The recent history of the Canadian healthcare system has been increasingly one of shortages. There are delays for services that impose risk and hardship, disparities between the accessibility of healthcare for rural versus urban populations, and a lack of adequate coverage for or access to prescription drugs, diagnostic services, and homecare. Add to these problems shortages of healthcare providers—in particular, physicians and nurses—and state-of-the-art equipment, and we can understand the universal agreement that the Canadian healthcare system (...) must change. The only question is how. Some argue for modifications within the basic framework of a one-tier single-payer system; others for more radical reform that will allow for infusions of money by expedients such as user fees, extra billing, or a full-blooded second tier where one can buy any healthcare one wants. a. (shrink)

Richard Lamm is an eloquent and insistent advocate for healthcare reform. In his paper, he argues that if reform is to be effective, a radical metamorphosis in the values underlying our present system must take place. “New realities” have made the “old values” unsustainable. Unless they are replaced by “new values,” we face a future of disastrous overspending, gross inequities in accessibility, poorer health for many, and more expensive dying.

Narrative medicine is one of medicine’s most important internal reforms, and it should be a critical dimension of healthcare debate. Healthcare reform must eventually ask not only how do we pay for healthcare and how do we distribute it, but more fundamentally, what kind of healthcare do we want? It must ask, in short, what are the goals of medicine? Yet, even though narrative medicine is crucial to answering these pivotal and inescapable questions, it is (...) not easy to describe. Many of its core claims go against the grain of common sense thinking about medicine. This article argues that the best way to understand narrative medicine is to tell a story that puts its emergence in historical context. (shrink)

Healthcare reforms in India have been a much-debated issue in the recent past. While the debate has focused mainly on the right to healthcare, another by-product that has evolved out of the debate was the current problem of medical malpractice and the healthcare law. The last decade has seen an increase in the healthcare facilities in the country. This, however, has come with a bulk of medical error cases which the courts have entertained. According to reports, (...) there has been an increase in medical litigation cases by 400% in the last decade. There are about 5.2 million cases of medical error in the country every year. While there exists a standard legal system in the country which entertains such complaints of medical malpractice, the attempt by regulators and medical practitioners should be to reduce these cases. This paper seeks to analyze the extent to which medical malpractice cases affect consumers. It analyzes the existing medical liability system which has mainly evolved through the jurisprudence laid down by the English courts and critiques it. It also looks into the major reasons for such medical mishaps. Authors argue that a “No-Fault” system may give better outcomes. They analyze this by looking at the no-fault liability model implemented in New Zealand. Narratives of no-fault liability being implemented in India have also been used. These are showcased from instances of Motor Vehicles Act, 1988, and Clinical Trial regulations. It is also argued that a by-product of a no-fault liability system is stringent regulations which are used to reduce the possibility of medical mishaps altogether. Lastly, the possible problems of the no-fault liability system are discussed in the paper. (shrink)

Why civility matters -- It starts with you!: developing self-awareness -- Do what you say and say what you mean: personal and professional integrity -- Good fences make great neighbors: building professional relationships -- Working in the salad bowl: the importance of teamwork -- Eliminate gossip and bullying: the bully-free workplace pledge -- You can't always get what you want: conflict resolution -- Taking it to the extreme: dealing with extreme incivility -- Paving the path to civility: the next step.

The 2010 national health reform law was written with heavy input from insurance and pharmaceutical corporations. Unfortunately, the law will leave 24 million Americans uninsured and tens of millions more woefully underinsured, such that a major illness would bankrupt them. Other developed nations have used non-profit, single-payer national health insurance to fully cover all of their residents for all needed medical care. By failing to enact such a program, the state has abdicated its responsibility to protect human health to (...) profit-seeking corporations. (shrink)

Chile has achieved great success in terms of growth and development. However, growing inequalities exist in relation to income and health status. The previous Chilean government began to reform the healthcare system with the aim of reducing health inequities. What is meant by “equity” in this context? What is the extent of the equity aimed for? A normative framework is required for public policy-makers to consider ideas about fairness in their decisions about healthcare reform. This paper (...) aims to discuss the main features of the Chilean healthcare reform and their implications for such a normative framework. (shrink)

