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  1. added 2020-02-25
    The Fifth Face of Fair Subject Selection: Population Grouping.Tomasz Żuradzki - 2020 - American Journal of Bioethics 20 (2):41-43.
    The article by MacKay and Saylor (2020) claims that the principle of fair subject selection yields conflicting imperatives (e.g. in the case of pregnant women) and should be understood as “a bundle of four distinct sub-principles” (i.e. fair inclusion, burden sharing, opportunity, distribution of third-party risks), each having conflicting normative recommendations (MacKay and Saylor 2020). The authors also offer guidance as to how we should navigate between subprinciples that may conflict with each other. The problem is a crucial one since (...)
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  2. added 2020-02-22
    Healthy Nails Versus Long Lives: An Analysis of a Dutch Priority Setting Proposal.Alex Voorhoeve - 2020 - In Nir Eyal, Samia A. Hurst, Christopher Murray, S. Andrew Schroeder & Daniel Wikler (eds.), Measuring the Global Burden of Disease: Philosophical Dimensions. New York, NY, USA: pp. 273-292.
    How should governments balance saving people from very large individual disease burdens (such as an early death) against saving them from middling burdens (such as erectile dysfunction) and minor burdens (such as nail fungus)? This chapter considers this question through an analysis of a priority-setting proposal in the Netherlands, on which avoiding a multitude of middling burdens takes priority over saving one person from early death, but no number of very small burdens can take priority over avoiding one death. It (...)
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  3. added 2020-01-21
    Genetically Engineered Mosquitoes, Zika and Other Arboviruses, Community Engagement, Costs, and Patents: Ethical Issues.Zahra Meghani & Christophe Boete - 2018 - PLoS Neglected Tropical Diseases 7 (12).
    Genetically engineered (GE) insects, such as the GE OX513A Aedes aegypti mosquitoes, have been designed to suppress their wild-type populations so as to reduce the transmission of vector-borne diseases in humans. Apart from the ecological and epidemiological uncertainties associated with this approach, such biotechnological approaches may be used by individual governments or the global community of nations to avoid addressing the underlying structural, systemic causes of those infections... We discuss here key ethical questions raised by the use of GE mosquitoes, (...)
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  4. added 2019-12-13
    The Case for Valuing Non-Health and Indirect Benefits.Govind Persad & Jessica du Toit - 2020 - In Ole F. Norheim, Ezekiel J. Emanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. New York, NY, USA: pp. 207-222.
    Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...)
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  5. added 2019-12-03
    Medical Privacy and Big Data: A Further Reason in Favour of Public Universal Healthcare Coverage.Carissa Véliz - 2019 - In T. C. de Campos, J. Herring & A. M. Phillips (eds.), Philosophical Foundations of Medical Law. Oxford, U.K.: Oxford University Press. pp. 306-318.
    Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about your health might (...)
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  6. added 2019-10-10
    First Come, First Served?Tyler M. John & Joseph Millum - 2019 - Ethics 130 (2):179-207.
    Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...)
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  7. added 2019-10-04
    Hormone Replacement Therapy: Informed Consent Without Assessment?Toni C. Saad, Bruce Philip Blackshaw & Daniel Rodger - 2019 - Journal of Medical Ethics 45 (12):1-2.
    Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic surgery (...)
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  8. added 2019-09-27
    Medical Crowdfunding, Political Marginalization, and Government Responsiveness: A Reply to Larry Temkin.Alida Liberman - 2019 - Journal of Practical Ethics 7 (1):40-48.
    Larry Temkin draws on the work of Angus Deaton to argue that countries with poor governance sometimes rely on charitable giving and foreign aid in ways that enable them to avoid relying on their own citizens; this can cause them to be unresponsive to their citizens’ needs and thus prevent the long-term alleviation of poverty and other social problems. I argue that the implications of this “lack of government responsiveness argument” (or LOGRA) are both broader and narrower than they might (...)
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  9. added 2019-08-05
    Have Reforms Reconciled Health Rights Litigation and Priority Setting in Costa Rica?Alessandro Luciano & Alex Voorhoeve - 2019 - Health and Human Rights 21 (2):283-293.
