About this topic
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. Responsibility and the Recursion Problem.Ben Davies - forthcoming - Ratio.
    A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...)
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  2. 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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  3. We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - forthcoming - Public Health Ethics.
    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 randomization procedures to allocate scarce life-saving resources in fewer cases than their proponents maintain and that the relevant decision makers should typically allocate scarce life-saving resources directly to (...)
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  4. Two Conceptions of Solidarity in Health Care.L. Chad Horne - forthcoming - Social Theory and Practice.
    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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  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. 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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  10. Why We Should Stop Using Animal-Derived Products on Patients Without Their Consent.Daniel Rodger - forthcoming - Journal of Medical Ethics.
    Medicines and medical devices containing animal-derived ingredients are frequently used on patients without their informed consent, despite a significant proportion of patients wanting to know if an animal-derived product is going to be used in their care. Here, I outline three arguments for why this practice is wrong. Firstly, I argue that using animal-derived medical products on patients without their informed consent undermines respect for their autonomy. Secondly, it risks causing non-trivial psychological harm. Thirdly, it is morally inconsistent to respect (...)
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  11. Justice, the Basic Social Contract and Health Care.Robert M. Veatch - forthcoming - Contemporary Issues in Bioethics.
  12. 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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  13. How the Past Matters for the Future: A Luck Egalitarian Sustainability Principle for Healthcare Resource Allocation.Andreas Albertsen - 2021 - Journal of Medical Ethics 47 (2):102-103.
    Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...)
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  14. What’s the Appropriate Target of Allocative Justification?Zara Anwarzai & Ricky Mouser - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):167-168.
    Building on work by Peterman, Aas, and Wasserman (2021), we modify their prospective benefit analysis to include only medically-relevant information about patients as persons without reference to their broader lives. Because patients (not their lives) must be treated equally, we argue that patients are the appropriate targets of allocative justification. We go on to challenge some of our current data-collection practices on this basis.
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  15. Precautionary Personhood: We Should Treat Patients with Disorders of Consciousness as Persons.Matthew Braddock - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):162-164.
    Should we allocate costly health care to patients diagnosed with disorders of consciousness (DoC), such as patients diagnosed as being in a vegetative state or minimally conscious state? Peterson, Aas, and Wasserman (2021) argue that we should in their paper “What justifies the allocation of health care resources to patient with disorders of consciousness?” Their key insight is that the expected benefits to this patient population helps to justify such allocations. However, their insight is attached to a consequentialist framework aimed (...)
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  16. Mistrust and Inconsistency During COVID-19: Considerations for Resource Allocation Guidelines That Prioritise Healthcare Workers.Alexander T. M. Cheung & Brendan Parent - 2021 - Journal of Medical Ethics 47 (2):73-77.
    As the USA contends with another surge in COVID-19 cases, hospitals may soon need to answer the unresolved question of who lives and dies when ventilator demand exceeds supply. Although most triage policies in the USA have seemingly converged on the use of clinical need and benefit as primary criteria for prioritisation, significant differences exist between institutions in how to assign priority to patients with identical medical prognoses: the so-called ‘tie-breaker’ situations. In particular, one’s status as a frontline healthcare worker (...)
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  17. Afro-Communitarianism and the Role of Traditional African Healers in the COVID-19 Pandemic.Luís Cordeiro-Rodrigues & Thaddeus Metz - 2021 - Public Health Ethics 14 (1):59-71.
    The COVID-19 pandemic has brought significant challenges to healthcare systems worldwide, and in Africa, given the lack of resources, they are likely to be even more acute. The usefulness of Traditional African Healers in helping to mitigate the effects of pandemic has been neglected. We argue from an ethical perspective that these healers can and should have an important role in informing and guiding local communities in Africa on how to prevent the spread of COVID-19. Particularly, we argue not only (...)
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  18. There is No Race Problem: Theorizing the Absence of Racial and Ethnic Disparity Data in Scotland After COVID-19.Tommy J. Curry - 2021 - In Scotland After the Virus. Edinburgh, UK: pp. 195-202.
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  19. ‘Personal Health Surveillance’: The Use of mHealth in Healthcare Responsibilisation.Ben Davies - 2021 - Public Health Ethics 14 (3):268-280.
