Just Health Care
Norman Daniels, Goldthwaite Professor and Former Chair of the Tufts Philosophy Department and Professor of Medical Ethics at Tufts Medical School Norman Daniels
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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Is health care special?
Rights to health care
General theories of justice
Some public policy issues
Is health care special?
Can we avoid talk about needs?
Not all preferences are created equal
Doing justice to providers
What are the obligations of providers to deliver just health care?
Does just health care violate provider liberty?
Does just health care deny physicians just economic rewards or incentives?
Does just health care threaten traditional ethical obligations of physicians to their patients?
Doth OSHA protect too much?
Prevention and OSHA regulation
Needs and speciestypical functioning
Disease and health
Disease and opportunity
Toward a distributive theory
The scope of justice
Fair equality of opportunity
Extending Rawlss theory to health care
Some qualifications and clarifications
Summary and applications
Equity of access to health care
When is access equal?
Three accounts of equitable access Equity as utilization for need
Decent minimums and the requirements of justice
Am I my parents keeper?
When are acts policies or institutions agebiased?
Does aging pose a distinct distribution problem?
Prudence and aging
Equal opportunity and health care for the elderly
Equity errors and the stability of savings institutions
in search of a rationale
beyond market regulation
The specialness of health protection and the problem of consent
a libertarian lament
Autonomy paternalism and risky lifestyle choices
Information and competency
Intrinsic and extrinsic rewards of risktaking
Voluntariness and justice
Worries and conclusions
Risk and opportunity
Biological monitoring in the lead standard
Individual variation in sensitivity and discrimination in employment
Summary and conclusions
Philosophy and public policy
2 Frameworks and contexts of compliance
access to health age-biased appeal argued argument argument sketch autonomy baseline benefits biological monitoring biomedical model burdens Chapter Charles Fried claim collective bargaining concern consent constraints contexts costs decisions discussion disease distributive justice economic effect elderly employers equal opportunity equality of opportunity equitable access equity of access example fair equality framework groups hazard pay health care health-care institutions health-care needs health-care services health-care system important income individual inequalities insurance scheme involve issues justice as fairness justify lead standard libertarian liberty Medicaid medical removal moral normal opportunity range normal range notion opportunity account opportunity principle OSHA OSHA's patients philosophical physicians preferences principles of justice problem proposal protection quasi-coerced question rationing Rawls Rawls's regulation relevant require right to health risk-taking social obligation society special sensitivities strategy stringent suggests talents and skills technological feasibility theory of justice tion utilization rates variation workers workplace