    The experience of Costa Rica highlights the potential for conflicts between the right to health and fair priority setting. For example, one study found that most favorable rulings by the Costa Rican constitutional court concerning claims for medications under the right to health were either for experimental treatments or for medicines that should have low priority based on health gain per unit of expenditure and severity of disease. In order to better align rulings with priority setting criteria, in 2014, the (...)
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  10. added 2019-07-16
    Considering Quality of Life While Repudiating Disability Injustice: A Pathways Approach to Setting Priorities.Govind Persad - 2019 - Journal of Law, Medicine and Ethics 47 (2):294-303.
    This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...)
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  11. added 2019-06-25
    Cross-Cultural Issues in European Bioethics.Donna L. Dickenson - 1999 - Bioethics 13 (3-4):249-255.
    This article, arising from a comparative European Commission project, analyses different national perspectives on bioethics issues.
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  12. added 2019-06-21
    Is Efficiency Ethical? Resource Issues in Health Care.Donna Dickenson - 1995 - In Brenda Almond (ed.), Introducing Applied Ethics. Oxford: Blackwell. pp. 229-246.
    How can we allocate scarce health care resources justly? In particular, are markets the most efficient way to deliver health services? Much blood, sweat and ink has been shed over this issue, but rarely has either faction challenged the unspoken assumption behind the claim made by advocates of markets: that efficiency advances the interests of both individuals and society. Whether markets actually do increase efficiency is arguably a matter for economists, but the deeper ethical question is whether efficiency is the (...)
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  13. added 2019-06-20
    Nurse Time as a Scarce Health Care Resource.Donna Dickenson - 1994 - In Geoffrey Hunt (ed.), Ethical Issues in Nursing. Routledge.
    For a long time discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. However, a narrow focus on medical resources prevents us from seeing that there are many cases-- perhaps the majority-- in which less dramatic but equally important issues of rationing occur. The allocation of nurses' time is one such issue.
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  14. added 2019-06-20
    Nurse Time as a Scarce Healthcare Resource.Donna Dickenson - 1994 - In Geoffrey Hunt (ed.), Ethical issues in nursing. London: Routledge. pp. 207-217.
    For a long time, discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. This narrow focus on medical resource prevents us from seeing that there are many cases-- perhaps even the majority--in which time is the real scarce resource, particularly nurse time. What ethical principles should apply to nurse time as a scarce health care resource?
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  15. added 2019-06-18
    Body Shopping: The Economy Fuelled by Flesh and Blood.Donna Dickenson - 2008 - Oxford: Oneworld.
    'An alarming and illuminating book. The story of how we have allowed private corporations to patent genes, to stockpile human tissue, and in short to make profits out of what many people feel ought to be common goods is a shocking one. No one with any interest at all in medicine and society and how they interact should miss this book, and it should be required reading for every medical student,'--Philip Pullman.
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  16. added 2019-06-12
    Sufficiency, Comprehensiveness of Health Care Coverage, and Cost-Sharing Arrangements in the Realpolitik of Health Policy.Govind Persad & Harald Schmidt - 2016 - In Carina Fourie & Annette Rid (eds.), What is Enough?: Sufficiency, Justice, and Health. New York: Oxford University Press. pp. 267-280.
    This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to drop their (...)
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  17. added 2019-06-06
    Social Epigenetics and Equality of Opportunity.Michele Loi, Lorenzo Del Savio & Elia Stupka - 2013 - Public Health Ethics 6 (2):142-153.
    Recent epidemiological reports of associations between socioeconomic status and epigenetic markers that predict vulnerability to diseases are bringing to light substantial biological effects of social inequalities. Here, we start the discussion of the moral consequences of these findings. We firstly highlight their explanatory importance in the context of the research program on the Developmental Origins of Health and Disease (DOHaD) and the social determinants of health. In the second section, we review some theories of the moral status of health inequalities. (...)
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  18. added 2019-06-06
    A Lockean Argument for Universal Access to Health Care.Daniel M. Hausman - 2011 - Social Philosophy and Policy 28 (2):166-191.