    There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...)
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  20. Grow the Pie, or the Resource Shuffle? Commentary on Munthe, Fumagalli and Malmqvist.Ben Davies - 2021 - Journal of Medical Ethics 47 (2):98-99.
    John Rawls’s ‘just savings’ principle is among the better-known attempts to outline how we should balance the claims of the present with the claims of the future generations on resources. A central element of Rawls’s approach involves endorsing a sufficientarian approach, where our central obligation is to ensure ‘the conditions needed to establish and to preserve a just basic structure’.1 This engaging paper by Christian Munthe, Davide Fumagalli and Erik Malmqvist does not explicitly mention Rawls’s work on this issue.2 Still, (...)
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  21. Healthcare, Responsibility and Golden Opportunities.Gabriel De Marco, Thomas Douglas & Julian Savulescu - 2021 - Ethical Theory and Moral Practice 1 (3).
    When it comes to determining how healthcare resources should be allocated, there are many factors that could—and perhaps should—be taken into account. One such factor is a patient’s responsibility for his or her illness, or for the behavior that caused it. Policies that take responsibility for the unhealthy lifestyle or its outcomes into account—responsibility-sensitive policies—have faced a series of criticisms. One holds that agents often fail to meet either the control or epistemic conditions on responsibility with regard to their unhealthy (...)
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  22. Radical Responsibility Beyond Empathy: Interreligious Resources Against Liberal Distortions of Nursing Care.Nathan Eric Dickman - 2021 - Nursing Philosophy 1 (1 Online first).
    In this paper, I bring together Jewish and Buddhist philosophical resources to develop a notion of radical responsibility that can confront a complicity within nursing and health care between empathy and (neo)liberal white supremacist hegemony. My inspiration comes from Angela Davis's call for building coalitions to advance struggles for peace and justice. I proceed as follows. First, I note ways phenomenology clarifies empathy's seeming foundational role in nursing care, and how such a formulation can be complicit with assumptions about private (...)
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  23. Nursing is Never Neutral: Political Determinants of Health and Systemic Marginalization.Nathan Eric Dickman & Roxana Chicas - 2021 - Nursing Inquiry 1 (Online First e12408):1-13.
    The nursing community in the United States polarized in September 2020 between Dawn Wooten's whistleblowing about forced hysterectomies at an immigration center in Georgia and the American Nurses Association's refusal to endorse a presidential candidate despite the Trump administration's mounting failures to address the public health crisis posed by the COVID‐19 pandemic. This reveals a need for more attention to political aspects of health outcome inequities. As advocates for health equity, nurses can join in recent scholarship and activism concerning the (...)
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  24. The ”Foreign” Virus?Magnus Egan & Attila Tanyi - 2021 - Etikk I Praksis - Nordic Journal of Applied Ethics 15 (2):29-47.
    In response to the Covid pandemic the Norwegian government put in place the strictest border closures in Norwegian modern history, restricting entry to most foreign nationals. The Prime Minister, Erna Solberg, justified these restrictions with reference to the rise of new Covid variants, and the need to limit visitors to Norway as much as possible. In this paper we critically examine both the justification given for the border closure, and explore the possible adverse effects this closure might bring about. We (...)
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  25. Understanding Government Decisions to De-Fund Medical Services Analyzing the Impact of Problem Frames on Resource Allocation Policies.Mark Embrett & Glen E. Randall - 2021 - Health Care Analysis 29 (1):78-98.
    Many medical services lack robust evidence of effectiveness and may therefore be considered “unnecessary” care. Proactively withdrawing resources from, or de-funding, such services and redirecting the savings to services that have proven effectiveness would enhance overall health system performance. Despite this, governments have been reluctant to discontinue funding of services once funding is in place. The focus of this study is to understand how the framing of an issue or problem influences government decision-making related to de-funding of medical services. To (...)
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  26. Love Thy Neighbour? Allocating Vaccines in a World of Competing Obligations.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (12):20-20.
    Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there (...)
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  27. Phantom Premise and a Shape-Shifting Ism: Reply to Hassoun.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (11).
