In this book, an international group of philosophers, economists and theologians focus on the relationship between justice, luck and responsibility in health care. Together, they offer a thorough reflection on questions such as: How should we understand justice in health care? Why are health care interests so important that they deserve special protection? How should we value health? What are its functions and do these make it different from other goods? Furthermore, how much equality should there be? Which inequalities in health and health care are unfair and which are simply unfortunate? Which matters of health care belong to the domain of justice, and which to the domain of charity? And to what extent should we allow personal responsibility to play a role in allocating health care services and resources, or in distributing the costs? With this book, the editors meet a double objective. First, they provide a comprehensive philosophical framework for understanding the concepts of justice, luck and responsibility in contemporary health care; and secondly, they explore whether these concepts have practical force to guide normative discussions in specific contexts of health care such as prevention of infectious diseases or in matters of reproductive technology. Particular and extensive attention is paid to issues regarding end-of-life care.

"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck. Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state? By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.

Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ([8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally.

When the noted political philosopher Iris Marion Young died in 2006, her death was mourned as the passing of "one of the most important political philosophers of the past quarter-century" (Cass Sunstein) and as an important and innovative thinker working at the conjunction of a number of important topics: global justice; democracy and difference; continental political theory; ethics and international affairs; and gender, race and public policy. In her long-awaited Responsibility for Justice, Young discusses our responsibilities to address "structural" injustices in which we among many are implicated (but for which we not to blame), often by virtue of participating in a market, such as buying goods produced in sweatshops, or participating in booming housing markets that leave many homeless. Young argues that addressing these structural injustices requires a new model of responsibility, which she calls the "social connection" model. She develops this idea by clarifying the nature of structural injustice; developing the notion of political responsibility for injustice and how it differs from older ideas of blame and guilt; and finally how we can then use this model to describe our responsibilities to others no matter who we are and where we live. With a foreward by Martha C. Nussbaum, this last statement by a revered and highly influential thinker will be of great interest to political theorists and philosophers, ethicists, and feminist and political philosophers.

Of every thousand children born in Iceland, two will die before their first birthday, but in Mozambique the death rate is sixty times higher. Even within countries - including some of the wealthiest - inequalities in longevity and health can be substantial. In recent years, epidemiologists have documented the extent of these inequalities both between and within countries, stimulating in turn research both on their sources and on possible means for their alleviation. These extensive and influential efforts in research and in policy development have raised health inequalities to a prominent position among the central concerns of both national and global health. Less attention has been given to careful analysis and refinement of some key concepts and values that guide and motivate these studies of health inequalities. The essays in this book demonstrate the need to identify and debate alternative positions on the choice of measures of health inequality; the definitions of 'inequality' and 'inequity' in health, and their interrelationship; the ethical basis for attaching priority to narrowing gaps in longevity and health among individuals, groups, and societies; and the possible solutions to a series of puzzles involving uncertainty and variable population size. The authors of these essays are philosophers, economists, epidemiologists, and physicians contributing to our understanding of ethical issues in population health. Their contributions will be of interest to anyone interested in inequalities in health, including specialists in health policy, public health, epidemiology, moral philosophy, demography, and health economics.

This book reflects on the many contributions made in and to European bioethics to date, in various locations, and from various disciplinary perspectives. In so doing, the book advances understanding of the academic and social status of European bioethics as it is being supported and practiced by various disciplines such as philosophy, law, medicine, and the social sciences, applied to a wide range of areas. The European focus offers a valuable counter-balance to an often prominent US understanding of bioethics. The volume is split into four parts. The first contains reflection on bioethics in the past, present and future, and also considers how comparison between countries and disciplines can enrich bioethical discourse. The second looks at bioethics in particular locations and contexts, including: policy, boardrooms and courtrooms; studios and virtual rooms; and society, while the third part explores the translation of theories and concepts of bioethics into the clinical setting. Chapter 10 of this book are freely available as downloadable Open Access PDFs under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. https://s3-us-west-2.amazonaws.com/tandfbis/rt-files/docs/Open+Access+Chapters/9780415737197_oachapter10.pdf

Should organ transplants be given to patients who have waited the longest, or need it most urgently, or those whose survival prospects are the best? The rationing of health care is universal and inevitable, taking place in poor and affluent countries, in publicly funded and private health care systems. Someone must budget for as well as dispense health care whilst aging populations severely stretch the availability of resources. The Ethics of Health Care Rationing is a clear and much-needed introduction to this increasingly important topic, considering and assessing the major ethical problems and dilemmas about the allocation, scarcity and rationing of health care. Beginning with a helpful overview of why rationing is an ethical problem, the authors examine the following key topics: What is the value of health? How can it be measured? What does it mean that a treatment is "good value for money"? What sort of distributive principles - utilitarian, egalitarian or prioritarian - should we rely on when thinking about health care rationing? Does rationing health care unfairly discriminate against the elderly and people with disabilities? Should patients be held responsible for their health? Why does the debate on responsibility for health lead to issues about socioeconomic status and social inequality? Throughout the book, examples from the US, UK and other countries are used to illustrate the ethical issues at stake. Additional features such as chapter summaries, annotated further reading and discussion questions make this an ideal starting point for students new to the subject, not only in philosophy but also in closely related fields such as politics, health economics, public health, medicine, nursing and social work.