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"Established in 1964, the federal Legal Services Program (later, Corporation) served a vast group of Americans desperately in need of legal counsel: the poor. At the program's zenith in 1981, more than 1,450 offices employing six thousand attorneys and three thousand paralegals worked to aid those who could not afford private attorneys. In Rationing Justice, Kris Shepard looks at this pioneering program's effect on the Deep South."--BOOK JACKET.
Established in 1964, the federal Legal Services Program (later, Corporation) served a vast group of Americans desperately in need of legal counsel: the poor. In Rationing Justice, Kris Shepard looks at this pioneering program's effect on the Deep South, as the poor made tangible gains in cases involving federal, state, and local social programs, low-income housing, consumer rights, domestic relations, and civil rights. While poverty lawyers, Shepard reveals, did not by themselves create a legal revolution in the South, they did force southern politicians, policy makers, businessmen, and law enforcement officials to recognize that they could not ignore the legal rights of low-income citizens. Having survived for four decades, America's legal services program has adapted to ever-changing political realities, including slashed budgets and severe restrictions on poverty law practice adopted by the Republican-led Congress of the mid-1990s. With its account of the relationship between poverty lawyers and their clients, and their interaction with legal, political, and social structures, Rationing Justice speaks poignantly to the possibility of justice for all in America.
In this groundbreaking analysis of Supreme Court decision-making, Andrew Coan explains how judicial caseload shapes the course of American constitutional law and the role of the Court in American society. Compared with the vast machinery surrounding Congress and the president, the Supreme Court is a tiny institution that can resolve only a small fraction of the constitutional issues that arise in any given year. Rationing the Constitution shows that this simple yet frequently ignored fact is essential to understanding how the Supreme Court makes constitutional law. Due to the structural organization of the judiciary and certain widely shared professional norms, the capacity of the Supreme Court to review lower-court decisions is severely limited. From this fact, Andrew Coan develops a novel and arresting theory of Supreme Court decision-making. In deciding cases, the Court must not invite more litigation than it can handle. On many of the most important constitutional questions—touching on federalism, the separation of powers, and individual rights—this constraint creates a strong pressure to adopt hard-edged categorical rules, or defer to the political process, or both. The implications for U.S. constitutional law are profound. Lawyers, academics, and social activists pursuing social reform through the courts must consider whether their goals can be accomplished within the constraints of judicial capacity. Often the answer will be no. The limits of judicial capacity also substantially constrain the Court’s much touted—and frequently lamented—power to overrule democratic majorities. As Rationing the Constitution demonstrates, the Supreme Court is David, not Goliath.
A clearly written and well structured textbook, providing an introduction to decision making and priority setting, this title brings together theories, practice and evidence from a wide range of disciplines.
What does it mean to be a "just" and "caring" society when we have only limited resources to meet unlimited health care needs? Do we believe that all lives are of equal value? Is human life priceless? Should a "just" and "caring" society refuse to put limits on health care spending? In Just Caring, Leonard Fleck reflects on the central moral and political challenges of health reform today. He cites the millions of Americans who go without health insurance, thousands of whom die prematurely, unable to afford the health care needed to save their lives. Fleck considers these deaths as contrary to our deepest social values, and makes a case for the necessity of health care rationing decisions. The core argument of this book is that no one has a moral right to impose rationing decisions on others if they are unwilling to impose those same rationing decisions on themselves in the same medical circumstances. Fleck argues we can make health care rationing fair, in ways that are mutually respectful, if we engage in honest rational democratic deliberation. Such civic engagement is rare in our society, but the alternative is endless destructive social controversy that is neither just nor caring.
'Medical need' is a factor in health care access decision-making, but merit-considerations are becoming important too. In the shortening of waiting time, priority arrangements are considered and/or introduced, based on non-medical criteria. Simultaneously, in terms of financing, health status has become important due to payment arrangements, limited insurance package options, etc. At the same time, health status disparities, due to socioeconomic inequalities, seem to be increasing. Under these circumstances, confronted with increased health spending, it is expected that rationing will become more eminent. Due to this, the emerging relevant questions are: Who will be responsible for rationing (the market, governments, bureaucrats, physicians, or others)? * How does it function (explicit or implicit)? * What are relevant and acceptable selection criteria (QUALYs, DALYs, health status, sex, age, etc.)? * To what extent is current rationing just? * What can be done to make it more just? *
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.
The identified lives effect describes the fact that people demonstrate a stronger inclination to assist persons and groups identified as at high risk of great harm than those who will or already suffer similar harm, but endure unidentified. As a result of this effect, we allocate resources reactively rather than proactively, prioritizing treatment over prevention. For example, during the August 2010 gold mine cave-in in Chile, where ten to twenty million dollars was spent by the Chilean government to rescue the 33 miners trapped underground. Rather than address the many, more cost effective mine safety measures that should have been implemented, the Chilean government and international donors concentrated efforts in large-scale missions that concerned only the specific group. Such bias as illustrated through this incident raises practical and ethical questions that extend to almost every aspect of human life and politics. What can social and cognitive sciences teach us about the origin and triggers of the effect? Philosophically and ethically, is the effect a "bias" to be eliminated or is it morally justified? What implications does the effect have for health care, law, the environment and other practice domains? This volume is the first to take an interdisciplinary approach toward answering this issue of identified versus statistical lives by considering a variety of perspectives from psychology, public health, law, ethics, and public policy.