Universal health coverage (UHC) is at the center of current efforts to strengthen health systems and improve the level and distribution of health and health services. This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC. As such, the report is relevant for every actor that affects that path and (...) governments in particular, as they are in charge of overseeing and guiding the progress toward UHC. (shrink)

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 independence and self-determination–justifies government action to ensure access to health care, because (roughly), just as individuals cannot protect themselves from crime and foreign invasion, so individuals are unable to provide for their own health care. Defense from disease is as important as defense from crime, and–although this is arguable–government action to guarantee access to health care does not itself undermine freedom. (shrink)

This article makes a moral argument for universal access to health care and for the legitimate function of government to guarantee that access. Constructed as a reply to the libertarian argument against universal access, this article utilizes the moral and political theory of John Locke, favored by libertarianism, to develop a Lockean argument for a view contrary to the libertarian philosophy. In particular, the argument here shows how libertarianism’s neglect of a crucial element of the natural-law (...) tradition, to which Locke adhered, not only undercuts the libertarian objection to universal access to health care but also underwrites an alternative argument in favor of such. (shrink)

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 financial status below a decent minimum. A design that places greater emphasis on preventing impoverishment and finances the achievement of that goal by reducing unnecessary subsidies to better-off households would better accord with a sufficientarian approach to health care. -/- . (shrink)

In response to our critics, we clarify and defend key ideas in the report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. First, we argue that procedural fairness has greater value than Dan Hausman allows. Second, we argue that the Report aligns with John Kinuthia’s view that a knowledgeable public and a capable civil society, alongside good facilitation, are important for effective public deliberation. Moreover, we agree with Kinuthia that the Report’s framework for procedural fairness applies (...) not merely within the health sector, but also to the wider budget process. Third, we argue that while Dheepa Rajan and Benjamin Rouffy-Ly are right that robust processes for equal participation are often central to a fair process, sometimes improvements in other aspects of procedural fairness, such as transparency, can take priority over strengthening participation. Fourth, while we welcome Sara Bennett and Maria Merritt’s fascinating use of the Report’s principles of procedural fairness to assess the U.S. President’s Emergency Plan for AIDS Relief, we argue that their application of the Report’s principle of equality to development partners’ decision-making requires further justification. (shrink)

In this paper, I distinguish two conceptions of solidarity, which I call solidarity as beneficence and solidarity as mutual advantage. I argue that only the latter is capable of providing a complete foundation for national universal health care programs. On the mutual advantage account, the rationale for universal insurance is parallel to the rationale for a labor union’s “closed shop” policy. In both cases, mandatory participation is necessary in order to stop individuals free-riding on an ongoing (...) system of mutually advantageous cooperation. (shrink)

Discussions concerning whether there is a natural right to health care may occur in various forms, resulting in policy recommendations for how to implement any such right in a given society. But health care policies may be judged by international standards including the UN Universal Declaration of Human Rights. The rights enumerated in the UDHR are grounded in traditions of moral theory, a philosophical analysis of which is necessary in order to adjudicate the value of (...) specific policies designed to enshrine rights such as a right to health care. We begin with an overview of the drafting of the UDHR and highlight the primary influence of natural law theory in validating the rights contained therein. We then provide an explication of natural law theory by reference to the writings of Thomas Aquinas, as well as elucidate the complementary “capabilities approach” of Martha Nussbaum. We conclude that a right to health care ought to be guaranteed by the state. (shrink)

We summarize key messages from the World Bank report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. A central lesson of the Report is that in decision-making on the path to UHC, procedural fairness matters alongside substantive fairness. Decision systems should be assessed using a complete conception of procedural fairness that embodies core commitments to impartial and equal consideration of interests and perspectives. These commitments demand that comprehensive information is gathered and disclosed and that justifications for (...) policies are publicly debated; that participation in decision-making is enabled; and that these characteristics of the decision system are institutionalised rather than up to the good will of decision-makers. Procedural fairness can improve equity in outcomes, raise legitimacy and trust, and can help make reforms last. While improving procedural fairness can be costly and there are barriers to achieving it, the range of instruments that countries at varying levels of income and institutional capacity have used with some success shows that, in many contexts, advances in procedural fairness in health financing are possible and worthwhile. (shrink)

We offer a summary of the WHO Report "Making Fair Choices on the Path to Universal Health Coverage".

