Just Health Care

Front Cover
Cambridge University Press, 1985 - Philosophy - 245 pages
How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of health care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area.
 

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Contents

Is health care special?
1
Rights to health care
4
General theories of justice
9
Some public policy issues
11
Is health care special?
17
Healthcare needs
19
Can we avoid talk about needs?
20
Not all preferences are created equal
23
Doing justice to providers
114
What are the obligations of providers to deliver just health care?
115
Does just health care violate provider liberty?
119
Does just health care deny physicians just economic rewards or incentives?
124
Does just health care threaten traditional ethical obligations of physicians to their patients?
135
Conclusion
138
Doth OSHA protect too much?
140
Prevention and OSHA regulation
142

Needs and speciestypical functioning
26
Disease and health
28
Disease and opportunity
32
Toward a distributive theory
36
The scope of justice
37
Fair equality of opportunity
39
Extending Rawlss theory to health care
42
Some qualifications and clarifications
48
Summary and applications
56
Equity of access to health care
59
When is access equal?
60
Three accounts of equitable access Equity as utilization for need
63
Decent minimums and the requirements of justice
74
Am I my parents keeper?
86
When are acts policies or institutions agebiased?
89
Does aging pose a distinct distribution problem?
94
Prudence and aging
98
Equal opportunity and health care for the elderly
103
Equity errors and the stability of savings institutions
108
Some qualifications
111
in search of a rationale
144
beyond market regulation
148
The specialness of health protection and the problem of consent
150
a libertarian lament
153
Autonomy paternalism and risky lifestyle choices
156
Information and competency
159
Intrinsic and extrinsic rewards of risktaking
162
Coercion
165
Voluntariness and justice
171
Worries and conclusions
176
Risk and opportunity
180
Biological monitoring in the lead standard
187
Individual variation in sensitivity and discrimination in employment
199
Summary and conclusions
218
Philosophy and public policy
221
2 Frameworks and contexts of compliance
223
Works cited
231
Index
238
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