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  1.  1
    No Longer Home Alone? Home Care and the Canada Health Act.Monique Lanoix - 2017 - Health Care Analysis 25 (2):168-189.
    In this paper, I argue that addressing the medical needs of older persons warrants expanding the array of insured services as described by the Canada Health Act to include home care. The growing importance of chronic care supports my call for federally regulated home care services as the nature of disease management has changed significantly in the last decades. In addition, if the values of equity, fairness and solidarity, which are the keystone values of the CHA, are to be upheld (...)
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  2.  5
    Concierge, Wellness, and Block Fee Models of Primary Care: Ethical and Regulatory Concerns at the Public–Private Boundary.Lynette Reid - 2017 - Health Care Analysis 25 (2):151-167.
    In bioethics and health policy, we often discuss the appropriate boundaries of public funding; how the interface of public and private purchasers and providers should be organized and regulated receives less attention. In this paper, I discuss ethical and regulatory issues raised at this interface by three medical practice models in which physicians provide insured services while requiring or requesting that patients pay for services or for the non-insured services of the physicians themselves or their associates. This choice for such (...)
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  3.  7
    Medical Need: Evaluating a Conceptual Critique of Universal Health Coverage.Lynette Reid - 2017 - Health Care Analysis 25 (2):114-137.
    Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...)
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  4. Introduction to the Special Issue: Precarious Solidarity—Preferential Access in Canadian Health Care.Lynette Reid - 2017 - Health Care Analysis 25 (2):107-113.
    Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries and (...)
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  5.  5
    How Medical Tourism Enables Preferential Access to Care: Four Patterns From the Canadian Context.Jeremy Snyder, Rory Johnston, Valorie A. Crooks, Jeff Morgan & Krystyna Adams - 2017 - Health Care Analysis 25 (2):138-150.
    Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: Inbound medical tourism to Canada’s public hospitals; Inbound medical tourism to a First Nations reserve; Canadian patients opting to go abroad for medical (...)
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  6.  8
    How Does Organisational Literacy Impact Access to Health Care for Homeless Individuals?Naomi Rebecca Hughes - 2017 - Health Care Analysis 25 (1):90-106.
    This article describes a study that examined the experiences of 27 individuals who frequented an Open Access homeless shelter in Toronto, Canada. The overarching aim of this study was to map the social organisation of health care in Toronto, with particular regards to the ways in which literacy, or the lack of literacy, mediates the experiences of homeless individuals attempting to gain access to health care. While terms such as “literate” or “illiterate” might be seen to reflect an individual’s level (...)
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  7.  9
    For the Sake of Justice: Should We Prioritize Rare Diseases?Niklas Juth - 2017 - Health Care Analysis 25 (1):1-20.
    This article is about the justifiability of accepting worse cost effectiveness for orphan drugs, that is, treatments for rare diseases, in a publicly financed health care system. Recently, three arguments have been presented that may be used in favour of exceptionally advantageous economic terms for orphan drugs. These arguments share the common feature of all referring to considerations of justice or fairness: the argument of the irrelevance of group size, the argument from the principle of need, and the argument of (...)
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  8.  9
    Intimacy and Sexuality in Institutionalized Dementia Care: Clinical-Ethical Considerations.Lieslot Mahieu, Luc Anckaert & Chris Gastmans - 2017 - Health Care Analysis 25 (1):52-71.
    Intimacy and sexuality expressed by nursing home residents with dementia remains an ethically sensitive issue for care facilities, nursing staff and family members. Dealing with residents’ sexual longings and behaviour is extremely difficult, putting a burden on the caregivers as well as on the residents themselves and their relatives. The parties in question often do not know how to react when residents express themselves sexually. The overall aim of this article is to provide a number of clinical-ethical considerations addressing the (...)
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  9.  14
    Ageism and Autonomy in Health Care: Explorations Through a Relational Lens.Laura Pritchard-Jones - 2017 - Health Care Analysis 25 (1):72-89.
    Ageism within the context of care has attracted increasing attention in recent years. Similarly, autonomy has developed into a prominent concept within health care law and ethics. This paper explores the way that ageism, understood as a set of negative attitudes about old age or older people, may impact on an older person’s ability to make maximally autonomous decisions within health care. In particular, by appealing to feminist constructions of autonomy as relational, I will argue that the key to establishing (...)
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  10.  8
    The Absent Interpreter in Administrative Detention Center Medical Units.Murielle Rondeau-Lutz & Jean-Christophe Weber - 2017 - Health Care Analysis 25 (1):34-51.
    The particular situation of the French administrative detention center medical units appears to be an exemplary case to study the difficulties facing medical practice. Indeed, the starting point of our inquiry was an amazing observation that needed to be addressed and understood: why are professional interpreters so seldom requested in ADC medical units, where one would expect that they would be “naturally” present? Aiming to fully explore the meanings of the “absent interpreter”, this article takes into account the possible meanings (...)
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  11.  3
    The Relevance of Group Size in Health Care Priority Setting: A Reply to Juth.Lars Sandman & Erik Gustavsson - 2017 - Health Care Analysis 25 (1):21-33.
    How to handle orphan drugs for rare diseases is a pressing problem in current health-care. Due to the group size of patients affecting the cost of treatment, they risk being disadvantaged in relation to existing cost-effectiveness thresholds. In an article by Niklas Juth it has been argued that it is irrelevant to take indirectly operative factors like group size into account since such a compensation would risk discounting the use of cost, a relevant factor, altogether. In this article we analyze (...)
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  12.  1
    Health Without Care? Vulnerability, Medical Brain Drain, and Health Worker Responsibilities in Underserved Contexts.Yusuf Yuksekdag - 2017 - Health Care Analysis:1-16.
    There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first (...)
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