Justice in medicine and public health

Cambridge Quarterly of Healthcare Ethics

Volumn 14, Issue 1, 2005, Pages 13-26

  Rhodes, Rosamond ^a,b  

^a MOUNT SINAI SCHOOL OF MEDICINE   (United States)

^b CITY UNIVERSITY OF NEW YORK   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

HEALTH CARE POLICY; HUMAN; INTENSIVE CARE UNIT; MEDICAL ETHICS; PUBLIC HEALTH SERVICE; QUALITY ADJUSTED LIFE YEAR; REVIEW; THEORETICAL STUDY; UNITED STATES;

EID: 13644264069     PISSN: 09631801     EISSN: None     Source Type: Journal    
DOI: 10.1017/s0963180105050036     Document Type: Review

References (37)

1. Aristotle. The Nicomachean Ethics of Aristotle, Ross WD, transl. London: Oxford University Press; 1971.
2. See note 1, Aristotle 1971:1130a9.
3. Rawls J. A Theory of Justice. Cambridge, Mass.: Harvard University Press; 1971.
4. Rawls J. Political Liberalism. New York: Columbia University Press; 1993.
5. See note 4, Rawls 1993:6.
6. See note 4, Rawls 1993:326.
7. See note 4, Rawls 1993:4.
8. See note 4, Rawls 1993:184.
9. See note 4, Rawls 1993:228-9.
10. See note 4, Rawls 1993:6.
11. Daniels N. Justice, health, and health care. In: Rhodes R, Battin MP, Silvers A, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002:6-23.
12. Daniels N, Sabin JE. Limits to health care: Fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy and Public Affairs 1997;26:303-50.
13. See note 11, Daniels 2002:8.
14. Brock DW. Priority to the worse off in health-care resource prioritization. In: Rhodes R, Battin MP, Silvers A, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002:362-72.
15. Brock DW. Aggregating costs and benefits. Philosophy and Phenomenological Research 1998;58:963-8.
16. Kamm FM. Whether to discontinue nonfutile use of a scarce resource. In: Rhodes R, Battin MP, Silvers A, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002:373-89.
17. Kamm FM. Morality, Mortality Vol I: Death and Who to Save From It. New York: Oxford University Press; 1993.
18. Wasserman D. Aggregation and the moral relevance of context in health-care decision making. In: Rhodes R, Battin MP, Silvers A, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002:65-77.
19. Rhodes R. Understanding the trusted doctor and constructing a theory of bioethics. Theoretical Medicine and Bioethics 2001;22(6):493-504. I have argued generally that physicians have a role-related responsibility to avoid making judgments about patients' worthiness and that they must treat all patients similarly based on medical considerations.
20. Although a subject for biomedical research may disproportionately affect a relatively disadvantaged population (e.g., the effect of lead paint on child development), the study findings and the subsequent public health policies will have implications for all of those who have been or who may be affected.
21. Green RM. Access to healthcare: Going beyond fair equality of opportunity. American Journal of Bioethics 2001;1(2):22-3.
22. Savulescu J. Justice and healthcare: The right to a decent minimum, not equality of opportunity. American Journal of Bioethics [online journal] 2001;1(2).
23. See note 4, Rawls 1993:328.
24. See note 4, Rawls 1993:284, xvii.
25. See note 4, Rawls 1993:xvii.
26. See note 4, Rawls 1993:283.
27. See note 4, Rawls 1993:228-9.
28. See note 4, Rawls 1993:236-7, fn. 23.
29. See note 4, Rawls 1993:318.
30. See note 4, Rawls 1993:184.
31. See note 4, Rawls 1993:184.
32. Daniels and prioritarians differ from Rawls on the difference principle in at least these ways: (a) For Rawls the difference principle is useful in the political domain. It is not a broadly applicable moral principle. (b) For Rawls, it is primarily applicable to political arrangements. It is relevant to healthcare only to the extent that treatment can maintain or restore citizens as functioning members. (c) For Rawls, the principle applies only to those who have the moral powers that enable them to cooperate in political arrangements. Those who use it as a broad moral principle tend to apply it to the worst off, but some such individuals are not and could never be citizens. (d) Stability justifies the difference principle in Rawls's framework. Extending the principle, beyond the narrow parameters that Rawls sets, requires additional justification.
33. In this analysis I am drawing freely on T.M. Scanlon's conception of justice. Scanlon TM. What We Owe to Each Other. Cambridge, Mass.: Belknap Press; 1998.
34. See note 11, Daniels 2002; Smith P. Justice, health, and the price of poverty. In: Rhodes R, Battin MP, Silvers A, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002:301-18;
35. Sheehan M, Sheehan P. Justice and the social reality of health: The case of Australia. In: Rhodes R, Battin MP, Silvers A, eds. Medicine and Social Justice: Essays on the Distribution of Health Care. New York: Oxford University Press; 2002:169-82.
36. I do not claim that this is a full elaboration of the relevant considerations for justice in medicine and public health.
37. Daniels's "relevance condition" appears to capture this aspect of policy setting. See note 11, Daniels 2002:16.