Contemporary bioethics begins with the perception that medical values are a matter of public, rather than merely professional, interest. Such was the message of delegates in Helsinki and of the New Jersey court that decided for Quinlan. It is a theme that lurks within almost every major bioethical treatise since the first edition of PrinciplesofBioethics. This perception also undergirds the increasingly popular suggestion that moral authority in the patient-physician relationship resides neither in the medical profession, nor in the singular will (...) of the patient, but in moral communities that link both parties with higher social orders. (shrink)

In speculating on the motives for government, English philosopher Thomas Hobbes identified the pervasive role of fear and the danger of violent death, holding famously that where no government prevails to secure physical safety and property, there can also be no enduring knowledge, art, or civilization—leaving human lives “solitary, poore [sic], nasty, brutish and short.”.

This paper examines the implications of the General Agreement on Trade in Services (GATS), the World Trade Organization’s agreement governing trade in health-related services, for health policy and healthcare reform in the United States. The paper describes the nature and scope of US obligations under the GATS, the ways in which the trade agreement intersects with domestic health policy, and the institutional factors that mediate trade-offs between health and trade policy. The analysis suggests that the GATS provisions on (...) market access, national treatment and domestic regulation, which are designed to eliminate ‘regulatory barriers’ to global trade in health services, limit the range of options that state and federal regulators and legislative bodies can employ to regulate the health sector and implement healthcare reforms. As such, the paper identifies the broader social and ethical implications of free trade policy. (shrink)

In 2014, the United States health care industry produced an estimated 480 million metric tons of carbon dioxide ; nearly 8% of the country's total emissions. The importance of sustainability in health care — as a business reliant on fossil fuels for transportation, energy, and operational functioning — is slowly being recognized. These efforts to green health care are incomplete, since they only focus on health care structures. The therapeutic relationship is the essence of health care — not the buildings (...) that contain the practice. As such, this article will first postulate reasons for a lack of environmental sustainability in US health care. Second, the article will focus on current green health care initiatives in the United States in which patients and physicians participate. Third, the rationale for participation in green initiatives will be explained. Fourth, the article will propose that, based on the environmental values of patients and physicians, health care insurance plans and health care insurance companies can be targeted for green health care reform, thereby closing the loop of sustainable health care delivery. (shrink)

It should surprise no one familiar with the problems in rural healthcare that 87% of a randomly selected sample of Nebraskans recently called for either fundamental or complete change of the healthcare system. Rural communities in the United, States have been hard hit by the rising cost of healthcare at a time of economic and demographic decline. Unable to sustain operating costs and personnel needs, rural hospitals and medical, practices have been forced to close their doors at (...) an, alarming rate.Furthermore, rural patients are decreasingly able to afford what services are available to them. Most must purchase insurance privately because they are unlikely to be insured through employment. Therefore, they pay dearly because they are not eligible for corporate rates and because insurance companies use experience instead of community rating to assess risk. (shrink)

For the last fifty years, the United States healthcare system has done an extremely poor job of delivering healthcare in a just and fair manner. The United States holds the dubious distinction of being the only industrialized nation in the world lacking provisions to ensure universal coverage. We attempt to provide some of the reasons this dysfunctional system has persisted and show that healthcare should not be a commodity. We begin with a brief historical overview of (...) class='Hi'>healthcare delivery in the United States since WWII. This is followed by a critical analysis of the for-profit model including reasons to support the view that healthcare should not be a free market commodity. We also demonstrate how special interest groups have been able to win support for their practices based on propaganda rather than fact. A brief analysis of the Affordable Care Act is offered along with critical comments regarding its ineffectiveness. We conclude with a brief overview of international approaches that have resulted in universal coverage and suggest the United States ought to adopt an approach similar to those outlined so that it no longer stands as the only industrialized nation to ignore the glaring problems that exist. (shrink)

