Just caring: Oregon, health care rationing, and informed democratic deliberation

Journal of Medicine and Philosophy 19 (4):367-388 (1994)
This essay argues that our national efforts at health reform ought to be informed by eleven key lessons from Oregon. Specifically, we must learn that the need for health care rationing is inescapable, that any rationing process must be public and visible, and that fair rationing protocols must be self-imposed through a process of rational democratic deliberation. Part I of this essay notes that rationing is a ubiquitous feature of our health care system at present, but it is mostly hidden rationing, which is presumptively unjust. Part II argues that the need for health care rationing is inescapable. Although Oregon is flawed as a model of health rationing, it gives us worthy moral lessons for health reform at the national level, which I analyze and defend in Part III. The most significant of these lessons is the importance of rational democratic deliberation in articulating fair rationing protocols for a community. In Part IV I sketch the philosophic justification for this approach and respond to some important criticisms from Daniels. Keywords: cost containment, democratic deliberation, fairness, justice, rationing CiteULike Connotea Del.icio.us What's this?
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1093/jmp/19.4.367
 Save to my reading list
Follow the author(s)
Edit this record
My bibliography
Export citation
Find it on Scholar
Mark as duplicate
Request removal from index
Revision history
Download options
Our Archive

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 30,248
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library
References found in this work BETA

No references found.

Add more references

Citations of this work BETA

Add more citations

Similar books and articles
Rationing Just Medical Care.Lawrence J. Schneiderman - 2011 - American Journal of Bioethics 11 (7):7 - 14.
Rationing and the Clinton Health Plan.Richard D. Lamm - 1994 - Journal of Medicine and Philosophy 19 (5):445-454.
Oregon Health Plan: Ration or Reason.Paige R. Sipes-Metzler - 1994 - Journal of Medicine and Philosophy 19 (4):305-314.
Must We Ration Health Care for the Elderly?Daniel Callahan - 2012 - Journal of Law, Medicine & Ethics 40 (1):10-16.
Just Caring: Health Reform and Health Care Rationing.Leonard M. Fleck - 1994 - Journal of Medicine and Philosophy 19 (5):435-443.
Added to PP index

Total downloads
18 ( #277,636 of 2,193,089 )

Recent downloads (6 months)
1 ( #290,279 of 2,193,089 )

How can I increase my downloads?

Monthly downloads
My notes
Sign in to use this feature