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"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck. Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state? By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.
In this book, an international group of philosophers, economists and theologians focus on the relationship between justice, luck and responsibility in health care. Together, they offer a thorough reflection on questions such as: How should we understand justice in health care? Why are health care interests so important that they deserve special protection? How should we value health? What are its functions and do these make it different from other goods? Furthermore, how much equality should there be? Which inequalities in health and health care are unfair and which are simply unfortunate? Which matters of health care belong to the domain of justice, and which to the domain of charity? And to what extent should we allow personal responsibility to play a role in allocating health care services and resources, or in distributing the costs? With this book, the editors meet a double objective. First, they provide a comprehensive philosophical framework for understanding the concepts of justice, luck and responsibility in contemporary health care; and secondly, they explore whether these concepts have practical force to guide normative discussions in specific contexts of health care such as prevention of infectious diseases or in matters of reproductive technology. Particular and extensive attention is paid to issues regarding end-of-life care.
Explores the moral dilemmas posed by disparities in health across nations
Social factors have a powerful influence on human health and longevity. Yet the social dimensions of health are often obscured in public discussions due to the overwhelming focus in health policy on medical care, individual-level risk factor research, and changing individual behaviours. Likewise, in philosophical approaches to health and social justice, the debates have largely focused on rationing problems in health care and on personal responsibility. However, a range of events over the past two decades such as the study of modern famines, the global experience of HIV/AIDS, the international women’s health movement, and the flourishing of social epidemiological research have drawn attention to the robust relationship between health and broad social arrangements. In Health Justice, Sridhar Venkatapuram takes up the problem of identifying what claims individuals have in regard to their health in modern societies and the globalized world. Recognizing the social bases of health and longevity, Venkatapuram extends the ‘Capabilities Approach’ of Amartya Sen and Martha Nussbaum into the domain of health and health sciences. In so doing, he formulates an inter-disciplinary argument that draws on the natural and social sciences as well as debates around social justice to argue for every human being’s moral entitlement to a capability to be healthy. An ambitious integration of the health sciences and the Capabilities Approach, Health Justice aims to provide a concrete ethical grounding for the human right to health, while advancing the field of health policy and placing health at the centre of social justice theory. With a foreword by Sir Michael Marmot, chair of the WHO Commission on the Social Determinants of Health.
Because medicine can preserve life, restore health and maintain the body's functions, it is widely acknowledged as a basic good that just societies should provide for their members. Yet, there is wide disagreement over the scope and content of what to provide, to whom, how, when, and why. In this unique and comprehensive volume, some of the best-known philosophers, physicians, legal scholars, political scientists, and economists writing on the subject discuss what social justice in medicine should be. Their contributions deepen our understanding of the theoretical and practical issues that run through the contemporary debate. The forty-two chapters in this reorganized second edition of Medicine and Social Justice update and expand upon the thirty-four chapters of the 2002 first edition. Eighteen chapters from the original volume are revised to address policy changes and challenging issues that have emerged in the intervening decade. Twenty-two of the chapters in this edition are entirely new. The treatment of foundational theory and conceptual issues related to access to health care and rationing medical resources have been expanded to provide a more comprehensive and nuanced discussion of the background concepts that underlie distributive justice debates, with global perspectives on health and well-being added. New additions to the section on health care justice for specific populations include chapters on health care for the chronically ill, soldiers, prisoners, the severely cognitively disabled, and the LGBT population. The section devoted to dilemmas and priorities addresses an array of topics that have recently become especially pressing because of new technologies or altered policies. New chapters address questions of justice related to genetics, medical malpractice, research on human subjects, pandemic and disaster planning, newborn screening, and justice for the brain dead and those with profound neurological injury. Reviews of the first edition: "This compilation brings a variety of perspectives, national settings, and disciplinary backgrounds to the topic and provides a unique survey of theoretical and applied thinking about the connections between health care and social justice... Physicians and others interested in this field will find this book an engaging introduction to the theoretical and practical challenges pertaining to social justice and health care." New England Journal of Medicine "Although much work in bioethics has focused on clinical encounters, there has been a current of discussion about questions of social justice for decades-at least since the allocation of access to dialysis was widely understood in the 1960s to be a matter of justice, not of medical judgment. This volume will facilitate heightened awareness and deeper discussion of such issues." JAMA "Impressively, the editors have chosen an array of essays that explore the philosophical and bioethical foundations of distributive justice; review the current practice of rationing and patients' access to care in a number of different countries; highlight the issues raised by various special needs groups; and then wrestle with some dilemmas in assessing priorities in distributing healthcare... This book is an excellent resource. " Doody's
"In this bold new edition, Gostin is joined by coauthor Lindsay F. Wiley to analyze the crucial role of law in addressing today's major health threats, including emerging infectious diseases, bioterrorism, natural disasters, car fatalities, gun violence, opioid overdoses, and chronic diseases caused by tobacco use, poor diet, and physical inactivity. The book creates an intellectual framework for the modern field of public health law and supports that framework with illustrations of the scientific, political, and ethical issues involved. In proposing innovative solutions for the future of the public's health, Gostin and Wiley's essential study provides a blueprint for coming public and political debates in this dynamic field. New issues covered in this edition: Corporate personhood rights raised in response to regulations of tobacco, food and beverages, alcohol, firearms, prescription drugs, and marijuana; local government authority to protect the public's health; deregulation and harm reduction as modes of public health law intervention; taxation, spending, and alteration of the socioeconomic environment as modes of public health law intervention; access to health care as a strategy for protecting the public's health; taxation, spending, licensing, zoning, and shared-use strategies for chronic disease prevention; the public health law perspective on violence and injury prevention; health justice as a framework for reducing health disparities and protecting the public's health"--Provided by publisher.