    This essay defends the controversial and indeed counterintuitive claim that there is a good argument to be made from a Lockean perspective for government action to guarantee access to health care. The essay maintains that this argument is in some regards more robust than the well-known argument in defense of universal health care spelled out by Norman Daniels, which this essay also examines in some detail. Locke's view that government should protect people's lives, property, and freedom–where freedom is understood as (...)
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  19. added 2019-06-06
    Justified Commitments? Considering Resource Allocation and Fairness in Médecins Sans Frontières‐Holland.Lisa Fuller - 2006 - Developing World Bioethics 6 (2):59-70.
    Non‐governmental aid programs are an important source of health care for many people in the developing world. Despite the central role non‐governmental organizations play in the delivery of these vital services, for the most part they either lack formal systems of accountability to their recipients altogether, or have only very weak requirements in this regard. This is because most NGOs are both self‐mandating and self‐regulating. What is needed in terms of accountability is some means by which all the relevant stakeholders (...)
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  20. added 2019-06-05
    The Political Ethics of Health.Daniel Weinstock - 2010 - Les Ateliers de L’Ethique 5 (1):105-118.
    This paper seeks to provide an overview of some of the main areas of debate that have emerged in recent years at the interface between theories of justice and health care. First, the paper consi- ders various positions as to what the index of justice with respect to health ought to be. It warns on practical and principled grounds against conceptual inflation of the notion of "health" as it appears in theories of distributive justice. Second, it considers how various standards (...)
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  21. added 2019-05-07
    Putting a Number on the Harm of Death.Joseph Millum - 2019 - In Espen Gamlund & Carl Tollef Solberg (eds.), Saving People from the Harm of Death. Oxford University Press. pp. 61-75.
    Donors to global health programs and policymakers within national health systems have to make difficult decisions about how to allocate scarce health care resources. Principled ways to make these decisions all make some use of summary measures of health, which provide a common measure of the value (or disvalue) of morbidity and mortality. They thereby allow comparisons between health interventions with different effects on the patterns of death and ill health within a population. The construction of a summary measure of (...)
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  22. added 2019-04-25
    Will More Organs Save More Lives? Cost‐Effectiveness and the Ethics of Expanding Organ Procurement.Govind Persad - 2019 - Bioethics 33 (6):684-690.
    The assumption that procuring more organs will save more lives has inspired increasingly forceful calls to increase organ procurement. This project, in contrast, directly questions the premise that more organ transplantation means more lives saved. Its argument begins with the fact that resources are limited and medical procedures have opportunity costs. Because many other lifesaving interventions are more cost‐effective than transplantation and compete with transplantation for a limited budget, spending on organ transplantation consumes resources that could have been used to (...)
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  23. added 2019-03-18
    Transparency Trade-Offs: Priority Setting, Scarcity, and Health Fairness.Govind Persad - 2019 - In I. Glenn Cohen, Barbara Evans, Holly Lynch & Carmel Shachar (eds.), Transparency in Health and Health Care. New York: Cambridge UP.
    This chapter argues that rather than viewing transparency as a right, we should regard it as a finite resource whose allocation involves tradeoffs. It then argues that those tradeoffs should be resolved by using a multi-principle approach to distributive justice. The relevant principles include maximizing welfare, maximizing autonomy, and giving priority to the worst off. Finally, it examines some of the implications for law of recognizing the tradeoffs presented by transparency proposals.
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  24. added 2019-03-18
    Between Social Justice and Market Justice: Ethics of Health Care Leadership.Marvin J. H. Lee - 2016 - Journal of Healthcare Ethics and Administration 2 (2).
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  25. added 2019-03-11
    Justice and Public Health.Govind Persad - 2019 - In Anna Mastroianni, Jeff Kahn & Nancy Kass (eds.), Oxford Handbook of Public Health Ethics. New York, NY, USA: pp. ch. 4.
    This chapter discusses how justice applies to public health. It begins by outlining three different metrics employed in discussions of justice: resources, capabilities, and welfare. It then discusses different accounts of justice in distribution, reviewing utilitarianism, egalitarianism, prioritarianism, and sufficientarianism, as well as desert-based theories, and applies these distributive approaches to public health examples. Next, it examines the interplay between distributive justice and individual rights, such as religious rights, property rights, and rights against discrimination, by discussing examples such as mandatory (...)
