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Summary There are several complementary issues involved in Health Care Justice. Distributive justice is primarily concerned with access to health care, but also with the distribution of other social goods that contribute to health. This can also encompass the scope of health care: what should be included in a public health care provision?  Health care justice also encompasses the role of rights in health care; this includes questions of how medical professionals should interact with patients, but also the rights of the medical professionals themselves, patient families, and broader groups such as the general public. This will also include the application of distinctive questions of justice (e.g racial justice; disability-related justice; gender justice, etc.) to health, including considerations of discrimination within health care, the effect of discrimination in other areas on people's health and access to care, as well as past and present unjust uses and refusals of health care.  In general questions of health care justice may emerge within a particular society, at a particular time. But they can also include issues of international and global justice, justice between generations, and the scope of justice (e.g. whether non-human animals have claims on the basis of justice).  The term may also relate to the role of legal justice in health care. For instance, we might wonder at what point, and for what kinds of misconduct, criminal law should be applied to cases of misconduct by medical professionals, or whether medics' central role in society should impact their employment rights, such as the right to strike action.  There are also questions about the relationship of health justice to justice in other areas. It is now widely recognised that health is affected not only by 'health care', but also - and probably more - by other social goods. Is there any reason, therefore, for a distinctive theory of 'health care justice', where we aim for equality of health care provision regardless of what happens elsewhere? Or should health care just be seen as one sector across which justice applies, with gains or losses in health fully commensurable with gains and losses in other areas of life? 
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  1. Ethical Consumerism, Human Rights, and Global Health Impact.Brian Berkey - forthcoming - Developing World Bioethics.
    In this paper, I raise some doubts about Nicole Hassoun's account of the obligations of states, pharmaceutical firms, and consumers with regard to global health, presented in Global Health Impact. I argue that it is not necessarily the case, as Hassoun claims, that if states are just, and therefore satisfy all of their obligations, then consumers will not have strong moral reasons, and perhaps obligations, to make consumption choices that are informed by principles and requirements of justice. This is because (...)
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  2. Responsibility and Healthcare.Ben Davies, Gabriel De Marco, Neil Levy & Julian Savulescu (eds.) - forthcoming - Oxford University Press.
    This edited collection brings together world-leading authors writing about a wide range of issues related to responsibility and healthcare, and from a variety of perspectives. Alongside a comprehensive introduction by the editors outlining the scope of the relevant debates, the volume contains 14 chapters, split into four sections. This volume pushes forward a number of important debates on responsibility and its role in contemporary healthcare. -/- The first and second groups of chapters focus, respectively, on (a) the potential justification and (...)
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  3. Rights to health care.H. Tristram Englehardt - forthcoming - The Foundations of Bioethics, Oxford University Press, Oxford.
    A basic human right to the delivery of health care, even to the delivery of a decent minimum of health care, does not exist. The difficult with talking of such rights should be apparent. It is difficult if not impossible both to respect the freedom of all and to achieve their long-range best interests. -/- Rights to health care constitute claims against others for either their services or their goods. Unlike rights to forbearance, which require others to refrain from interfering, (...)
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  4. Tackling disrespect.Vikki Entwistle, Alan Cribb & Polly Mitchell - forthcoming - Journal of Health Services Research and Policy.
    Disrespect in health care often persists despite firm commitments to respectful service provision. This conceptual paper highlights how the ways in which respect and disrespect are characterised can have practical implications for how well disrespect can be tackled. We stress the need to focus explicitly on disrespect (not only respect) and propose that disrespect can usefully be understood as a failure to relate to people as equals. This characterisation is consonant with some accounts of respect but sometimes obscured by a (...)
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  5. How (Not) to Make Trade-Offs Between Health and Other Goods.Antti Kauppinen - forthcoming - Cambridge Quarterly of Healthcare Ethics.
    In the context of a global pandemic, there is good health-based reason for governments to impose various social distancing measures. However, such measures also cause economic and other harms to people at low risk from the virus. In this paper, I examine how to make such trade-offs in a way that is respectfully justifiable to their losers. I argue that existing proposals like using standard QALY (quality-adjusted life-year) valuations or WELLBYs (wellbeing-adjusted life-years) as the currency for trade-offs do not allow (...)
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  6. Providing health care for the indigent.David M. Kinzer - forthcoming - Scarce Medical Resources and Justice.
