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Because medicine can preserve life, restore health and maintain the body's functions, it is widely acknowledged as a basic good that just societies should provide for their members. Yet, there is wide disagreement over the scope and content of what to provide, to whom, how, when, and why. In this unique and comprehensive volume, some of the best-known philosophers, physicians, legal scholars, political scientists, and economists writing on the subject discuss what social justice in medicine should be. Their contributions deepen our understanding of the theoretical and practical issues that run through the contemporary debate. The forty-two chapters in this reorganized second edition of Medicine and Social Justice update and expand upon the thirty-four chapters of the 2002 first edition. Eighteen chapters from the original volume are revised to address policy changes and challenging issues that have emerged in the intervening decade. Twenty-two of the chapters in this edition are entirely new. The treatment of foundational theory and conceptual issues related to access to health care and rationing medical resources have been expanded to provide a more comprehensive and nuanced discussion of the background concepts that underlie distributive justice debates, with global perspectives on health and well-being added. New additions to the section on health care justice for specific populations include chapters on health care for the chronically ill, soldiers, prisoners, the severely cognitively disabled, and the LGBT population. The section devoted to dilemmas and priorities addresses an array of topics that have recently become especially pressing because of new technologies or altered policies. New chapters address questions of justice related to genetics, medical malpractice, research on human subjects, pandemic and disaster planning, newborn screening, and justice for the brain dead and those with profound neurological injury. Reviews of the first edition: "This compilation brings a variety of perspectives, national settings, and disciplinary backgrounds to the topic and provides a unique survey of theoretical and applied thinking about the connections between health care and social justice... Physicians and others interested in this field will find this book an engaging introduction to the theoretical and practical challenges pertaining to social justice and health care." New England Journal of Medicine "Although much work in bioethics has focused on clinical encounters, there has been a current of discussion about questions of social justice for decades-at least since the allocation of access to dialysis was widely understood in the 1960s to be a matter of justice, not of medical judgment. This volume will facilitate heightened awareness and deeper discussion of such issues." JAMA "Impressively, the editors have chosen an array of essays that explore the philosophical and bioethical foundations of distributive justice; review the current practice of rationing and patients' access to care in a number of different countries; highlight the issues raised by various special needs groups; and then wrestle with some dilemmas in assessing priorities in distributing healthcare... This book is an excellent resource. " Doody's
Rosamond Rhodes, PhD, is Director of Bioethics Education and Professor of Medical Education at Mount Sinai School of Medicine. She is also Professor of Philosophy at The Graduate Center, CUNY, and Professor of Bioethics at Union Graduate College. In her philosophical writing she has discussed the work of Hobbes, Aristotle, Kant, and Rawls, and addressed a broad range of topics in bioethics. Margaret P. Battin, MFA, PhD, is Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, Division of Medical Ethics, at the University of Utah. She has authored, co-authored, edited, or co-edited about twenty books, among them a study of philosophical issues in suicide, a collection on age-rationing of medical care, a text on professional ethics, a collection of her essays on end-of-life issues, and a second collection of her essays (and fiction) on end-of-life issues. Anita Silvers, PhD, Professor and Chair of Philosophy at San Francisco State University, is the recipient of the American Philosophical Association's Quinn Prize and the Chair of the APA Committee on Inclusiveness. She has written extensively on issues of medicine and justice for people with disabilities and chronic illnesses, elderly people, neonates, and other especially vulnerable groups. Her philosophical theory of justice is enriched by experience in advocacy and on the ethics committee of a county hospital that serves these populations.
Table of Contents
|Justice, Health, and Health Care||p. 17|
|Justice, Liberty, and the Choice of Health-System Structure||p. 35|
|A Utilitarian Approach to Justice in Health Care||p. 47|
|Justice Pluralism: Resource Allocation in Medicine and Public Health||p. 59|
|Health Risk and Health Security||p. 71|
|Aggregation and the Moral Relevance of Context in Health Care Decision-Making||p. 79|
|Why There Is No Right to Health Care||p. 91|
|Equality, Democracy, and the Human Right to Health Care||p. 97|
|Access and Rationing|
|Unequal by Design: Health Care, Distributive Justice, and the American Political Process||p. 107|
|Justice of and Within Health Care Finance||p. 121|
|Setting Priorities for a Basic Minimum of Accessible Health Care||p. 131|
|Why Justice Requires Rationing in Health Care||p. 143|
|Priority to the Worse Off in Health Care Resource Prioritization||p. 155|
|Whether to Discontinue Nonfutile Use of a Scarce Resource||p. 165|
|Responsibility for Health Status||p. 179|
|Health Care Justice and Political Agency 2011||p. 201|
|Allocating Health Care Resources in the UK: Putting Principles into Practice||p. 219|
|Global Health, Human Rights, and Distributive Justice||p. 231|
|Equal Access to Health Care Under the UN Disability Rights Convention||p. 245|
|Justice, Health, and the Price of Poverty||p. 255|
|Racial Groups, Distrust, and the Distribution of Health Care||p. 265|
|Gender Justice in the Health Care System: An Elusive Goal||p. 279|
|Justice for Gay and Lesbian People in Health Care||p. 289|
|Health Care Justice for the Chronically Ill and Disabled: A Deficiency in Justice Theory and How to Cure It||p. 299|
|Getting from Here to There: Claiming Justice for the Severely Cognitively Disabled||p. 313|
|Cognitive Surrogacy, Assisted Participation, and Moral Status||p. 325|
|Health Care Reform and Children's Right to Health Care: A Modest Proposal||p. 335|
|Premature and Compromised Neonates||p. 347|
|Age Rationing Under Conditions of Injustice||p. 355|
|Health Care for Soldiers||p. 363|
|Social Justice and Correctional Health Services||p. 373|
|Dilemmas and Priorities|
|Are Pre-existing Condition Exclusion Clauses Just? Lessons from Causal and Ethical Considerations Regarding Genetic Testing||p. 387|
|Oral and Mental Health Services||p. 401|
|Limits of Science and Boundaries of Access: Alternative Health Care||p. 413|
|Just Expectations: Family Caregivers, Practical Identities, and Social Justice in the Provision of Health Care||p. 433|
|Justice in Research on Human Subjects||p. 445|
|Just Genetics: The Ethical Challenges of Personalized Medicine||p. 461|
|Expanded Newborn Screening: Contemporary Challenges to the Parens Patriae Doctrine and the Use of Public Resources||p. 475|
|Justice, Profound Neurological Injury, and Brain Death||p. 485|
|Justice in Transplant Organ Allocation||p. 505|
|Justice in Planning for Pandemics and Disasters||p. 523|
|Justice Has (Almost) Nothing to Do With It: Medical Malpractice and Tort Reform||p. 531|
|Table of Contents provided by Ingram. All Rights Reserved.|