David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Bioethics 12 (3):212–235 (1998)
Over the past 10 years, John Harris has made important contributions to thinking about distributive justice in health care. In his latest work, Harris controversially argues that clinicians should stop prioritising patients according to prognosis. He argues that the good or benefit of health care is providing each individual with an opportunity to live the best and longest life possible for him or her. I call this thesis, opportunism. For the purpose of distribution of resources in health care, Harris rejects welfarism (the thesis that the good of health care is well-being) and argues that utilitarianism in general may lead to de facto discrimination against groups of people needing health care. I argue that well-being is a superior theory of the good of health care to Harris' opportunism. Harris' concerns about utilitarianism can be better addressed by: (i) relating justice more closely to reasons for action; (ii) by conceptualising the relationship between reasons for action and the value of the consequences of those actions as a plateau rather than scalar relationship. Justice can be understood as satisfying as many equally rational claims on resources as possible. The rationality of a person's claim on health resources turns on the strength of that person's reasons to promote certain health-related states of affairs. I argue that the strength of that reason does not track the expected value of that state of affairs in a fully scalar fashion. Rather a person can have most reason to promote some state of affairs, even though he or she could promote other more valuable states of affairs. Thus there can be equal reason for a distributor of public resources to save either of two people, even though one will have a better and more valuable life. This approach, while addressing many of Harris' concerns about utilitarianism, does not imply that doctors should give up prioritising patients according to prognosis altogether, but it does allow that patients with lower but reasonable prognosis should have a share of public resources.
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
|Through your library||Configure|
References found in this work BETA
No references found.
Citations of this work BETA
Duff Waring (2004). Adequate Conscious Life and Age-Related Need: F.M. Kamm's Approach to Patient Selection. Bioethics 18 (3):234–248.
Similar books and articles
Dan W. Brock (2000). Broadening the Bioethics Agenda. Kennedy Institute of Ethics Journal 10 (1):21-38.
T. M. Wilkinson (2010). Community, Public Health and Resource Allocation. Public Health Ethics 3 (3):267-271.
Robert A. Pearlman (1992). An Ethical Framework for Rationing Health Care. Journal of Medicine and Philosophy 17 (1):79-96.
H. S. Richardson (2010). Public Health Doctors' Ancillary-Care Obligations. Public Health Ethics 3 (1):63-67.
Craig Blinderman (2009). Palliative Care, Public Health and Justice: Setting Priorities in Resource Poor Countries. Developing World Bioethics 9 (3):105-110.
Dan W. Brock (1988). Justice and the Severely Demented Elderly. Journal of Medicine and Philosophy 13 (1):73-99.
Dani Filc (2007). The Liberal Grounding of the Right to Health Care: An Egalitarian Critique. Theoria 54 (112):51-72.
Thomas Schramme (2007). The Significance of the Concept of Disease for Justice in Health Care. Theoretical Medicine and Bioethics 28 (2):121-135.
John Hardwig (1987). Robin Hoods and Good Samaritans: The Role of Patients in Health Care Distribution. Theoretical Medicine and Bioethics 8 (1).
Dan W. Brock (2001). Children's Rights to Health Care. Journal of Medicine and Philosophy 26 (2):163 – 177.
Added to index2009-01-28
Total downloads89 ( #11,190 of 1,089,048 )
Recent downloads (6 months)1 ( #69,722 of 1,089,048 )
How can I increase my downloads?