David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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Journal of Medicine and Philosophy 32 (5):519 – 536 (2007)
Long-term care is controversial because it involves foundational disputes. Some are moral-economic, bearing on whether the individual, the family, or the state is primarily responsible for long-term care, as well as on how one can establish a morally and financially sustainable long-term-care policy, given the moral hazard of people over-using entitlements once established, the political hazard of media democracies promising unfundable entitlements, the demographic hazard of relatively fewer workers to support those in need of long-term care, the moral hazard to responsibility of shifting accountability to third parties, and the bureaucratic hazard of moving from individual and family choice to bureaucratic oversight. These disputes are compounded by controversies regarding the nature of the family (Is it to be regarded primarily as a socio-biological category, a fundamental ontological category of social reality, or a construct resulting from the consent of the participants?), as well as its legal and moral autonomy and authority over its members. As the disputes show, there is no common understanding of respect and human dignity that will easily lead out of these disputes. The reflections on long-term care in this issue underscore the plurality of moralities defining bioethics.
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Citations of this work BETA
Mark J. Cherry (2015). Re-Thinking the Role of the Family in Medical Decision-Making. Journal of Medicine and Philosophy 40 (4):451-472.
H. T. Engelhardt (2010). Beyond the Best Interests of Children: Four Views of the Family and of Foundational Disagreements Regarding Pediatric Decision Making. Journal of Medicine and Philosophy 35 (5):499-517.
X. Chen & R. Fan (2010). The Family and Harmonious Medical Decision Making: Cherishing an Appropriate Confucian Moral Balance. Journal of Medicine and Philosophy 35 (5):573-586.
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