Using the conceptual lenses offered by the ideational and cultural path taken in the health care arena, this article attempts to explain the trajectory of recent major health care reforms in Italy and the reasons for their failure, as well as providing some directions for successful intervention. A diachronic analysis of the relatively under-investigated phenomenon of health care reforms in Italy is carried out, drawing on a systematic review of the Italian and international literature combined with the research work carried (...) out by the Author. For all the three major health reforms examined, a significant gap between the authoritative policy choices taken and the overall implementation, in terms of process and system changes, can be observed, determining a growing distance between the theoretical efficiency and the practical effectiveness of the Italian National Health Service (NHS) as well as its detachment from the social system. The main obstacle to effective reform seems to be the cultural hegemony of the administrative-managerial and the biomedical paradigms, which, by reinforcing one another, yielded infertile ground for renewing in a post-modern sense the Italian NHS. The various Reforms have not been conceived to break such a positivistic monopoly in that they did not promote cultural or educational intervention. In this context, intervention that acts at a cultural level, such as reforming university education for physicians and managers or devising immigration policies to attract adequately acculturated people to the Italian NHS, seems to be the most promising. (shrink)

Abstract“Comprehensive Healthcare for America” is a largely single-payer reform proposal that, by applying the insights of behavioral economics, may be able to rally patients and clinicians sufficiently to overcome the opposition of politicians and vested interests to providing all Americans with less complicated and less costly access to needed healthcare.

The increasing costs of healthcare delivery led to different political and administrative approaches trying to preserve the core values of the welfare state. This approach has well documented weaknesses namely with regard to healthcare rationing. The objective of this paper is to evaluate if independent healthcare regulation is an important tool with regard to the construction of fair processes for setting limits to healthcare. Methodologically the authors depart from Norman Daniels’ and James Sabin’s theory of accountability (...) for reasonableness and try to determine if new regulatory models—namely independent agencies—perform better with regard to the public disclosure of the reasons and rationales of healthcare rationing. In publicly financed healthcare systems independent regulation is an important tool to assure fair and reasonable procedures of prioritising services. In accordance with the principle of public accountability, independent regulatory agencies are particularly well suited to assure publicity of the decision-making processes, relevance of the rationale involved and particularly mechanisms for challenge and dispute resolution regarding limit setting decisions. It follows that independent healthcare regulation could be regarded not only as an instrument for performance improvement but also as a tool of social justice. The authors conclude by stating that accountability for reasonableness should be regarded as a landmark of any healthcare reform. And therefore regulators have the social task of assuring that the rationales for limit-setting decisions are clearly accessible to the public. (shrink)

Background Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. Objectives The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Methods Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six (...) long-term care institutions. Results With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of ‘need’ is transformed into the principle of ‘economic demand’. Conclusion Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care. (shrink)

Healthcare professionals decide wisely about personalized medicine, treatment plans, and resource allocation by utilizing big data analytics and machine learning. To guarantee that algorithmic recommendations are impartial and fair, however, ethical issues relating to prejudice and data privacy must be taken into account. Big data analytics and machine learning have a great potential to disrupt healthcare, and as these technologies continue to evolve, new opportunities to reform healthcare and enhance patient outcomes may arise. In order to (...) investigate the patient’s outcomes with empirical evidence, this research was conducted using an online survey to incorporate healthcare professionals, patient’s reviews, and clinical staff. The data were analyzed using SmartPLS 4.0 to predict the structural model. The findings revealed a direct impact as positive influence of using machine learning on healthcare performance and patient outcomes through big data analytics. Moreover, it is evident that this can lead to personalized treatment plans, early interventions, and improved patient outcomes. Additionally, big data analytics can help healthcare providers optimize resource allocation, improve operational efficiency, and reduce costs. The impact of big data analytics on patient outcome and healthcare performance is expected to continue to grow, making it an important area for investment and research. (shrink)

Last year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. As a result, healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning (...) its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine's most ethically rich and challenging fields. Bioethics' distancing from mental illness is perhaps best explained by two overarching themes: 1) An intrinsic opposition between approaches to personhood rooted in Bioethics' early efforts to protect the competent individual from abuses in the research setting; and 2) Structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics' relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider. (shrink)

In September 1994, theNew York Timescarried a front page article declaring healthcare reform dead in Congress. The obituary on healthcare followed a Congressional decision not to pursue the issue further in 1994. Although Congress and the President will likely revisit healthcare reform during 1995, the choices may be between various incremental steps, rather than substantive changes to bring about universal coverage.