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  26. added 2019-01-08
    Pharmacogenomic Inequalities: Strategies for Justice in Biomedical Research and Healthcare.Giovanni De Grandis - 2017 - Diametros 51:153-172.
    The paper discusses the possibility that the benefits of pharmacogenomics will not be distributed equally and will create orphan populations. I argue that since these inequalities are not substantially different from those produced by ‘traditional’ drugs and are not generated with the intention to discriminate, their production needs not be unethical. Still, the final result is going against deep-seated moral feelings and intuitions, as well as broadly accepted principles of just distribution of health outcomes and healthcare. I thus propose two (...)
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  27. added 2018-12-09
    Three Things Clinicians Should Know About Disability.Joel Michael Reynolds - 2018 - AMA Journal of Ethics 12 (20):E1181-1187.
    The historical relationship between health care professionals and people with disabilities is fraught, a fact all the more troubling in light of the distinctive roles clinicians play in both establishing and responding to that which is considered normal or abnormal by society at large. Those who wish to improve their clinical practice might struggle, however, to keep up with developments across numerous disability communities as well as the ever-growing body of disability studies scholarship. To assist with this goal, I offer (...)
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  28. added 2018-12-03
    Response to Ruud ter Meulen.Ruth Chadwick - 2015 - Diametros 43:21-27.
    In addition to thinking about the meanings of solidarity, it is important to address how solidarity of the appropriate sort can be cultivated. Possibilities include the transformative power of key individuals or events; and the role of institutions. In health care it is suggested that a combination of the two strategies is required. Professional conduct includes not only acting in 'face to face' delivery, but also engaging with those institutions which enable or disable certain ways of acting, so that they (...)
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  29. added 2018-12-03
    Solidarity: Its Levels of Operation, Relationship to Justice, and Social Causes.Wojciech Załuski - 2015 - Diametros 43:96-102.
    The paper provides an analysis of the relationship between the concepts of justice and solidarity. The point of departure of the analysis is Ruud ter Meulen’s claim that these concepts are different but mutually complementary, i.e. are two sides of the same coin. In the paper two alternative accounts of the relationship are proposed. According to the first one, solidarity can be defined in terms of justice, i.e. is a special variety of liberal justice, viz. social liberal justice, which, apart (...)
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  30. added 2018-12-03
    Rescuing Solidarity From Its Carers. A Response to Professor ter Meulen.Giovanni De Grandis - 2015 - Diametros 43:28-43.
    The paper points out three serious problems in Ruud ter Meulen’s view of solidarity and of its role in healthcare ethics. First, it is not clear whether and to what extent ter Meulen expects normative concepts to be rooted in existing social practices: his criticism of liberal theories of justice seems to imply a different view on this issue than his implicit assumption that normative concepts are independent from social and historical trends. Second, it is not clear at which level (...)
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  31. added 2018-12-03
    Justice and Solidarity: Compound, Confound, Confuse.Thomas Nys - 2015 - Diametros 43:72-78.
    In response to Ruud ter Meulen’s contribution, it is argued that, although the relationship between these concepts is both tight and complex, solidarity should be carefully distinguished from justice. Although ter Meulen wants to defend a normative conception of solidarity, the relation to its descriptive component is not always very clear. As a normative concept it should not collapse into that of justice; and as a descriptive notion it is obviously defective. In order to successfully navigate between these unhappy alternatives, (...)
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  32. added 2018-11-18
    The Normative Significance of Identifiability.Tomasz Żuradzki - 2019 - Ethics and Information Technology 21 (4):295-305.
    According to psychological research, people are more eager to help identified individuals than unidentified ones. This phenomenon significantly influences many important decisions, both individual and public, regarding, for example, vaccinations or the distribution of healthcare resources. This paper aims at presenting definitions of various levels of identifiability as well as a critical analysis of the main philosophical arguments regarding the normative significance of the identifiability effect, which refer to: (1) ex ante contractualism; (2) fair distribution of chances and risks; (3) (...)
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  33. added 2018-11-14
    Harms and Wrongs in Epistemic Practice.Simon Barker, Charlie Crerar & Trystan S. Goetze - 2018 - Royal Institute of Philosophy Supplement 84:1-21.
