How should medical services be distributed within society? Who should pay for them? Is it right that large amounts should be spent on sophisticated technology and expensive operations, or would the resources be better employed in, for instance, less costly preventive measures? These and others are the questions addreses in this book. Norman Daniels examines some of the dilemmas thrown up by conflicting demands for medical attention, and goes on to advance a theory of justice in the distribution of health (...) care. The central argument is that health care, both preventive and acute, has a crucial effect on equality of opportunity, and that a principle guaranteeing equality of opportunity must underly the distribution of health-care services. Access to care, preventive measures, treatment of the elderly, and the obligations of doctors and medical administrations are fully discussed, and the theory is shown to underwrite various practical policies in the area. (shrink)

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Book Information Women and Human Development: The Capabilities Approach. By Martha C. Nussbaum. Cambridge University Press. Cambridge/New York. 2000. Pp. xxi + 312.

One widely accepted way of justifying universal access to health care is to argue that access to health care is necessary to ensure health, which is necessary to provide equality of opportunity. But the evidence on the social determinants of health undermines this argument.

Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care.

A universal entitlement to health care can be grounded in the liberty principle. A detailed examination of Rawls's discussion of health care in Justice as Fairness shows that Rawls himself recognized that illness is a threat to the basic liberties, yet failed to recognize the implications of this fact for health resource allocation. The problem is that one cannot know how to allocate health care dollars until one knows which basic liberties one seeks to protect, and yet one cannot know (...) which basic liberties to protect until one knows how health care dollars will be allocated. The solution is to design the list of basic liberties and the health care system in tandem so as to fit each other, such that every citizen is guaranteed a set of basic liberties and access to the health services needed to secure them. (shrink)

Among political philosophers - and indeed public officials - it is generally believed that some sort of general principle of distributional equality can provide solid moral foundations for universal access to health care. In fact, this belief is so widely received that even among those who are very critical of egalitarianism, few have expressed doubts about the prospects for an egalitarian defense of universal access to health care. The purpose of this paper is to put pressure on this received view.

This book develops some of the most important themes of Sen's works over the last decade. He argues in a rich and subtle approach that we should be concerned with people's capabilities rather than their resources or welfare.

In this major book Martha Nussbaum, one of the most innovative and influential philosophical voices of our time, proposes a kind of feminism that is genuinely international, argues for an ethical underpinning to all thought about development planning and public policy, and dramatically moves beyond the abstractions of economists and philosophers to embed thought about justice in the concrete reality of the struggles of poor women. Nussbaum argues that international political and economic thought must be sensitive to gender difference as (...) a problem of justice, and that feminist thought must begin to focus on the problems of women in the third world. Taking as her point of departure the predicament of poor women in India, she shows how philosophy should undergird basic constitutional principles that should be respected and implemented by all governments, and used as a comparative measure of quality of life across nations. (shrink)