Reform in public health: where does it take nursing?The Australian healthcare system is undergoing changes that are impacting tangibly on professional nursing practice. While the evidence is clear that the changes pose a challenge to maintaining standards amidst resource cuts and restructuring, the processes through which these changes occur and the decisions which drive the reforms remain complex and largely obscure. This paper intends to stimulate further thinking and debate among nurses about the effects of these reforms on (...) the conduct of practice, both in terms of our emerging discipline and our ability to conduct clinical nursing practice. It offers a way of understanding the policy ‘reform’ process through an application of policy analysis grounded in critical social theory. The discussion sets out to apply these analytical propositions to specific events that constitute examples of change in the nursing workplace, and to focus on the implications for nurses and health service clientele. (shrink)

Traditionally, healthcare workers have had the right to refuse to participate in abortions or physician-assisted suicide, but more recently there has been a movement in white Evangelical circles to expand these rights to include the refusal of any treatment at all to same-sex couples or their children, transgender individuals, or others who offend the provider’s moral sensibilities. Religious freedom of conscience exists in an uneasy tension with laws protecting equal rights in a liberal polity, and it is a particularly (...) fraught question in the context of medicine, where providers’ consciences must be balanced against patients’ rights to access appropriate care. This article examines the refusal of care to classes of people, usually classes defined by various sexual issues with which the caregivers disagree. This expands conscientious refusals from the traditional concept of responses to actions and instead directs it at specific types of people. The article draws on Reformed thought to argue that such refusals are not justified and are, in fact, both a profound misreading of Christian morality and a new and dangerously expansive account of the right to conscientious refusal in medicine. (shrink)

At an early stage of its foundation, new China became clear about the nature of public welfare and quickly developed medical and health services, which was well received by the World Health Organization. The marketization and the reduction of input into medical and health services from the 1980s created severe adverse consequences. After the SARS' outbreak in 2003, China started to give serious consideration to its medical and health system, and to work at developing medical and health services. The new (...) healthcare reform launched in 2009 re-emphasizes fairness and public welfare, and China's achievements have been remarkable. Of course, there are still many problems to be solved in the reform, which also paves the way for increasing the reform in future. (shrink)

In recent years, policy debates in the United States have focused heavily on rising healthcare costs and what measures can be taken to ensure greater provision of healthcare to individuals of limited means. Much of the rhetoric on this subject has taken on an explicitly moral character, and one common sentiment is that healthcare is or should be viewed as a basic human right. However, the notion of a right to healthcare has not been well articulated, (...) and critics have failed to distinguish between legal and moral rights. Additionally, there are numerous problems inherent to viewing healthcare as a basic human right-many of which are in direct conflict with distinctly American conceptualizations of rights. The present paper reviews the debate over “rights”-both legal and natural-to healthcare, and argues that problems associated with natural rights arguments render them severely compromised. Instead, market systems commonly accepted in American society may be better suited to reducing healthcare costs and increasing access to services in the United States. (shrink)

Arguments both in favor and against including undocumented immigrants in healthcare reform abound. However, many of these arguments, including ones that are favorable towards immigrants, are ethically problematic, and for the same reason; namely, that they either support or deny the inclusion of undocumented immigrants in healthcare reform based on their perceived level of desert, due to their alleged contribution to our social utility, or lack thereof. This encourages gauging the lives and worth of undocumented immigrants (...) in terms of their productivity or output, rather than viewing them as intrinsically valuable human beings. This, in turn, contributes to the instrumentalization of undocumented immigrants’ welfare; for even arguments in favor of including them in healthcare reform encourage viewing them as, in Kantian language, mere means instead of ends in themselves. In this paper, I will be critical of arguments that either seek to exclude or include undocumented immigrants from healthcare reform or access based on social utility and will, instead, champion arguments in favor of inclusion that rely on fostering a sense of solidarity and identification amongst citizens and migrants. (shrink)