    In ‘Against vaccine nationalism’, Nicole Hassoun misrepresents our argument, distorts our position and ignores crucial distinctions we present in our article, ‘Love thy neighbor? Allocating vaccines in a world of competing obligations’. She has created a strawman that does not resemble our position. In this reply, we address two features of ‘Against vaccine nationalism’. First, we address a phantom premise. Hassoun misattributes to us a thesis, according to which citizen-directed duties are stronger than noncitizen-directed duties. This thesis is a figment (...)
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  28. Medical Cosmopolitanism: The Global Extension of Justice in Healthcare Practice.Luvuyo Gantsho & Christopher S. Wareham - 2021 - Developing World Bioethics 21 (3):131-138.
    Developing World Bioethics, Volume 21, Issue 3, Page 131-138, September 2021.
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  29. Ordeals, Women and Gender Justice.Anca Gheaus - 2021 - Economics and Philosophy 37 (1):8-22.
    Rationing health care by ordeals is likely to have different effects on women and men, and on distinct groups of women. I show how such putative effects of ordeals are relevant to achieving gender justice. I explain why some ordeals may disproportionately set back women’s interest in discretionary time, health and access to health care, and may undermine equality of opportunity for positions of advantage. Some ordeals protect the interests of the worse-off women yet set back the interests of better-off (...)
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  30. Continuous Glucose Monitoring as a Matter of Justice.Steven R. Kraaijeveld - 2021 - HEC Forum 33 (4):345-370.
    Type 1 diabetes (T1D) is a chronic illness that requires intensive lifelong management of blood glucose concentrations by means of external insulin administration. There have been substantial developments in the ways of measuring glucose levels, which is crucial to T1D self-management. Recently, continuous glucose monitoring (CGM) has allowed people with T1D to keep track of their blood glucose levels in near real-time. These devices have alarms that warn users about potentially dangerous blood glucose trends, which can often be shared with (...)
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  31. Incorporating Health Equity Into COVID-19 Reopening Plans: Policy Experimentation in California.Emily A. Largent, Govind Persad, Michelle M. Mello, Danielle M. Wenner, Daniel B. Kramer, Brownsyne Tucker Edmonds & Monica Peek - 2021 - American Journal of Public Health 1 (1):e1-e8.
    California has focused on health equity in the state’s COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California’s 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier’s test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must (...)
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  32. Social Exclusion, Epistemic Injustice and Intellectual Self-Trust.Jon Leefmann - 2021 - Social Epistemology 22 (ahaed of print):1-11.
    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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  33. What Does an African Ethic of Social Cohesion Entail for Social Distancing?Thaddeus Metz - 2021 - Developing World Bioethics 21 (1):7-16.
    The most prominent strand of moral thought in the African philosophical tradition is relational and cohesive, roughly demanding that we enter into community with each other. Familiar is the view that being a real person means sharing a way of life with others, perhaps even in their fate. What does such a communal ethic prescribe for the coronavirus pandemic? Might it forbid one from social distancing, at least away from intimates? Or would it entail that social distancing is wrong to (...)
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  34. Against Draconian Penalties for Covid-19 Quarantine Infringements.Elias Moser - 2021 - Etikk I Praksis - Nordic Journal of Applied Ethics 2:17-28.
    In 2020, after the first Covid-19 lockdown, several countries implemented a policy of contact tracing and self-isolating for individuals who crossed borders or came into contact with infected people. To enforce these restrictions, some states imposed very harsh monetary penalties for people who violated them. Behind these harsh fines lies an instrumental rationale. They allow the state to avoid implementing a system of labor-intensive and costly surveillance and enforcement. In this article I argue that such severe penalties are extremely unjust. (...)
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  35. Sustainability Principle for the Ethics of Healthcare Resource Allocation.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2021 - Journal of Medical Ethics 47 (2):90-97.
    We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We (...)
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  36. Difficult Trade-Offs in Response to COVID-19: The Case for Open and Inclusive Decision-Making.Ole Frithjof Norheim, Joelle Abi-Rached, Liam Kofi Bright, Kristine Baeroe, Octavio Ferraz, Siri Gloppen & Alex Voorhoeve - 2021 - Nature Medicine 27:10-13.
    We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.
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  37. Prioritizing the Prevention of Early Deaths During Covid‐19.Govind Persad - 2021 - Hastings Center Report 51 (2):42-43.
