Medicine and Social Justice: Essays on the Distribution of Health Care / Edition 1

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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

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Editorial Reviews

Doody's Review Service
Reviewer: Laura L. Sessums, JD, MD (Walter Reed Army Medical Center)
Description: This is a compilation of essays that offer varied perspectives on the theory and practice of distributive justice in healthcare.
Purpose: 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.
Audience: The majority of the authors are affiliated with a department of philosophy and the book is targeted towards philosophers and medical ethicists who have an interest in access to healthcare. Nonetheless, a few of the authors are physicians, lawyers, political scientists and politicians, and each offers a different perspective on these vexing issues. In addition to those with a theoretical interest in this area, policymakers, politicians, health plan designers and health policy activists also will find this book enlightening.
Features: Each essay is self-contained, so the book can be read in snatches or used easily as a resource when researching a specific question. When read from cover to cover, it offers an extremely broad survey of perspectives on the issue of healthcare access around the world. The essays do not follow any specific political perspective nor is a particular agenda apparent. For the U.S. reader, the book offers no simplistic answers to solve the problems of our imperiled healthcare system. Nonetheless, the essay "Unequal by Design: Health Care, Distributive Justice, and the American Political Process" provides a very interesting political analysis of our current quagmire. The essay "Responsibility for Health Status" explicates beautifully a very important issue that confronts those designing any governmental health plan.
Assessment: This book is an excellent resource.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780195143546
  • Publisher: Oxford University Press
  • Publication date: 8/29/2002
  • Edition description: Older Edition
  • Edition number: 1
  • Pages: 488
  • Product dimensions: 10.00 (w) x 7.20 (h) x 1.30 (d)

Meet the Author

Rosamond Rhodes, PhD is Director of Bioethics Education and Professor of Medical Education at Mount Sinai School of Medicine. She is also Professor of Philosophy at The Graduate Center, CUNY, and Professor of Bioethics at Union Graduate College. In her philosophical writing she has discussed the work of Hobbes, Aristotle, Kant, and Rawls, and addressed a broad range of topics in bioethics.

Margaret Pabst Battin is Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, Division of Medical Ethics, at the University of Utah. She has authored, co-authored, edited, or co-edited some twenty books, among them a study of philosophical issues in suicide; a collection on age-rationing of medical care; a text on professional ethics; and a collection of her essays on end-of-life issues, The Least Worst Death. A second collection of her essays (and fiction) on end-of-life issues, entitled Ending Life, was published in spring 2005 by Oxford University Press. She is the lead author of two multiauthored projects, Drugs and Justice: Seeking a Consistent, Coherent, Comprehensive View (Oxford, 2008) and The Patient as Victim and Vector: Ethics and Infectious Disease (Oxford, 2009). She is currently at work on an historical sourcebook on ethical issues in suicide, a book on world population growth and reproductive rights, and several projects on spinal cord injury.

Anita Silvers, Professor and Chair of Philosophy at San Francisco State University, is the recipient of the American Philosophical Association's Quinn Prize and the Chair of the APA Committee on Inclusiveness. She has written extensively on issues of medicine and justice for people with disabilities and chronic illnesses, elderly people, neonates, and other especially vulnerable groups. Her philosophical theory of justice is enriched by experience in advocacy and on the ethics committee of a county hospital that serves these populations.

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Table of Contents

I Theoretical Foundations
1 Justice, Health, and Health Care 6
2 Justice and the Basic Structure of Health-Care Systems 24
3 Multiculturalism and Just Health Care: Taking Pluralism Seriously 38
4 Utilitarian Approaches to Justice in Health Care 53
5 Aggregation and the Moral Relevance of Context in Health-Care Decision Making 65
6 Why There Is No Right to Health Care 78
7 Specifying the Content of the Human Right to Health Care 84
II Rationing and Access in Today's World
8 Unequal by Design: Health Care, Distributive Justice, and the American Political Process 102
9 Health-Care Justice and Agency 121
10 Treatment According to Need: Justice and the British National Health Service 134
11 Rationing Decisions: Integrating Cost-Effectiveness with Other Values 144
12 Resources and Rights: Court Decisions in the United Kingdom 156
13 Justice and the Social Reality of Health: The Case of Australia 169
14 Justice for All? The Scandinavian Approach 183
15 Ethics, Politics, and Priorities in the Italian Health-Care System 191
16 Philosophical Reflections on Clinical Trials in Developing Countries 197
III Special Needs of Social Groups
17 Racial Groups, Distrust, and the Distribution of Health Care 212
18 Gender Justice in the Health-Care System: Past Experiences, Present Realities, and Future Hopes 224
19 Bedside Justice and Disability: Personalizing Judgment, Preserving Impartiality 235
20 The Medical, the Mental, and the Dental: Vicissitudes of Stigma and Compassion 248
21 Children's Right to Health Care: A Modest Proposal 259
22 Age Rationing Under Conditions of Injustice 270
23 Just Expectations: Family Caregivers, Practical Identities, and Social Justice in the Provision of Health Care 278
24 Caring for the Vulnerable by Caring for the Caregiver: The Case of Mental Retardation 290
25 Justice, Health, and the Price of Poverty 301
IV Dilemmas for Medicine and Health-Care Systems: Assessment and Priorities
26 Alternative Health Care: Limits of Science and Boundaries of Access 319
27 Justice in Transplant Organ Allocation 345
28 Priority to the Worse Off in Health-Care Resource Prioritization 362
29 Whether to Discontinue Nonfutile Use of a Scarce Resource 373
30 Disability, Justice, and Health Systems Performance Assessment 390
31 Responsibility for Health Status 405
32 Does Distributive Justice Require Universal Access to Assisted Reproduction? 426
33 Premature and Compromised Neonates 438
34 Just Caring: Do Future Possible Children Have a Just Claim to a Sufficiently Healthy Genome? 446
Index 459
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