To contribute to our understanding of the relationship between philosophical ideas and medical and healthcare models. A diachronic analysis is put in place in order to evaluate, from an innovative perspective, the influence over the centuries on medical and healthcare models of two philosophical concepts, particularly relevant for health: how Man perceives his identity and how he relates to Nature. Five epochs are identified—the Archaic Age, Classical Antiquity, the Middle Ages, the Modern Age, the ‘Postmodern’ Era—which can be (...) seen, à la Foucault, as ‘fragments between philosophical fractures’. From a historical background perspective, up to the early 1900s progress in medical and healthcare models has moved on a par with the evolution of philosophical debate. Following the Second World War, the Health Service started a series of reforms, provoked by anti-positivistic philosophical transformations. The three main reforms carried out however failed and the medical establishment remained anchored to a mechanical, reductionist approach, perfectly in line with the bureaucratic stance of the administrators. In this context, future scenarios are delineated and an anthropo-ecological model is proposed to re-align philosophy, medicine and health care. (shrink)

The healthcare crisis that has developed in the last two decades during China's economic reform has caused healthcare and hospital financing reforms to be largely experienced by patients as a crisis in the patient–healthcare professional relationship (PPR) at the bedside. The nature and magnitude of this crisis were epitomized by the "Harbin Scandal"—an incident that took place in August 2005 in a Harbin teaching hospital in which the family of an elderly patient hospitalized in the intensive (...) care unit (ICU) for 66 days paid over RMB ¥6 million. The news was publicized globally and ended in the firing of six top hospital administrators including the hospital president and the ICU director. This paper seeks to show that the Chinese healthcare crisis is ultimately linked to a conflict of interests between patients and healthcare professionals (HCPs), which is inherent in the reformed healthcare system of China. Hence the crisis is, at its core, a crisis of fidelity and confidence that must be restored to the PPR. At the "macro" level, it is simplistic to blame the crisis on the failure of the market system, and at the "micro" level, it is naïve to expect that a contractual understanding of the PPR will effectively restore the confidence of patients. This paper will show that the fiduciary relationship and medical professionalism share similar attributes, with fidelity being the core value of both. It concludes that the loss of medical fidelity implies the dissolution of the PPR and the demise of the medical profession and challenges Chinese HCPs to keep their fidelity as a means to both protect their patients’ interests and to preserve their profession's survival. (shrink)

Examining health policy and its recent reform misadventures in the United States from a moral viewpoint is painful. That the nation devotes 14% of its Gross Domestic Product to health servicesand yet lets more than 40 million citizens go without health coverage strikes critics, both foreign and domestic, as a disgrace explicable only by ethical deficiencies distinctive to the American value system. There is certainly merit in this critique, which understandably incites fire and brimstone about the urgent moral imperative (...) of getting the nation on the path of righteousness at last. (shrink)

We pose the question: Is consumer sovereignty in the healthcare market fact or fiction? Consumer sovereignty in healthcare implies that society benefits at large when healthcare organizations compete to develop high quality healthcare products while reducing the cost of doing business (reflected in low prices), and when consumers choose wisely among healthcare products by purchasing those high quality products at low prices. We develop a theoretical model that encourages systematic empirical research to investigate whether consumer (...) sovereignty in healthcare is fact or fiction. In doing so, we develop a series of theoretical propositions that may demonstrate that consumer sovereignty is more fiction than fact. Specifically, healthcare consumers lack the ability, motivation, and opportunity to choose healthcare products that are high in quality and low in price. Similarly, healthcare firms lack the ability, motivation, and opportunity to compete in ways to develop and market higher quality products at lower prices. (shrink)

The current concern with reforming and regulating managed care under the general rubric of “patients' rights” has eclipsed the more fundamental need to legislate the human rights of those without adequate access to any healthcare. To characterize the regulatory activity as a “rights” movement inflates its moral dimension. The concept of “rights” carries a serious and powerful moral force that is currently inappropriately applied to the parochial concerns of a segment of the population privileged to have health insurance coverage. (...) By contrast, the language of “rights” refers to a high level of universality for the most rudimentary of human concerns. If there was a universal right to become a patient equal to other patients, a concept of patients' rights would have legitimacy. As it is, however, the central determinant of this “right” is how much the insurance policy costs and what is covered. To so diminish the meaning of “right” within the miasma of managed care is to lose sight of the real possibilities of applying a positive “right” to healthcare and, in the long run, is to diminish the ethics of healthcare. (shrink)