The factions debating health care reform in the United States have gravitated toward one of two positions: that just health care is an individual responsibility or that it must be regarded as a national concern. Both arguments overlook a third possibility: that justice in health care is multilayered and requires the participation of multiple and diverse communities. Communities of Health Care Justice makes a powerful ethical argument for treating communities as critical moral actors that play key roles in defining and upholding just health policy. Drawing together the key community dimensions of health care, and demonstrating their neglect in most prominent theories of health care justice, Charlene Galarneau postulates the ethical norms of community justice. In the process, she proposes that while the subnational communities of health care justice are defined by shared place, including those bound by culture, religion, gender, and race that together they define justice. As she constructs her innovative theorization of health care justice, Galarneau also reveals its firm grounding in the work of real-world health policy and community advocates. Communities of Health Care Justice not only strives to imagine a new framework of just health care, but also to show how elements of this framework exist in current health policy, and to outline the systemic, conceptual, and structural changes required to put these justice norms into fuller practice.
"In this bold fourth edition, Lindsay F. Wiley builds on the foundation laid by Lawrence O. Gostin to define public health law and ethics for a new generation of leaders and scholars. Their examination of the scope and limits of governmental powers and duties to protect the public's health takes on new urgency in light of the devastation caused by the 2020 coronavirus pandemic and the stark inequities it revealed. Their insistence that social justice must be prioritized as a core value of public health ethics animates their analysis of communicable disease control strategies, chronic disease prevention programs, the opioid overdose and gun violence crises, and more. They elucidate what is at stake for the public in legal debates regarding the regulatory powers of administrative agencies, erosion of local government autonomy by state legislatures, and tensions between federal and state officials over safety-net programs. They focus particularly on the role of the courts in striking down popular laws and policies, boosting religious liberty and gun rights, and eroding protections for fundamental rights to sexual and reproductive freedom and racial and gender equality. The book creates an intellectual framework for ensuring that public health interventions are evidence-based and consistent with ethical values. Its incisive analysis of challenging trade-offs between individual rights and collective needs reveals complex answers to the essential question of what fellow community members owe each other when it comes to health"--
Budgets of governments and private insurances are limited. Not all drugs and services that appear beneficial to patients or physicians can be covered. Is there a core set of benefits that everyone should be entitled to? If so, how should this set be determined? Are fair decisions just impossible, if we know from the outset than not all needs can be met? While early work in bioethics has focused on clinical issues and a narrow set of principles, in recent years there has been a marked shift towards addressing broader population-level issues, requiring consideration of more demanding theories in philosophy, political science, and economics. At the heart of bioethics' new orientation is the goal of clarity on a complex set of questions in rationing and resource allocation. Rationing and Resource Allocation in Healthcare: Essential Readings provides key excerpts from seminal and pertinent texts and case studies about these topics, contextualized by original introductions. The volume is divided into three broad sections: Conceptual Distinctions and Ethical Theory; Rationing; and Resource Allocation. Containing the most important and classic articles surrounding the theoretical and practical issues related to rationing and how to allocate scare medical resources, this collection aims to assist and inform those who wish to be a part of bioethics' 21st century shift including practitioners and policy-makers, and students and scholars in the health sciences, philosophy, law, and medical ethics.
Who has what and why in our societies is a pressing issue that has prompted explanation and exposition by philosophers, politicians and jurists for as long as societies and intellectuals have existed. It is a primary issue for a society to tackle this and these answers have been diverse. This collection of essays approaches some of these questions and answers to shed light on neglected approaches to issues of distribution and how these issues have been dealt with historically, socially, conceptually, and practically. The volume moves away from the more dominating and traditionally cast understandings of distributive justice and shows novel and unique ways to approach distributive issues and how these can help enlighten our course of action and thought today by creating new pathways of understanding. The editors and contributors challenge readers by exploring the role and importance of restorative justice within distributive justice, exploring the long shadow of practices of trusteeship, and concepts of social and individual rights and obligations in welfare and economic systems, social protection/provision schemes, egalitarian practices and post-colonial African political thought. Distributive Justice Debates in Political and Social Thought empowers the reader to cast a more critical and historically complete light on the idea of a fair share and the implications it has on societies and the individuals who comprise them.