Springer Verlag (2019)

Abstract
This book focuses on justice and its demands in the way of providing people with medical care. Building on recent insights on the nature of moral perceptions and motivations from the neurosciences, it makes a case for the traditional medical ethic and examines its financial feasibility. The book starts out by giving an account of the concept of justice and tracing it back to the practices and tenets of Hippocrates and his followers, while taking into account findings from the neurosciences. Next, it considers whether the claim that it is just to limit medical care for everyone to some basic minimum is justifiable. The book then addresses finances and expenditures of the US health care system and shows that the growth of expenditures and the percentage of the gross national product spent on health care make for an unsustainable trajectory. In light of the question what should be changed, the book suggests that overdiagnosis and medicalizing normal behavior lead to harmful, costly and unnecessary interventions and are the result of unethical behavior on the part of the pharmaceutical industry and extensive ethical failures of the FDA. The book ends with suggestions about what can be done to put the U.S. health care system on the path to sustainability, better medical care, and compliance with the demands of justice.
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ISBN(s) 978-3-030-21706-8   978-3-030-21707-5   3030217094   3030217086   303021706X   9783030217068
DOI 10.1007/978-3-030-21707-5
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Chapters BETA
Suggesting Policies and Practices for Increasing Justice and Assuring the Sustainability of the U.S. Healthcare System

The goal of this chapter is to suggest policies and practices that would render the U.S. health care system just and sustainable by: Curbing current unethical and scientifically unsound medical practices that are unjustifiably harmful and of little or no benefit; Financing healthcare by drawing upon... see more

Practices and Policies in the U.S. Health Care System that Are Scientifically and Ethically Unjustifiable: They Should Not and Cannot Persist

This chapter continues identification and analysis of medical practices and policies that are very costly and should not be allowed to persist because they are unethical, either because they are unjustified on scientific grounds or because of violation of justice and hence, unethical. Such activitie... see more

Overdiagnosing, Overtreating, and Overmedicalizing Behavior and Feelings

This chapter continues to pursue and document unjustifiable medical practices that need to be curbed as much as possible so as to eliminate this source of unsustainable costs. In this case, the source is the enormous diagnostic inflation of mental disorders. Diagnostic inflation treats normal behavi... see more

Overdiagnosing, Overtesting, and Overmedicalizing Physical Conditions

This chapter documents two major contributors to the path of unsustainability within the U.S. healthcare system. First, is the sheer ever-higher-rising costs of medical services, and the relativity poor outcomes as compared with the world’s other nations, all of whom spend considerably less. This is... see more

Advocating Basic Minimum Medical Care: A Case of Justice Denied

There is a widespread assumption that it is just to guarantee all individuals access to a basic minimum of healthcare. I contend in this chapter that this is based on a flawed concept and application of justice: it fails to use the generic concept of justice—namely of what we owe one another, that i... see more

The Cognitive Bases for Deciding When Policies Are Just

It has long been recognized that, psychologically, we experience ought, a moral demand, when we relate a choice before us to our conception of an ideal self. Based on this reality, ideal observer theories have been promulgated for centuries. I draw on Roderick Firth’s most precise version. What is r... see more

What Justice Demands

Drawing upon the neurosciences and other empirical observations, I argue that the moral demands of justice are expressed in our natural inhibitions and proclivities, namely inhibitions of avoiding harming one another and in our proclivities to spawn offspring, nurturing and sustaining them, and prot... see more

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