In the present paper it is argued that genetic interventions on human embryos are in principle permissible if they promote the health of the persons that these embryos will one day become and impermissible if they compromise their health. This so called health-intervention principle is reached by, inter alia, rejecting alternative approaches to the problem of the permissibility of genetic intervention. The health-intervention principle can be interpreted in different ways depending on how the notion of health is understood. The central (...) part of the paper is an attempt to find a concept of health which is such that it makes the health-intervention principle normatively plausible. For this purpose I examine two influential competing theories of health: Cristopher Boorse’s biostatistical theory of health and Lennart Nordenfelt’s welfare theory of health. I argue that the health-intervention principle is more plausible if health is understood in the latter sense, although it is not ruled out that the principle may be given an even more plausible explication in terms of some other notion of health. (shrink)

Today, health systems around the world are under pressure to create greater value for patients and society [81, p. 1, 119]; increasing access, improving client orientation and responsiveness, reducing medical errors and safety, restraining utilization via managed care, and implementing priority allocation of resources for high-burden health problems are examples of strategies towards this end. The quality paradigm by virtue of its strategic consumer focus and its methods for achieving operational excellence has proved an effective approach for creating higher value (...) in many sectors. If applied in a deliberate and holistic manner, the quality paradigm can bring about a more cost-effective organization of the health systems. In this article, we apply quality concepts to healthcare in a conceptual format; we characterize the health system’s customers and outputs with their quality dimensions. The product of this effort is a blueprint for a customer-driven health system which identifies six types of customers, nine types of outputs and the associated operations. As a preliminary step, a new analysis and definition of health and disease is provided. Rethinking the structure of health system in this manner and the related conceptual model can guide medical research, health sciences education, and health services policy, and help the practitioner to integrate all modern trends in healthcare delivery. (shrink)