Health, Luck, and Justice

Erscheinungsjahr 2009
ISBN: 978-0-691-14053-7
Verlag: Princeton University Press

Buch, Englisch, 252 Seiten, Format (B × H): 164 mm x 242 mm, Gewicht: 505 g

"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck.Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state?By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.

Autoren/Hrsg.

Segall, Shlomi

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Medizinische Ethik
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Public Health, Gesundheitsmanagement, Gesundheitsökonomie, Gesundheitspolitik
• Geisteswissenschaften Philosophie Angewandte Ethik & Soziale Verantwortung Medizinische Ethik

Inhaltsverzeichnis

Preface iv

Introduction 1

Chapter 1: Justice, Luck, and Equality 9

I. Rawlsian vs. Luck Egalitarian Justice 10

II. Inequality vs. Equality 14

III. Reasonable Avoidability vs. Responsibility 19

Part I Health Care 27

Chapter 2: Responsibility- Insensitive Health Care 29

I. The Fair Opportunity Account 30

II. Opportunities and Life Plans 34

III. Th e Democratic Equality Account 37

Chapter 3: Ultra- Responsibility- Sensitive Health Care: "All- Luck Egalitarianism" 45

I. A Test Case: Justifying Medical Treatment for Smoking- Related Diseases 46

II. Some Preliminary Problems with All- Luck Egalitarianism 48

III. What's Wrong with Neutralizing Luck as Such? 51

IV. All- Luck Egalitarianism, Moral Luck, and Desert 54

Chapter 4: Tough Luck? Why Luck Egalitarians Need

Not Abandon Reckless Patients 58

I. Luck Egalitarian Attempts to Defl ect the Abandonment Objection 59

II. Value Pluralism 64

III. Three Objections to Luck Egalitarian Value Pluralism 66

IV. A Potential Solution? 68

Chapter 5: Responsibility- Sensitive Universal Health Care 74

I. Meeting Basic Needs 75

II. Health Care as a Public Good 78

III. Some Counter- Objections and Clarifi cations 80

IV. In- Kind Health Care 83

Part II: Health 87

Chapter 6: Why Justice in Health? 89

I. Is Health Care (Still) Special? 89

II. Why a Separate Th eory of Justice in Health? 92

Chapter 7: Luck Egalitarian Justice in Health 98

I. Rawlsian vs. Luck Egalitarian Justice in Health 99

II. Two Problems with Fair Equality of Opportunity for Health 101

III. Health Inequalities between the Sexes Revisited 105

Chapter 8: Equality or Priority in Health? 111

I. The Value of Equality in Health 112

II. Some Potential Objections and Qualifi cations 115

III. Luck Prioritarian Justice in Health 118

Chapter 9: Distributing Human Enhancements 121

I. What Is Human Enhancement? 122

II. The Treatment vs. Enhancement Distinction 124

III. "Fair" Skin and Other Potential Objections 130

IV. Equality or Priority in Enhancement? 133

Part III: Health without Borders 137

Chapter 10: Devolution of Health Care Services 139

I. The Case for Devolution 141

II. How Devolution Upsets Distributive Justice 143

III. Ignoring Cultural Preferences in Health Care 144

IV. How Devolution Weakens Social Solidarity 148

V. Imposing a Uniform Pattern of Consumption 150

Chapter 11: Global Justice and National Responsibility for Health 153

I. Justice, Responsibility, and Double Standards 155

II. "The Health of Nations" and the Global Economic Order 158

III. Holding Nations Responsible for Th eir Health 160

IV. National Responsibility and Future Generations 162

V. Equality or Suffi ciency in Global Health? 165

VI. Intergalactic Egalitarianism 168

Conclusion 171

Notes 175

Bibliography 221

Index 235

Über Autor(innen)

Segall, Shlomi
Shlomi Segall is lecturer in the Department of Political Science and the Integrative Program of Philosophy, Economics, and Political Science (PEP) at the Hebrew University of Jerusalem.