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  7. Ethical Considerations for Global Health Decision-Making: Justice-Enhanced Cost-Effectiveness Analysis of New Technologies for Trypanosoma brucei gambiense.Maria W. Merritt, C. Simone Sutherland & Fabrizio Tediosi - forthcoming - Public Health Ethics:phy013.
    We sought to assess formally the extent to which different control and elimination strategies for human African trypanosomiasis Trypanosoma brucei gambiense would exacerbate or alleviate experiences of societal disadvantage that traditional economic evaluation does not take into account. Justice-enhanced cost-effectiveness analysis is a normative approach under development to address social justice considerations in public health decision-making alongside other types of analyses. It aims to assess how public health interventions under analysis in comparative evaluation would be expected to influence the clustering (...)
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  8. Special Supplement: What Do We Owe the Elderly? Allocating Social and Health Care Resources.Ruud ter Meulen, Eva Topinková & Daniel Callahan - forthcoming - Hastings Center Report.
  9. Obesity and Responsibility for Health.Rekha Nath - forthcoming - In Benjamin Davies, Gabriel De Marco, Neil Levy & Julian Savulescu (eds.), Responsibility and Healthcare. Oxford: Oxford University Press.
    This chapter examines the case for health care policies aimed at holding obese individuals responsible for their weight and for obesity-related health issues. In particular, it considers the merits of two arguments for policies that would seek to make obese individuals bear some of the higher health care costs associated with being that way. On the fairness argument, it is claimed that such policies would serve the interests of fairness by holding obese individuals to account for irresponsible lifestyle choices that (...)
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  10. Qualifying'the Normal Functioning View': Towards a Consensus on a Functioning-Based Framework of Health Justice.Lasse Nielsen - forthcoming - Journal of Medicine and Philosophy.
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  11. Rationing, Responsibility, and Vaccination During COVID-19: A Conceptual Map.Jin K. Park & Ben Davies - forthcoming - American Journal of Bioethics:1-14.
    Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about vaccine-sensitive resource (...)
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  12. Justice, the basic social contract and health care.Robert M. Veatch - forthcoming - Contemporary Issues in Bioethics.
  13. Global Obligations and the Human Right to Health.Bill Wringe - forthcoming - In Tracy Isaacs, Kendy Hess & Violetta Igneski (eds.), Collective Obligation: Ethics, Ontology and Applications.
    In this paper I attempt to show how an appeal to a particular kind of collective obligation - a collective obligation falling on an unstructured collective consisting of the world’s population as a whole – can be used to undermine recently influential objections to the idea that there is a human right to health which have been put forward by Gopal Sreenivasan and Onora O’Neill. -/- I take this result to be significant both for its own sake and because it (...)
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  14. World Citizenship and Global Health.Xuanpu Zhuang - forthcoming - In Himani Bhakuni & Lucas Miotto (eds.), Justice in Global Health: New Perspectives and Current Issues. Routledge. pp. 15-37.
    In this chapter, I argue for a weak notion of equal world citizenship, which implies that individuals in the world ought to live as equal world citizens in a significant sense, and then discuss its implications in global health.
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  15. How to Balance Lives and Livelihoods in a Pandemic.Matthew D. Adler, Richard Bradley, Marc Fleurbaey, Maddalena Ferranna, James Hammitt, Remi Turquier & Alex Voorhoeve - 2023 - In Julian Savulescu & Dominic Wilkinson (eds.), Pandemic Ethics: From Covid-19 to Disease X. Oxford: Oxford University Press. pp. 189-209.
    Control measures, such as “lockdowns”, have been widely used to suppress the COVID-19 pandemic. Under some conditions, they prevent illness and save lives. But they also exact an economic toll. How should we balance the impact of such policies on individual lives and livelihoods (and other dimensions of concern) to determine which is best? A widely used method of policy evaluation, benefit–cost analysis (BCA), answers these questions by converting all the effects of a policy into monetary equivalents and then summing (...)
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  16. NHS Underfunding and the Lopsided Socialized Model.Ognjen Arandjelović - 2023 - Ethics, Medicine and Public Health 28:Article 100902.
    Background: The funding of health care is a major challenge to governments all across the world; the UK presents a useful and illustrative case. -/- Methodology: In this article I explain why the manner in which the provision of health care in the UK is organized is fundamentally incoherent and continuing to ignore this incoherence is bound to lead to ever-greater problems. -/- Discussion: Our society must decide on its priorities; herein I do not wish to argue what these ought (...)
