David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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American Journal of Bioethics 11 (12):32-40 (2011)
Enormous gaps between HIV burden and health care availability in low-income countries raise severe ethical problems. This article analyzes four HIV-priority dilemmas with interest across contexts and health systems. We explore principled distributive conflicts and use the Atkinson index to make explicit trade-offs between health maximization and equality in health. We find that societies need a relatively low aversion to inequality to favor treatment for children, even with large weights assigned to extending the lives of adults: higher inequality aversion is needed to share resources equally between high-cost and low-cost treatment; higher inequality aversion is needed to favor treatment rather than prevention, and the highest inequality aversion is needed to favor sharing treatment between urban and rural regions rather than urban provision of treatment. This type of ethical sensitivity analysis may clarify the ethics of health policy choice.
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References found in this work BETA
Norman Daniels (2008). Just Health: Meeting Health Needs Fairly. Cambridge University Press.
K. A. Johansson, D. Jerene & O. F. Norheim (2008). National HIV Treatment Guidelines in Tanzania and Ethiopia: Are They Legitimate Rationing Tools? Journal of Medical Ethics 34 (6):478-483.
Kjell Arne Johansson, Ingrid Miljeteig, Hamisi Kigwangalla & Ole Frithjof Norheim (2011). HIV Priorities and Health Distributions in a Rural Region in Tanzania: A Qualitative Study. Journal of Medical Ethics 37 (4):221-226.
Samuel J. Kerstein & Greg Bognar (2010). Complete Lives in the Balance. American Journal of Bioethics 10 (4):37 – 45.
Larry S. Temkin (2003). Egalitarianism Defended. Ethics 113 (4):764-782.
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