In a context of imperfect risk protection, households may protect against the impact of a health shock by employing various financial and non-financial coping mechanisms, such as foregoing or reducing needed medical care, labor substitution, consumption reduction, borrowing money, dissaving, and selling assets. However, leveraging certain coping mechanisms may reduce future productivity, potentially trapping households in chronic or persistent poverty. Resources and risk are not necessarily shared equitably within a household; the ability and willingness of the household to (...) leverage coping mechanisms, or the choice of coping mechanism may depend on the social protection policy context, household socioeconomic status, and type of intrahousehold risk sharing. Vietnam has been making policy changes aimed towards achieving Universal Health Coverage for the past several decades, culminating in a 2015 change mandating universal insurance coverage. This can potentially influence both providers in making decisions around service delivery and households around financing care. This research aims to contribute to the literature exploring the relationships among direct and indirect health care costs, potentially maladaptive coping mechanisms, and household living standards, within the particular health financing and social protection environment in Vietnam. (shrink)

The major objective of this study was to investigate whether visual impairments (VI) impact mental health literacy among first-generation university students (FGUS). A descriptive survey research method was used to examine the mental health literacy of 132 purposive sample of FGUS with and without VI from three federal universities in Southern Nigeria. A 35-item MHL Scale (MHLS) for university students (Crobach’s α=0.83) with 5-point response was used for data collection. Questionnaire distribution was achieved through the help of two (...) research assistants. Means, standard deviations, analysis of variance and regression plot were employed to analyze the research data. Participants’ mean age was 24.96±3.86 years. Results showed a higher level of mental health literacy across seven domains of the MHL Scale among students with VI compared to those without this disability. The students identified mental health literacy they possess including the ability to recognize specific disorders, the ability to seek mental health information, the ability to identify risk factors and causes, the ability to understand self-treatment options, the ability to access professional assistance, and positive behaviors that promote awareness and help-seeking. VI did not significantly impact the mental health literacy of FGUS with VI. VI explained only 6.31% of the variation in MHL among FGUS with VI. Accordingly, mental health literacy is an essential skill that should be acquired by everyone, including those who suffer from specific disorders and professionals who care for them. Further effort is required in order to improve the mental literacy of FGUS without VI in Nigerian universities. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey (...) was voluntary and anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

A principal challenge facing the progressive bioethics project is the crafting of a consistent message on biopolitical issues that divide progressives. -/- The regulation of enhancement technologies is one of the issues central to this emerging biopolitics, pitting progressive defenders of enhancement, “technoprogressives,” against progressive critics. This essay [PDF] will argue that technoprogressive biopolitics express the consistent application of the core progressive values of the Enlightenment: the right of individuals to control their own bodies, brains and reproduction according to their (...) own conscience, under democratic states that work for the public good. -/- Insofar as left bioconservatives want to ensure the safety of therapies and their equitable distribution, these concerns can be addressed by thorough and independent regulation and a universal health care system, and a progressive bioethics of enhancement can unite both enthusiasts and skeptics. Insofar as bioconservative concerns are motivated by deeper hostility to the Enlightenment project however, by assertion of pre-modern reverence for human uniqueness for instance, then a common program is unlikely. -/- imageAfter briefly reviewing the political history and contemporary landscape of biopolitical debates about enhancement, the essay outlines three meta-policy contexts that will impact future biopolicy: the pressure to establish a universal, cost-effective health insurance system, the aging of industrial societies, and globalization. Technoprogressive appeals are outlined that can appeal to key constituencies, and build a majority coalition in support of progressive change. Finally, some guiding principles for a technoprogressive approach to biopolicy are offered. (shrink)