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  17. Epistemic virtues of harnessing rigorous machine learning systems in ethically sensitive domains.Thomas F. Burns - 2023 - Journal of Medical Ethics 49 (8):547-548.
    Some physicians, in their care of patients at risk of misusing opioids, use machine learning (ML)-based prediction drug monitoring programmes (PDMPs) to guide their decision making in the prescription of opioids. This can cause a conflict: a PDMP Score can indicate a patient is at a high risk of opioid abuse while a patient expressly reports oppositely. The prescriber is then left to balance the credibility and trust of the patient with the PDMP Score. Pozzi1 argues that a prescriber who (...)
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  18. Open and Inclusive: Fair processes for financing universal health coverage.Elina Dale, David B. Evans, Unni Gopinathan, Christoph Kurowski, Ole Frithjof Norheim, Trygve Ottersen & Alex Voorhoeve - 2023 - Washington, DC: World Bank.
    This World Bank Report offers a new conception of fair decision processes in health financing. It argues that such procedural fairness can contribute to fairer outcomes, strengthen the legitimacy of decision processes, build trust in authorities, and promote the sustainability of reforms on the path to health coverage for all.
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  19. Criteria For the Fairness of Health Financing Decisions: A Scoping Review.Elina Dale, Elizabeth Peacocke, Espen Movik, Alex Voorhoeve, Trygve Ottersen, Ole Frithjof Norheim, Christoph Kurowski, Unni Gopinathan & David B. Evans - 2023 - Health Policy and Planning 38 (1):i13–i35.
    Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which (...)
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  20. Healthcare Priorities: The “Young” and the “Old”.Ben Davies - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):174-185.
    Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should have a (...)
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  21. Procedural Fairness and the Resilience of Health Financing Reforms in Ukraine.Yuriy Dzhygyr, Elina Dale, Alex Voorhoeve, Unni Gopinathan & Kateryna Maynzyuk - 2023 - Health Policy and Planning 38 (1):i59-i72.
    In 2017, Ukraine’s Parliament passed legislation establishing a single health benefit package for the entire population called the Programme of Medical Guarantees,‎ financed through general taxes and administered by a single national purchasing agency. This legislation was in line with key principles for financing universal health coverage. However, health professionals and some policymakers have been critical of elements of the reform, including its reliance on general taxes as the source of funding. Using qualitative methods and drawing on deliberative democratic theory (...)
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  22. The shared ethical framework to allocate scarce medical resources: a lesson from COVID-19.Ezekiel J. Emanuel & Govind Persad - 2023 - The Lancet 401 (10391):1892–1902.
    The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair (...)
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  23. Two Conceptions of Solidarity in Health Care.L. Chad Horne - 2023 - Social Theory and Practice 49 (2):261-285.
    In this paper, I distinguish two conceptions of solidarity, which I call solidarity as beneficence and solidarity as mutual advantage. I argue that only the latter is capable of providing a complete foundation for national universal health care programs. On the mutual advantage account, the rationale for universal insurance is parallel to the rationale for a labor union’s “closed shop” policy. In both cases, mandatory participation is necessary in order to stop individuals free-riding on an ongoing system of mutually advantageous (...)
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  24. Cost Sharing in Managed Care and the Ethical Question of Business Purpose.Robert C. Hughes - 2023 - Journal of Managed Care and Specialty Pharmacy 29 (8):965-69.
    For-profit managed care organizations face decisions about cost sharing that can involve a tradeoff between the interests of investors and the interests of patients. No successful business can ignore the interests of its investors, but moral philosophy points to ethical reasons for managed care organizations to make patients’ health, rather than investors’ profit, their primary goal. One reason is the ethical obligation of all businesses to avoid wrongful exploitation of vulnerable customers. An insurance company’s cost-sharing policy can exploit customers either (...)
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  25. Towards a new model of global health justice: the case of COVID-19 vaccines.Nancy S. Jecker, Caesar A. Atuire & Susan J. Bull - 2023 - Journal of Medical Ethics 49 (5):367-374.
    This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad range of global actors up and down the chain of vaccine development who contribute to global vaccine inequities. Section 1 (Background) presents an overview of moments in which diverse global actors, each with their own priorities and aims, shaped subsequent vaccine distribution. Section 2 (Collective action failures) characterises collective action failures (...)