Gender, ‘race’, poverty, health and discourses of health reform in the context of globalization: a postcolonial feminist perspective in policy researchIn this paper, I draw on extant literature and my empirical work to discuss the impact of globalization and healthcare reform on the lives of women — those from countries of the South as well as of the North. First, I review briefly the economic hardships identified in different sectors of the population that have been attributed to (...) how globalization is now working. Second, I examine what these global processes mean for health, with particular focus on poverty, gender, racialization and health. Third, I reflect on how nurse scientists might develop research agendas in the 21st century that would foster social transformation and social justice for all people. The position taken here is not an indictment of globalization. Rather, I argue that globalization is a fact in all of our lives. There are positive aspects of globalization. There are also negative aspects which we must collectively address, given that the issues identified can have deleterious consequences for the world’s poor, women in particular. I suggest that, to construct knowledge for practice and praxis, research agendas of the future should be inclusive of subaltern voices. I argue that drawing on a postcolonial feminist epistemology might help us to define such agendas, and express the multilayered sociopolitical contexts of health and illness in advocacy with policy‐makers. (shrink)

This article focuses on healthcare ethics discussions in Estonia. We begin with an overview of the reform policies that the healthcare institutions have undergone since the region regained independence from the Soviet Union in 1991. The principles of distributing healthcare services and questions regarding just what ethical healthcare should look like have received abundant coverage in the national media. An example of this is the exceptionally public case of V—a woman with leukemia whose expensive drugs (...) the national health insurance fund refused to compensate. In our subsequent discussion, we focus on a grand-scale local healthcare and research project—the Estonian Genome Project—that attempts to include 1 million DNA samples into one database. (shrink)

The health care systems in Austria, Germany and Switzerland owe their institutional structure to different historical developments. While Austria and Germany voted for the Bismarck-Model of social health insurance,Switzerland adopted a voluntary system of health insurance. In all three countries, until very recently, the different challenges which the healthcare sector faced were met by piecemeal approaches and by stop and go policies, which, in the long run were not very successful either in containing costs or in improving efficacy and (...) efficiency. During the 1990 more fundamental reforms in the health care systems of all three countries took place. Germany and Switzerland chose the path of deregulation of the health insurance system, which consequently strengthened the competition between the insurance companies, and, to some extent between the suppliers of medical services. While this can be seen as an essential part of the reform process for these two countries, Austria favors a state-oriented and interventionist approach in order to meet the challenges. (shrink)

The United Nations Educational, Scientific and Cultural Organization's Declaration on Bioethics and Human Rights asserts that governments are morally obliged to promote health and to provide access to quality healthcare, essential medicines and adequate nutrition and water to all members of society. According to UNESCO, this obligation is grounded in a moral commitment to promoting fundamental human rights and emerges from the principle of social responsibility. Yet in an era of ethical pluralism and contentions over the universality of human (...) rights conventions, the extent to which the UNESCO Declaration can motivate behaviors and policies rests, at least in part, upon accepting the moral arguments it makes. In this essay I reflect on a state's moral obligation to provide healthcare from the perspective of Islamic moral theology and law. I examine how Islamic ethico-legal conceptual analogues for human rights and communal responsibility, ḥuqūq al-’ibād and farḍ al-kifāyah and other related constructs might be used to advance a moral argument for healthcare provision by the state. Moving from theory to application, I next illustrate how notions of human rights and social responsibility were used by Muslim stakeholders to buttress moral arguments to support American healthcare reform. In this way, the paper advance discourses on a universal bioethics and common morality by bringing into view the concordances and discordances between Islamic ethico-legal constructs and moral arguments advanced by transnational health policy advocates. It also provides insight into applied Islamic bioethics by demonstrating how Islamic ethico-legal values might inform the discursive outputs of Muslim organizations. (shrink)