Background: The World Health Organization has endorsed a community-based health insurance scheme (CBHIS) as a shared financing plan to improve access to health services and ensure universal coverage of the healthcare delivery system. Such a contributory scheme is the most likely option to provide health insurance coverage when governments cannot offer direct health care support. Despite improvements in access to current healthcare services, Ethiopia’s healthcare delivery remained low, owing to the country’s underdeveloped healthcare (...) finance system. As a result, the present study assessed CBHIS coverage and its predictors in Ethiopia at the individual and community level. Methods: The availability of CBHIS was checked via a criterion: at least one of the cluster respondents had to be enrolled in CBHIS. This study was based on secondary data from the Ethiopia Mini Demography and Health Survey (EMDHS) 2019 and included 7724 respondents. The study population was described using percentage and frequency. Four multilevel mixed-effects logistic regression modelling stages were performed to control for variations due to heterogeneity across clusters, and determinant predictors of CBHIS enrollment were outplayed. Results: The prevalence of CBHIS enrollment in Ethiopia was 33.13%. Rural residents were 3.218 times (AOR = 3.218; 95% CI: 1.521, 6.809), male household heads were 1.574 times (AOR = 1.574, 95% CI: 1.105, 2.241), getting funds from the safety net program were times 2.062 (AOR = 2.062, 95% CI: 1.297, 3.279), attending the primary educational level was 1.686 times (AOR = 1.686, 95% CI: 1.007, 2.821), bank accounts were 1.373 times (AOR = 1.373, 95% CI: 1.052, 1.792), and wealth index was 1.356 times (AOR = 1.356, 95% CI: 1.001, 1.838) more likely associated with CBHIS coverage, whereas the regions, the other religions, and women aged 20– 24 had lower odds of CBHIS coverage. Conclusion: In Ethiopia, regional healthcare expenditure per capital, religious affiliation, women age range, residents, sex of household head, funds from the safety net program, formal educational level, and having bank accounts were associated with community-based health insurance scheme coverage. (shrink)

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 end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

The study aimed to identify the effect of Total Quality Management in achieving the requirements of the quality of job life among university college employees, and the researchers used the descriptive and analytical approach, and used a main tool to collect information, which is: the questionnaire. The study population reached (596) academic and administrative employees distributed among (5) University colleges in Gaza Strip, and a stratified random sample of (240) employees was selected, approximately (40.3%) of the study population. SPSS software (...) was used to analyze the data. The study concluded that the application of the requirements of total quality management in university colleges in Gaza Strip is appropriate in general in terms of: (the commitment of the top management to total quality management, organizational structure, management with facts, focus on beneficiaries, staff empowerment, and continuous improvement). The sample on the dimensions of total quality management with a relative weight is (69.93%). And that the elements of job quality in university colleges in Gaza Strip are generally adequate in terms of: (moral working conditions, wages and rewards, participation in decision-making, handling of complaints and grievances, benefits provided to employees), where the response of the sample respondents was about the dimensions of job quality with a relative weight (63.30%), and the existence of a strong positive relationship between Total Quality Management in university colleges in Gaza Strip. And that there is a statistically significant effect of the variables of comprehensive quality management and quality of career in university colleges in Gaza Strip at a significance level (α = 0.05). And that the dimensions of total quality management most influencing the dimensions of job quality are: (empowering employees; continuous improvement; focusing on beneficiaries; managing with facts). The absence of differences between the answers of the sample members about the impact of Total Quality Management in achieving the requirements of the quality of the job life of the employees in university colleges due to the variable (academic qualification, years of service). And the existence of differences attributed to a variable (gender in favor of the male category, the college in favor of the university college of applied sciences category, and the nature of work attributed to an academic category with an administrative position). Among the most important recommendations of the study is the necessity for university colleges to be keen on: (achieving job satisfaction, employee participation when setting regulations and policies and making important decisions, adhering to scientific research requirements and encouraging scientific achievements and career creativity among employees, while providing material and moral facilities for scientific research and development, developing mechanisms and patterns of electronic work). University colleges must provide benefits to employees such as: (providing health care, organizing leisure trips, contributing to solving economic problems, providing club subscriptions). And the necessity for university colleges to pay attention to handling complaints and grievances through: (Assigning an efficient and competent committee to handle complaints and grievances in all fairness and transparency, adopting and following up the results of the application of handling complaints and grievances, protecting complainants from any arbitrary action against them). And the need for the Ministry of Education and Higher Education to develop the evaluation role of the National Authority for Accreditation, Quality and Quality of Higher Education Institutions to evaluate the performance of university colleges, to ensure the application of academic and administrative quality standards in colleges, and to seek the help of quality and excellence experts in evaluating the application of Total Quality Management in the academic and administrative f ield in accordance with regional performance standards And global. (shrink)