    In this Correspondence, I argue that given that scarcity has existed both for critical care resources and for vaccines, allocating critical care resources to prioritize the prevention of early COVID-19 deaths (i.e. COVID-19 deaths among younger patients) could valuably counterbalance the disproportionate exclusion of minority patients and those with life shortening disabilities that age-based vaccine allocation produces. -/- Covid-19 deaths early in life have overwhelmingly befallen minorities and people with life-shortening disabilities. Policies preventing early deaths prevent an outcome widely recognized (...)
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  38. Improving the Ethical Review of Health Policy and Systems Research: Some Suggestions.Govind Persad - 2021 - Journal of Law, Medicine and Ethics 49 (1):123-125.
    Consistent and well-designed frameworks for ethical oversight enable socially valuable research while forestalling harmful or poorly designed studies. I suggest some alterations that might strengthen the valuable checklist Rattani & Hyder propose for the ethical review of health policy and systems research (HPSR), or prompt future work in the area.
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  39. Public Perspectives on COVID-19 Vaccine Prioritization.Govind Persad, Ezekiel J. Emanuel, Samantha Sangenito, Aaron Glickman, Steven Phillips & Emily A. Largent - 2021 - JAMA Network Open 4:e217943.
    In this survey study of 4735 US adults, respondents of all demographic and political affiliations agreed with prioritizing COVID-19 vaccine access for health care workers, adults of any age with serious comorbid conditions, frontline workers (eg, teachers and grocery workers), and Black, Hispanic, Native American, and other communities that have been disproportionately affected by COVID-19. Older adult respondents were less likely than younger respondents to list healthy people older than 65 years as 1 of their top 4 priority groups. These (...)
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  40. Conditioning Principles: On Bioethics and The Problem of Ableism.Joel Michael Reynolds - 2021 - In Elizabeth Victor & Laura Guidry Grimes (eds.), Applying Nonideal Theory to Bioethics: Living and Dying in a Nonideal World. Springer. pp. 99-118.
    This paper has two goals. The first is to argue that the field of bioethics in general and the literature on ideal vs. nonideal theory in particular has underemphasized a primary problem for normative theorizing: the role of conditioning principles. I define these as principles that implicitly or explicitly ground, limit, or otherwise determine the construction and function of other principles, and, as a result, profoundly impact concept formation, perception, judgment, and action, et al. The second is to demonstrate that (...)
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  41. The Complex Relationship Between Disability Discrimination and Frailty Scoring.Joel Michael Reynolds, Charles E. Binkley & Andrew Shuman - 2021 - American Journal of Bioethics 21 (11):74-76.
    In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...)
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  42. How Can We Decide a Fair Allocation of Healthcare Resources During a Pandemic?Cristina Roadevin & Harry Hill - 2021 - Journal of Medical Ethics 47 (12):84-84.
    Whenever the government makes medical resource allocation choices, there will be opportunity costs associated with those choices: some patients will have treatment and live longer, while a different group of patients will die prematurely. Because of this, we have to make sure that the benefits we get from investing in treatment A are large enough to justify the benefits forgone from not investing in the next best alternative, treatment B. There has been an increase in spending and reallocation of resources (...)
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  43. Religious Accommodation in Bioethics and the Practice of Medicine.William R. Smith & Robert Audi - 2021 - Journal of Medicine and Philosophy 46 (2):188-218.
    Debates about the ethics of health care and medical research in contemporary pluralistic democracies often arise partly from competing religious and secular values. Such disagreements raise challenges of balancing claims of religious liberty with claims to equal treatment in health care. This paper proposes several mid-level principles to help in framing sound policies for resolving such disputes. We develop and illustrate these principles, exploring their application to conscientious objection by religious providers and religious institutions, accommodation of religious priorities in biomedical (...)
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  44. Centrifugal and Centripetal Thinking About the Biopsychosocial Model in Psychiatry.Kathryn Tabb - 2021 - European Journal of Analytic Philosophy 17 (2):(M3)5-28.
    The biopsychosocial model, which was deeply influential on psychiatry following its introduction by George L. Engel in 1977, has recently made a comeback. Derek Bolton and Grant Gillett have argued that Engel’s original formulation offered a promising general framework for thinking about health and disease, but that this promise requires new empirical and philosophical tools in order to be realized. In particular, Bolton and Gillett offer an original analysis of the ontological relations between Engel’s biological, social, and psychological levels of (...)
