Public Health Ethics 12 (2):133-144 (2019)

Ben Davies
Oxford University
Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health.
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DOI 10.1093/phe/phz008
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References found in this work BETA

Freedom of the Will and the Concept of a Person.Harry G. Frankfurt - 1971 - Journal of Philosophy 68 (1):5-20.
The Theory and Practice of Autonomy.Gerald Dworkin - 1988 - Cambridge University Press.
Freedom of the Will and the Concept of a Person.Harry Frankfurt - 2004 - In Tim Crane & Katalin Farkas (eds.), Metaphysics: A Guide and Anthology. Oxford University Press.
Health, Luck, and Justice.Shlomi Segall - 2009 - Princeton University Press.

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Citations of this work BETA

Justice, Inequality, and Health.Gopal Sreenivasan - 2009 - Stanford Encyclopedia of Philosophy.
Precision Medicine and the Fragmentation of Solidarity.Leonard M. Fleck - forthcoming - Medicine, Health Care and Philosophy.

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