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  26. How Do People Balance Death against Lesser Burdens?Veronika Luptakova & Alex Voorhoeve - 2023 - In Matthew Lindauer (ed.), Advances in Experimental Political Philosophy. London: Bloomsbury. pp. 123-158.
  27. The Anti-Vaxxer as a Moral Equal.Takunda Matose - 2023 - Philosophy Today 67 (1):51-65.
    In this article, I argue that in portending potentially fatal harm to immunocompromised others, certain vaccine-hesitant views create a paradox for democratic deliberation on public health matters. In this paradox, either vaccine-hesitant views entailing potential harm to others are entertained as legitimate public health policy, or these views are disallowed, excluding discussion of competing harms from the deliberative process. In either case, the result is a deliberative process in which some group is not treated with the consideration owed to free (...)
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  28. Medical Rules of Eligibility – Can Preferential Medical Treatment Provisions Be Ethically Justified?Daniel Messelken - 2023 - In Sheena M. Eagan & Daniel Messelken (eds.), Resource Scarcity in Austere Environments. Springer Verlag. pp. 133-153.
    In emergency situations and while medical resources are sufficient, doctors are expected to prioritize and treat patients according to medical criteria only. In MASSCAL situations and when medical resources become insufficient, patient selection and prioritization changes. Rules of triage are applied with the aim of getting the best result possible under the circumstances, e.g., saving the largest number; collective health outweighs individual health. Still, according to the standard ethical principles, non-medical criteria should never influence the doctors’ decision of who will (...)
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  29. Fair domestic allocation of monkeypox virus countermeasures.Govind Persad, R. J. Leland, Trygve Ottersen, Henry Richardson, Carla Saenz, G. Owen Schaefer & Ezekiel J. Emanuel - 2023 - Lancet Public Health 8 (5):e378–e382.
    Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...)
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  30. Clarifying the Discussion on Prioritization and Discrimination in Healthcare.Joona Räsänen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):139-140.
    Discrimination is an important real-life issue that affects many individuals and groups. It is also a fruitful field of study that intersects several disciplines and methods. This Special Section brings together papers on discrimination and prioritization in healthcare from leading scholars in bioethics and closely related fields.
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  31. Ethical and legal race‐responsive vaccine allocation.Bastian Steuwer & Nir Eyal - 2023 - Bioethics 37 (8):814-821.
    In many countries, the COVID‐19 pandemic varied starkly between different racial and ethnic groups. Before vaccines were approved, some considered assigning priority access to worse‐hit racial groups. That debate can inform rationing in future pandemics and in some of the many areas outside COVID‐19 that admit of racial health disparities. However, concerns were raised that “race‐responsive” prioritizations would be ruled unlawful for allegedly constituting wrongful discrimination. This legal argument relies on an understanding of discrimination law as demanding color‐blindness. We argue (...)
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  32. More Carrots, Less Sticks: Encouraging Good Stewardship in the Global Antimicrobial Commons.Cristian Timmermann - 2023 - Health Care Analysis 31 (1):53-57.
    Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.
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  33. Voluntariness or legal obligation? An ethical analysis of two instruments for fairer global access to COVID-19 vaccines.Katja Voit, Cristian Timmermann, Marcin Orzechowski & Florian Steger - 2023 - Frontiers in Public Health 11:995683.
    Introduction: There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation. -/- Methods: The main documents discussing the two strategies are (...)
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  34. Advancing a Data Justice Framework for Public Health Surveillance.Mara Buchbinder, Eric Juengst, Stuart Rennie, Colleen Blue & David L. Rosen - 2022 - AJOB Empirical Bioethics 13 (3):205-213.
    Background Bioethical debates about privacy, big data, and public health surveillance have not sufficiently engaged the perspectives of those being surveilled. The data justice framework suggests that big data applications have the potential to create disproportionate harm for socially marginalized groups. Using examples from our research on HIV surveillance for individuals incarcerated in jails, we analyze ethical issues in deploying big data in public health surveillance. -/- Methods We conducted qualitative, semi-structured interviews with 24 people living with HIV who had (...)
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  35. Justice, Transparency and the Guiding Principles of the UK’s National Institute for Health and Care Excellence.Victoria Charlton - 2022 - Health Care Analysis 30 (2):115-145.
