Just caring : health care rationing and democratic deliberation / Leonard M. Fleck.

Format:

Book

Author/Creator:

Fleck, Leonard M., author.

Series:

Oxford scholarship online.

Oxford scholarship online

Language:

English

Subjects (All):

Health care rationing--Moral and ethical aspects--United States.

Health care rationing.

Public health--Moral and ethical aspects--United States.

Public health.

Health services accessibility--United States.

Health services accessibility.

Right to health--United States.

Right to health.

Health care reform--United States.

Health care reform.

Social justice--United States.

Social justice.

Physical Description:

1 online resource (479 pages)

Edition:

First edition.

Place of Publication:

New York ; Oxford University Press, 2023.

Language Note:

English

Summary:

Leonard Fleck reflects on the central moral and political challenges of health reform today. The core argument of this book is that no one has a moral right to impose rationing decisions on others if they are unwilling to impose those same rationing decisions on themselves in the same medical circumstances.

Contents:

Intro

CONTENTS

1 JUST CARING: AN INTRODUCTION

The "Just Caring" Problem: Core Argument

Rationing Justly: The Moral Challenge

Applications of the Deliberative Model

2 THE ETHICAL CHALLENGES OF HEALTH CARE RATIONING

The Story of Coby Howard and Its Lessons

Why Health Care Rationing Is Inescapable

Renal Dialysis and the Medicare End-Stage Renal Disease (ESRD) Amendments

The Totally Implantable Artificial Heart (TIAH)

3 PRICING HUMAN LIFE: GETTING BEYOND TRAGIC CHOICES

Is Human Life Priceless?

Tragic Choices or Tragic Disingenuousness? Invisible Rationing

Invisible Rationing and the Publicity Condition

Managed Care and Health Care Rationing

4 ELEMENTS OF HEALTH CARE JUSTICE

Is Health Care Morally Special?

Non-ideal Justice: A Moral Analysis and Defense

Pluralism, Justice, and Rational Democratic Deliberation

5 RATIONAL DEMOCRATIC DELIBERATION: SCOPE AND STRUCTURE

The Scope of Rational Democratic Deliberation

Fair Health Care Rationing: Not Markets, Not Physicians, Not Bureaucrats

Rational Democratic Deliberation: Taking Seriously the Tragedy of the Commons

Rational Democratic Deliberation: Key Structural Features

Rational Democratic Deliberation and Fair Health Care Rationing

Wide Reflective Equilibrium and Just Health Care Rationing

Priority Setting, Wide Reflective Equilibrium, and Rational Democratic Deliberation: Addressing the Stability Problem

Facts, Wide Reflective Equilibrium, and Democratic Deliberation

Constitutional Principles of Health Care Justice and Rational Democratic Deliberation

Evaluating the Deliberative Process

Objections and Responses

6 SETTING LIMITS FOR EFFECTIVE COSTLY THERAPIES

Problem Introduction

Setting Limits: Options in the ESRD Program

Setting Limits: Options for HIV+/AIDS Patients.

Setting Limits: The Case of Artificial Hearts

Setting Limits: Concluding Comments

7 LAST-CHANCE THERAPIES

Introduction: Scope of the Problem

Why Last-Chance Therapies? Weak Moral Arguments

Last-Chance Therapies and Rational Democratic Deliberation

Futility and Last-Chance Therapies

8 RATIONING, CATASTROPHICILLNESS, AND DISABLED PATIENTS

Introduction: The Scope of the Problem

Needs Are Not Enough

Effectiveness Must Matter

The Oregon Plan and the Disability Critique

Health Care Justice and the Disability Critique

Defining the Disabled: Ethical Implications

Conclusions

9 IS AGE-BASED RATIONING EVER "JUST ENOUGH"?

Defining the Problem: Can We Accept Natural Limits to Life?

Justice and Age-Based Rationing: Fair Innings

The Prudential Life Span Account

Age-Based Rationing: Major Objections

Age-Based Rationing: Responses to Objections

Age-Based Rationing and the Duty to Rescue

10 DO FUTURE POSSIBLE CHILDREN HAVE A JUST CLAIM TO A SUFFICIENTLY HEALTHY GENOME?

Framing the Issue

Preimplantation Genetic Diagnosis (PGD): A Historical Side Note

Does Justice Require Public Funding for Limited PGD?

Concluding Comments: Justice and Genetic Enhancement

11 ORGAN TRANSPLANTATION: WHEN IS ENOUGH ENOUGH?

Scope of the Issue

The Maximization Argument: A Critical Moral Analysis

The Pittsburgh Protocol: How Dead Must Donors Be?

Organ Procurement and Financial Incentives: A Critical Assessment

Presumed Consent/Duty to Donate: Critical Remarks

Justice and Multi-Organ Transplants or Retransplants

Concluding Comments

12 THE LIBERALISM PROBLEM

Justice, Health Care Needs, and Morally Controversial Interventions

Liberal Communitarianism: Is It Just Enough? Is It Liberal Enough?

Resolving the Liberalism Problem: Public Reason and Public Interests.

Concluding Reflections

13 THE ETHICAL CHALLENGES OF PRIORITY SETTING IN PUBLIC HEALTH

Defining the Problem

The Scope of Public Health: Challenges and Choices

Health Care Justice and Public Health: When Is Enough Enough?

Setting Public Health Priorities Justly: The Limits of Moral Theory

14 FINANCING HEALTH CARE FAIRLY

Why National Health Insurance?

Why Health Reform?

Assessing Competing Proposals for Health Reform

Health Savings Accounts: A Critical Assessment

Health Care Vouchers: A Critical Assessment

Single-Payer Reform: A Constructive Proposal

Summary and Reflective Conclusions

NOTES

REFERENCES

INDEX

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X.

Notes:

Previously issued in print: 2009.

Includes bibliographical references and index.

Derived record based on print version record and publisher information.

ISBN:

0-19-770742-4

1-282-54382-2

9786612543821

0-19-972289-7

OCLC:

647897715