In medical ethics, discussions of justice have tended to focus on questions of inequality: how to secure equal access to health care, and how to set priorities when resources are scarce. The extent to which abstract notions of justice should inform these issues is still a fraught one however. Are all inequalities morally problematic? How important are moral concerns in setting priorities in health care and public health? How much inequality in health should we tolerate? The central question that senior bioethicists ...
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In medical ethics, discussions of justice have tended to focus on questions of inequality: how to secure equal access to health care, and how to set priorities when resources are scarce. The extent to which abstract notions of justice should inform these issues is still a fraught one however. Are all inequalities morally problematic? How important are moral concerns in setting priorities in health care and public health? How much inequality in health should we tolerate? The central question that senior bioethicists Powers and Faden pose in this book--the first to really focus issues of justice on public health in particular--is, which inequalities matter most?LIn order to answer this question, they develop a unique theory of social justice that can cope with the specific context of health care policy, although indeed it can also be applied to education, employment opportunities, and other social problems where resources are limited. A substantial part of the book is a useful review of the approaches to the problem, as they contrast their "social justice" approach with, among others, philosophers like Rawls and Nussbaum. Their own approach rejects a utilitarian or distributive approach in favor of a six dimensional theory of well-being, arguing that we are morally obligated to meet the needs of social groups that are least well-off in those dimensions. The audience for the book is primarily bioethicists, but also social/political philosophers as well as anyone interested in the growing topic of justice and health care.
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