    The National Institute for Health and Care Excellence (NICE) is the UK’s primary healthcare priority-setting body, responsible for advising the National Health Service in England on which technologies to fund and which to reject. Until recently, the normative approach underlying this advice was described in a 2008 document entitled ‘Social value judgements: Principles for the development of NICE guidance’ (SVJ). In January 2020, however, NICE replaced SVJ with a new articulation of its guiding principles. Given the significant evolution of NICE’s (...)
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  36. "Where you live should not determine whether you live". Global justice and the distribution of COVID-19 vaccines.Göran Collste - 2022 - Ethics and Global Politics 15 (2):43-54.
    In 2020, the world faced a new pandemic. The corona infection hit an unprepared world, and there were no medicines and no vaccines against it. Research to develop vaccines started immediately and in a remarkably short time several vaccines became available. However, despite initiatives for global equitable access to COVID-19 vaccines, vaccines have so far become accessible only to a minor part of the world population. In this article, I discuss the global distribution of COVID-19 vaccines from an ethical point (...)
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  37. Reproductive Embryo Editing: Attending to Justice.Inmaculada De Melo-Martín - 2022 - Hastings Center Report 52 (4):26-33.
    The use of genome embryo editing tools in reproduction is often touted as a way to ensure the birth of healthy and genetically related children. Many would agree that this is a worthy goal. The purpose of this paper is to argue that, if we are concerned with justice, accepting such goal as morally appropriate commits one to rejecting the development of embryo editing for reproductive purposes. This is so because safer and more effective means exist that can allow many (...)
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  38. Medical AI and human dignity: Contrasting perceptions of human and artificially intelligent (AI) decision making in diagnostic and medical resource allocation contexts.Paul Formosa, Wendy Rogers, Yannick Griep, Sarah Bankins & Deborah Richards - 2022 - Computers in Human Behaviour 133.
    Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions of being (...)
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  39. We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - 2022 - Public Health Ethics 15 (1):87-103.
    In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...)
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  40. Justice and the racial dimensions of health inequalities: A view from COVID‐19.Agomoni Ganguli-Mitra, Kaveri Qureshi, Gwenetta D. Curry & Nasar Meer - 2022 - Bioethics 36 (3):252-259.
    In this paper, we take up the call to further examine structural injustice in health, and racial inequalities in particular. We examine the many facets of racism: structural, interpersonal and institutional as they appeared in the COVID-19 pandemic in the UK, and emphasize the relevance of their systemic character. We suggest that such inequalities were entirely foreseeable, for their causal mechanisms are deeply ingrained in our social structures. It is by recognizing the conventional, un-extraordinary nature of racism within social systems (...)
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  41. Good Enough? The Minimally Good Life Account of the Basic Minimum.Nicole Hassoun - 2022 - Australasian Journal of Philosophy 100 (2):330-341.
    ABSTRACT What kind of basic minimum do we owe to others? This paper defends a new procedure for answering this question. It argues that its minimally good life account has some advantages over the main alternatives and that neither the first-, nor third-, person perspective can help us to arrive at an adequate account. Rather, it employs the second-person perspective of free, reasonable, care. There might be other conditions for distributive justice, and morality certainly requires more than helping everyone to (...)
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  42. Responding to the Tragedies of Our Time - The Human Right to Health and the Virtue of Creative Resolve.Nicole Hassoun - 2022 - Global Justice: Theory Practice Rhetoric 13 (2):41-59.
    We live in tragic times. Millions are sheltering in place to avoid exacerbating the Coronavirus (COVID-19) pandemic. How should we respond to such tragedies? This paper argues that the human right to health can help us do so because it inspires human rights advocates, claimants, and those with responsibility for fulfilling the right to try hard to satisfy its claims. That is, the right should, and often does, give rise to what I call_ the virtue of creative resolve_. This resolve (...)
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  43. Scarcity, Justice, and Health Crisis Leadership.Matti Häyry - 2022 - Philosophies 7 (3):48.
    The COVID-19 pandemic has created or revealed scarcities in many domains: medical, civic, economic, and ideological. Responses to these are analyzed in the framework of a map of justice and an imperative of openness. The main argument is that whatever the view of justice chosen by public health authorities, they should be able and willing to disclose it to the citizens. Objections are considered and qualifications added, but the general conclusion is that in liberal democracies, truth-telling by those in power, (...)
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  44. Toward Informed User Decisions About Pharmacological Cognitive Enhancement.Polaris Koi - 2022 - Cambridge Quarterly of Healthcare Ethics 31 (4):545-556.