    This volume has its roots in two recent developments within mainstream analytic epistemology: a growing recognition over the past two or three decades of the active and social nature of our epistemic lives; and, more recently still, the increasing appreciation of the various ways in which the epistemic practices of individuals and societies can, and often do, go wrong. The theoretical analysis of these breakdowns in epistemic practice, along with the various harms and wrongs that follow as a consequence, constitutes (...)
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  34. added 2018-10-08
    Bursting Bubbles? QALYs and Discrimination.Ben Davies - 2019 - Utilitas 31 (2):191-202.
    The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it (...)
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  35. added 2018-09-20
    Justifying Public Health Surveillance: Basic Interests, Unreasonable Exercise, and Privacy.Alan Rubel - 2012 - Kennedy Institute of Ethics Journal 22 (1):1-33.
    Surveillance plays a crucial role in public health, and for obvious reasons conflicts with individual privacy. This paper argues that the predominant approach to the conflict is problematic, and then offers an alternative. It outlines a Basic Interests Approach to public health measures, and the Unreasonable Exercise Argument, which sets forth conditions under which individuals may justifiably exercise individual privacy claims that conflict with public health goals. The view articulated is compatible with a broad range conceptions of the value of (...)
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  36. added 2018-09-05
    Calibrating QALYs to Respect Equality of Persons.Franklin Donald - 2016 - Utilitas (1):1-23.
    Comparative valuation of different policy interventions often requires interpersonal comparability of benefit. In the field of health economics, the metric commonly used for such comparison, quality adjusted life years (QALYs) gained, has been criticized for failing to respect the equality of all persons’ intrinsic worth, including particularly those with disabilities. A methodology is proposed that interprets ‘full quality of life’ as the best health prospect that is achievable for the particular individual within the relevant budget constraint. This calibration is challenging (...)
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  37. added 2018-08-30
    Animal Experimentation and the Argument From Limited Resources.Charles K. Fink - 1991 - Between the Species 7 (2):90-95.
    Animal rights activists are often accused of caring more about animals than about human beings. How, it is asked, can activists condemn the use of animals in biomedical research—research that improves human health and saves human lives? In this article, I argue that even if animal experimentation might eventually provide cures for many serious diseases, given the present state of the world, we are not justified supporting this research; rather, we ought to devote our limited resources to other forms of (...)
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  38. added 2018-08-16
    Which Values Should Be Built Into Economic Measures?S. Andrew Schroeder - 2019 - Economics and Philosophy 35 (3):521-536.
    Many economic measures are structured to reflect ethical values. I describe three attitudes towards this: maximalism, according to which we should aim to build all relevant values into measures; minimalism, according to which we should aim to keep values out of measures; and an intermediate view. I argue the intermediate view is likely correct, but existing versions are inadequate. In particular, economists have strong reason to structure measures to reflect fixed, as opposed to user-assessable, values. This implies that, despite disagreement (...)
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  39. added 2018-08-16
    Standard of Care, Institutional Obligations, and Distributive Justice.Douglas MacKay - 2015 - Bioethics 29 (4):352-359.
    The problem of standard of care in clinical research concerns the level of treatment that investigators must provide to subjects in clinical trials. Commentators often formulate answers to this problem by appealing to two distinct types of obligations: professional obligations and natural duties. In this article, I investigate whether investigators also possess institutional obligations that are directly relevant to the problem of standard of care, that is, those obligations a person has because she occupies a particular institutional role. I examine (...)
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  40. added 2018-08-16
    Care Drain as an Issue of Global Gender Justice.Anca Gheaus - 2013 - Ethical Perspectives 20 (1).
    The gendered division of labour in combination with the feminisation of international migration contribute to shortages of care, a phenomenon often called ‘care drain’. I argue that this phenomenon is an issue of global gender justice. I look at two methodological challenges and favourably analyse the suggestions that care drain studies should include the effects of fathers’ and other male caregivers’ migration and, in some cases, the effects of migration within national borders. I also explain why care drain is a (...)
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  41. added 2018-04-27
    Brain Drain, Health, and Global Justice.Alex Sager - 2012 - In Rebecca S. Shah (ed.), The International Migration of Health Workers: Ethics, Rights, and Justice. Palgrave-Macmillan. pp. 103-117.
