Just caring: Oregon, health care rationing, and informed democratic deliberation
Journal of Medicine and Philosophy 19 (4):367-388 (1994)
| Abstract | This essay argues that our national efforts at health reform ought to be informed by eleven key lessons from Oregon. Specifically, we must learn that the need for health care rationing is inescapable, that any rationing process must be public and visible, and that fair rationing protocols must be self-imposed through a process of rational democratic deliberation. Part I of this essay notes that rationing is a ubiquitous feature of our health care system at present, but it is mostly hidden rationing, which is presumptively unjust. Part II argues that the need for health care rationing is inescapable. Although Oregon is flawed as a model of health rationing, it gives us worthy moral lessons for health reform at the national level, which I analyze and defend in Part III. The most significant of these lessons is the importance of rational democratic deliberation in articulating fair rationing protocols for a community. In Part IV I sketch the philosophic justification for this approach and respond to some important criticisms from Daniels. Keywords: cost containment, democratic deliberation, fairness, justice, rationing CiteULike Connotea Del.icio.us What's this? | |||||||||
| Keywords | No keywords specified (fix it) | |||||||||
| Categories | ||||||||||
| Options |
|
|||||||||
Download options| PhilPapers Archive |
Upload a copy of this paper Check publisher's policy on self-archival Papers currently archived: 5,865 |
| External links |
 |
| Through your library | Configure |
Similar books and articlesLawrence J. Schneiderman (2011). Rationing Just Medical Care. American Journal of Bioethics 11 (7):7 - 14.
Leonard M. Fleck (2011). Just Caring: Health Care Rationing, Terminal Illness, and the Medically Least Well Off. Journal of Law, Medicine and Ethics 39 (2):156-171.
Alberto Infante (1995). Setting Priorities in the Spanish Health Care System. Journal of Medicine and Philosophy 20 (6).
Daniel Callahan (2012). Must We Ration Health Care for the Elderly? Journal of Law, Medicine and Ethics 40 (1):10-16.
Ole Frithjof Norheim (1995). The Norwegian Welfare State in Transition: Rationing and Plurality of Values as Ethical Challenges for the Health Care System. Journal of Medicine and Philosophy 20 (6):639-655.
Paige R. Sipes-Metzler (1994). Oregon Health Plan: Ration or Reason. Journal of Medicine and Philosophy 19 (4):305-314.
Richard D. Lamm (1994). Rationing and the Clinton Health Plan. Journal of Medicine and Philosophy 19 (5):445-454.
Theresa Drought (1992). Justice and the Moral Acceptability of Rationing Medical Care: The Oregon Experiment. Journal of Medicine and Philosophy 17 (1).
Robert A. Pearlman (1992). An Ethical Framework for Rationing Health Care. Journal of Medicine and Philosophy 17 (1).
Leonard M. Fleck (1994). Just Caring: Health Reform and Health Care Rationing. Journal of Medicine and Philosophy 19 (5):435-443.
Analytics
Monthly downloads |
Added to index2010-08-24Total downloads11 ( #100,810 of 556,803 )Recent downloads (6 months)1 ( #64,847 of 556,803 )How can I increase my downloads? |
My notes
Discussion