    Pharmacological cognitive enhancement (PCE) refers to the use of pharmaceuticals to improve cognitive function when that use is not intended to prevent or treat disease. Those who favour a liberal approach to PCE trust users to make informed decisions about whether enhancing is in their best interest. The author argues that making informed decisions about PCE requires a nuanced risk-benefit analysis that is not accessible to many users. Presently, the PCE use of prescription medications such as methylphenidate and modafinil is (...)
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  45. Social Exclusion, Epistemic Injustice and Intellectual Self-Trust.Jon Leefmann - 2022 - Social Epistemology 36 (1):117-127.
    This commentary offers a coherent reading of the papers presented in the special issue ‘Exclusion, Engagement, and Empathy: Reflections on Public Participation in Medicine and Technology’. Focusing on intellectual self-trust it adds a further perspective on the harmful epistemic consequences of social exclusion for individual agents in healthcare contexts. In addition to some clarifications regarding the concepts of ‘intellectual self-trust’ and ‘social exclusion’ the commentary also examines in what ways empathy, engagement and participatory sense-making could help to avoid threats to (...)
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  46. Artificial Intelligence in a Structurally Unjust Society.Ting-An Lin & Po-Hsuan Cameron Chen - 2022 - Feminist Philosophy Quarterly 8 (3/4):Article 3.
    Increasing concerns have been raised regarding artificial intelligence (AI) bias, and in response, efforts have been made to pursue AI fairness. In this paper, we argue that the idea of structural injustice serves as a helpful framework for clarifying the ethical concerns surrounding AI bias—including the nature of its moral problem and the responsibility for addressing it—and reconceptualizing the approach to pursuing AI fairness. Using AI in healthcare as a case study, we argue that AI bias is a form of (...)
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  47. Value assessment frameworks: who is valuing the care in healthcare?Jonathan Anthony Michaels - 2022 - Journal of Medical Ethics 48 (6):419-426.
    Many healthcare agencies are producing evidence-based guidance and policy that may determine the availability of particular healthcare products and procedures, effectively rationing aspects of healthcare. They claim legitimacy for their decisions through reference to evidence-based scientific method and the implementation of just decision-making procedures, often citing the criteria of ‘accountability for reasonableness’; publicity, relevance, challenge and revision, and regulation. Central to most decision methods are estimates of gains in quality-adjusted life-years, a measure that combines the length and quality of survival. (...)
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  48. Research bystanders, justice, and the state: Reframing the debate on third‐party protections in health research.Nicholas Murphy & Charles Weijer - 2022 - Bioethics 36 (8):865-873.
    Research participants are afforded protections to ensure their rights and welfare are not unduly jeopardized by research activities. Yet people who do not meet the criteria for research participant status may likewise be impacted by research activities, and ethicists argue that protections should be afforded these “research bystanders.” The standard rationale for extending protections to research bystanders contends that they are sufficiently like research participants that the ethical principles governing health research ought to extend to them. In this article we (...)
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  49. Reserve system design for allocation of scarce medical resources in a pandemic: some perspectives from the field.Parag Pathak, Govind Persad, Tayfun Sönmez & M. Utku Unver - 2022 - Oxford Review of Economic Policy 38 (4):924–940.
    Reserve systems are a tool to allocate scarce resources when stakeholders do not have a single objective. This paper introduces some basic concepts about reserve systems for pandemic medical resource allocation. At the onset of the Covid-19 pandemic, we proposed that reserve systems can help practitioners arrive at compromises between competing stakeholders. More than a dozen states and local jurisdictions adopted reserve systems in initial phases of vaccine distribution. We highlight several design issues arising in some of these implementations. We (...)
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  50. COVID-19 Vaccine Refusal and Fair Allocation of Scarce Medical Resources.Govind Persad & Emily A. Largent - 2022 - JAMA Health Forum 3 (4):e220356.
    When hospitals face surges of patients with COVID-19, fair allocation of scarce medical resources remains a challenge. Scarcity has at times encompassed not only hospital and intensive care unit beds—often reflecting staffing shortages—but also therapies and intensive treatments. Safe, highly effective COVID-19 vaccines have been free and widely available since mid-2021, yet many Americans remain unvaccinated by choice. Should their decision to forgo vaccination be considered when allocating scarce resources? Some have suggested it should, while others disagree. We offer a (...)
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