    This chapter criticizes policies that aim to restrict the emigration or immigration of skilled workers, analyzes the ethics of recruitment, and proposes basing an ethics of skilled migration based on the violation of negative duties not to uphold unjust institutions.
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  42. added 2018-04-27
    International NGO Health Programs in a Non-Ideal World: Imperialism, Respect & Procedural Justice.Lisa Fuller - 2012 - In E. Emanuel J. Millum (ed.), Global Justice and Bioethics. Oxford University Press. pp. 213-240.
    Many people in the developing world access essential health services either partially or primarily through programs run by international non-governmental organizations (INGOs). Given that such programs are typically designed and run by Westerners, and funded by Western countries and their citizens, it is not surprising that such programs are regarded by many as vehicles for Western cultural imperialism. In this chapter, I consider this phenomenon as it emerges in the context of development and humanitarian aid programs, particularly those delivering medical (...)
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  43. added 2018-04-24
    Public Health, Beneficence and Cosmopolitan Justice.L. Horn - 2015 - South African Journal of Bioethics and Law 8 (2):30.
    This article proposes that, in line with moral-cosmopolitan theorists, affluent nations have an obligation, founded in justice and not merely altruism or beneficence, to share the responsibility of the burden of public health implementation in low-income contexts. The current Ebola epidemic highlights the fact that countries with under-developed health systems and limited resources cannot cope with a significant and sudden health threat. The link between burden of disease, adverse factors in the social environment and poverty is well established and confirmed (...)
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  44. added 2018-04-24
    Public Health and Social Justice: Forging the Links.L. Horn - 2015 - South African Journal of Bioethics and Law 8 (2):26.
    The purpose of this article is to explore the concept and scope of public health and to argue that particularly in low-income contexts, where social injustice and poverty often impact significantly on the overall health of the population, the link between public health and social justice should be a very firm one. Furthermore, social justice in these contexts must be understood as not simply a matter for local communities and nation-states, but in so far as public health is concerned, as (...)
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  45. added 2018-01-19
    How to Allocate Scarce Health Resources Without Discriminating Against People with Disabilities.Tyler M. John, Joseph Millum & David Wasserman - 2017 - Economics and Philosophy 33 (2):161-186.
    One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all (...)
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  46. added 2018-01-04
    Liberty, Mill and the Framework of Public Health Ethics.Madison Powers, Ruth Faden & Yashar Saghai - 2012 - Public Health Ethics 5 (1):6-15.
    In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...)
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  47. added 2018-01-04
    Public Health and Public Goods.Jonny Anomaly - 2011 - Public Health Ethics 4 (3):251-259.
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  48. added 2017-11-21
    Why Health-Related Inequalities Matter and Which Ones Do.Alex Voorhoeve - 2019 - In Ole Frithjof Norheim, Ezekiel Emmanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. New York: Oxford University Press. pp. 145-62.
    I outline and defend two egalitarian theories, which yield distinctive and, I argue, complementary answers to why health-related inequalities matter: a brute luck egalitarian view, according to which inequalities due to unchosen, differential luck are bad because unfair, and a social egalitarian view, according to which inequalities are bad when and because they undermine people’s status as equal citizens. These views identify different objects of egalitarian concern: the brute luck egalitarian view directs attention to health-related well-being, while social egalitarianism focuses (...)
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  49. added 2017-10-27
    Valuing Stillbirths.John Phillips & Joseph Millum - 2015 - Bioethics 29 (6):413-423.
    Estimates of the burden of disease assess the mortality and morbidity that affect a population by producing summary measures of health such as quality-adjusted life years and disability-adjusted life years. These measures typically do not include stillbirths among the negative health outcomes they count. Priority-setting decisions that rely on these measures are therefore likely to place little value on preventing the more than three million stillbirths that occur annually worldwide. In contrast, neonatal deaths, which occur in comparable numbers, have a (...)
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  50. added 2017-10-27
    Incidence, Prevalence, and Hybrid Approaches to Calculating DALYs.S. Andrew Schroeder - 2012 - Population Health Metrics 10 (19).
    When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question (...)
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