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  45. Aligning Patient’s Ideas of a Good Life with Medically Indicated Therapies in Geriatric Rehabilitation Using Smart Sensors.Cristian Timmermann, Frank Ursin, Christopher Predel & Florian Steger - 2021 - Sensors 21 (24):8479.
    New technologies such as smart sensors improve rehabilitation processes and thereby increase older adults’ capabilities to participate in social life, leading to direct physical and mental health benefits. Wearable smart sensors for home use have the additional advantage of monitoring day-to-day activities and thereby identifying rehabilitation progress and needs. However, identifying and selecting rehabilitation priorities is ethically challenging because physicians, therapists, and caregivers may impose their own personal values leading to paternalism. Therefore, we develop a discussion template consisting of a (...)
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  46. Triage and Justice in an Unjust Pandemic: Ethical Allocation of Scarce Medical Resources in the Setting of Racial and Socioeconomic Disparities.Benjamin Tolchin, Sarah C. Hull & Katherine Kraschel - 2021 - Journal of Medical Ethics 47 (3):200-202.
    Shortages of life-saving medical resources caused by COVID-19 have prompted hospitals, healthcare systems, and governmentsto develop crisis standards of care, including 'triage protocols' to potentially ration medical supplies during the public health emergency. At the same time, the pandemic has highlighted and exacerbated racial, ethnic, and socioeconomic health disparities that together constitute a form of structural racism. These disparities pose a critical ethical challenge in developing fair triage systems that will maximize lives saved without perpetuating systemic inequities. Here we review (...)
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  47. The Ethics of Grandfather Clauses in Healthcare Resource Allocation.Gry Wester, Leah Zoe Gibson Rand, Christine Lu & Mark Sheehan - 2021 - Bioethics 35 (2):151-160.
    A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excellence (NICE) in the United Kingdom. NICE provides evidence‐based guidance on healthcare technologies and public health interventions that influence resource allocation decisions in the National Health Service (NHS) and the broader public (...)
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  48. Assessing the Wellbeing Impacts of the COVID-19 Pandemic and Three Policy Types: Suppression, Control, and Uncontrolled Spread.Matthew D. Adler, Richard Bradley, Maddalena Ferranna, Marc Fleurbaey, James Hammitt & Alex Voorhoeve - 2020 - Thinktank 20 Policy Briefs for the G20 Meeting in Saudi Arabia 2020.
    The COVID-19 crisis has forced a difficult trade-off between limiting the health impacts of the virus and maintaining economic activity. Welfare economics offers tools to conceptualize this trade-off so that policy-makers and the public can see clearly what is at stake. We review four such tools: the Value of Statistical Life (VSL); the Value of Statistical Life Years (VSLYs); Quality-Adjusted Life-Years (QALYs); and social welfare analysis, and argue that the latter are superior. We also discuss how to choose policies that (...)
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  49. Rural Bioethics: The Alaska Context.Fritz Allhoff & Luke Golemon - 2020 - HEC Forum 32 (4):313-331.
    With by far the lowest population density in the United States, myriad challenges attach to healthcare delivery in Alaska. In the “Size, Population, and Accessibility” section, we characterize this geographic context, including how it is exacerbated by lack of infrastructure. In the “Distributing Healthcare” section, we turn to healthcare economics and staffing, showing how these bear on delivery—and are exacerbated by geography. In the “Health Care in Rural Alaska” section, we turn to rural care, exploring in more depth what healthcare (...)
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  50. COVID-19 and Mental Health: Government Response and Appropriate Measures.Genevieve Bandares-Paulino & Randy A. Tudy - 2020 - Eubios Journal of Asian and International Bioethics 30 (7):378-382.
    As governments around the world imposed lockdowns or stay-at-home measures, people began to feel the stress as time dragged on. There were already reports on some individuals committing suicide. How do governments respond to such a phenomenon? Our main focus is the Philippine government and how it responded to the COVID-19 pandemic. In this paper, we argue that the problem with COVID-19 went forth just dealing with physical health. First, people suffer not just from being infected but the psychological stress (...)
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