as a societal responsibility by the state.⁸ Nevertheless, health rights have yielded some advances, in some places; in the control that women have over their bodies and in the prospect for reducing the still-shocking statistics of maternal mortality.

As will be pointed out below, Yamin occupies a number of different vantage points, geographies, and methodologies in reviewing shifts in advocacy over three decades (between 1991–2019).⁹ Over seven chapters, she covers several challenges confronting those struggling for human rights. For example, she moves from military authoritarianism in Latin America and the struggle for human rights in the 1970s, to the...