La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de (...) salud. Por lo tanto, el informe es pertinente para cada agente que infl uye en ese camino y en particular para los gobiernos, ya que se encargan de supervisar y guiar el progreso hacia la cobertura universal de salud. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs (...) focused on one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

The present article is presenting the ‘Healthcare Hazards and Its Impact on Health Insurance Business – An Overview during COVID-19’. The present paper studied the health insurance, health insurance plans in India, Indian market size, health care industry, government actions for the COVID-19, and healthcare business in India, private health insurance in India, hazardous of the healthcare industry and health insurances, and Indian healthcare issues in 2019. The author has concluded that all insurance (...) policies are levied higher taxes by the government, these lead higher income to the companies, and these are creating how commissions to the agents and other insurance organizations under reinsurance, but no benefits to the insured. It may not be a long term benefit, why because there is no maturity fund/income, because of these are shortterm benefits; how many of the policyholders are getting the benefits from the general health insurance companies. Hence, the research is required to calculate for the need of levy-the tax from the non-claimant portion of the income of the general health insurance on an annual basis to the health department of the nation. (shrink)

Attaining Nirvana Using the Universal Formula: Eliminating Imbalances in the Body, Emotions, Mind, and Spirituality -/- By Angelito Malicse -/- Introduction -/- Nirvana, the state of ultimate peace and liberation, can only be attained by eliminating all imbalances in the body, emotions, mind, and spirituality. My universal formula, which follows the law of balance in nature, the law of karma as a systemic principle, and feedback mechanisms, provides an exact path to achieving this state. -/- Imbalances in human (...) life arise due to physical illnesses, negative emotions, irrational thinking, and spiritual confusion. These imbalances cause suffering, preventing people from achieving inner peace. By applying my universal formula, one can correct these defects and align with the natural laws that govern life, leading to a harmonious existence and the attainment of Nirvana. -/- This essay will provide real-world examples of how imbalances arise in each aspect of human existence and how applying my universal formula eliminates them. It will also highlight the importance of medicine, positive emotions, deep faith in God or Divine Essence, and how they contribute to balance and enlightenment. -/- 1. The Role of the Body in Creating Imbalance and the Solution -/- Example of Physical Imbalance: Chronic Illness Due to an Unhealthy Lifestyle -/- Scenario: A person consumes excessive processed foods, avoids exercise, and does not get enough sleep. Over time, they develop obesity, diabetes, and heart disease. These physical imbalances create suffering by limiting mobility, causing chronic pain, and shortening lifespan. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The body requires proper nutrition, movement, and rest to function optimally. A balanced diet, regular exercise, and sufficient sleep restore equilibrium. -/- Apply the Law of Karma as a Systemic Principle: The body operates as a biological system, and like any system, it must be free of defects to function correctly. Eliminating unhealthy habits and seeking medical care corrects these defects, restoring proper function. -/- Use Feedback Mechanisms for Self-Correction: Pain, fatigue, and illness are signals from the body indicating an imbalance. Instead of ignoring these warnings, one should adjust lifestyle choices, preventing further suffering. -/- Example of Physical Imbalance: Addiction (Alcoholism, Drug Use, Smoking) -/- Scenario: A person suffers from alcohol addiction, which damages their liver, distorts their judgment, and causes conflict in relationships. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The human body cannot function well when it is poisoned by harmful substances. Eliminating alcohol and drugs and replacing them with healthy habits restores physical and mental balance. -/- Apply the Law of Karma as a Systemic Principle: Addiction is a defect in the nervous system—it alters brain chemistry, leading to dependency. Medical treatment, rehabilitation, and psychological support correct this defect, helping the person regain control. -/- Use Feedback Mechanisms for Self-Correction: Withdrawal symptoms, declining health, and damaged relationships are signals of imbalance. Recognizing these signs motivates change, leading to recovery. -/- The Importance of Medicine -/- Medicine plays a crucial role in restoring physical balance. When the body suffers from illness, medical intervention corrects internal imbalances. However, medicine must be combined with lifestyle changes and emotional stability for long-term health. -/- 2. The Role of Emotions in Creating Imbalance and the Solution -/- Example of Emotional Imbalance: Uncontrolled Anger and Hatred -/- Scenario: A man is always angry at his coworkers, leading to stress, conflicts, and isolation. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: Anger disrupts inner peace and must be regulated through emotional awareness and self-discipline. -/- Apply the Law of Karma as a Systemic Principle: Uncontrolled anger is a defect in the emotional system. Practicing patience, forgiveness, and communication corrects this defect, leading to healthier interactions. -/- Use Feedback Mechanisms for Self-Correction: Frequent stress, tension, and failed relationships indicate emotional imbalance. Recognizing these effects motivates change toward emotional stability. -/- The Importance of Positive Emotions in Human Relationships -/- Positive emotions such as love, compassion, and gratitude create harmony in relationships. Expressing kindness and understanding balances social interactions, reducing conflicts and strengthening bonds. This balance is necessary for personal peace and the path to Nirvana. -/- 3. The Role of Spirituality in Creating Imbalance and the Solution -/- Causes of Spiritual Imbalance -/- Spiritual imbalances occur when a person lacks connection, purpose, or faith. The main causes include: -/- 1. Materialism and Excessive Focus on the Physical World – Prioritizing wealth, power, or pleasure over inner peace and wisdom leads to dissatisfaction. -/- 2. Religious Dogma and Fear-Based Beliefs – When spirituality is based on fear, guilt, or rigid doctrines, it creates psychological distress rather than enlightenment. -/- 3. Loss of Faith or Meaning in Life – When people lose trust in God, Divine Essence, or Higher Purpose, they experience emptiness and existential suffering. -/- 4. Isolation and Lack of Spiritual Practice – A lack of meditation, prayer, or reflection disconnects people from inner wisdom. -/- Example of Spiritual Imbalance: Loss of Faith and Meaning -/- Scenario: A person feels lost, purposeless, and disconnected from life. -/- Solution Using the Universal Formula: -/- Follow the Universal Law of Balance in Nature: The soul craves connection to something greater. Engaging in spiritual practices like prayer, meditation, or service restores spiritual balance. -/- Apply the Law of Karma as a Systemic Principle: A loss of faith is a defect in the spiritual system. Deepening one’s connection to God, Divine Essence, or Higher Guidance corrects this defect, bringing fulfillment. -/- Use Feedback Mechanisms for Self-Correction: Depression and existential dread indicate spiritual emptiness. Seeking meaning through faith and selfless service restores harmony. -/- The Importance of Deep Faith in God or Divine Essence -/- Faith provides inner stability, helping people endure suffering and maintain hope and resilience. A deep connection with the Divine or Universal Truth aligns human existence with higher wisdom, guiding one toward Nirvana. -/- Conclusion -/- Attaining Nirvana requires eliminating imbalances in the body, emotions, mind, and spirituality. My universal formula provides the exact method to restore balance by aligning with natural laws, correcting systemic defects, and using feedback mechanisms for self-correction. -/- By embracing health, positive emotions, wisdom, and spiritual faith, one can transcend suffering and achieve ultimate peace. This is the path to Nirvana—the state of complete harmony with the universe. -/- . (shrink)

Introduction: Universal health coverage (UHC) was introduced in Iran in 2014. The aim of this study was to evaluate the usage rate of health services by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after UHC implementation. Material and methods: In 2018, in a cross-sectional study, we evaluated the outpatients’ needs (within its previous month) and inpatients’ needs (within its previous 6 months) of HIV/AIDS patients in Isfahan province (the center of Iran). Concurrently, we estimated the essential (...) health care services that HIV/AIDS patients have to receive regularly, including vaccination for hepatitis B, measurement of CD4, tuberculosis (TB) assessments and TB treatment, anti-retroviral therapy, examination of viral load, treatment approach, and drug side effects counseling. Two checklists were used for assessing the utilization of health services and essential health cares for HIV/AIDS patients, validated by the Ministry of Health and Medical Education of Iran. Data were analyzed by χ2 test, Pearson’s correlation coefficient, and Spearman’s correlation test. Results: Two hundred and thirteen HIV/AIDS patients completed the questionnaires. The mean age of participants was 41.14 ± 9.23. The outpatient service utilization rate was 31.94% in the previous month and the rate of hospitalization was 126 per 1,000 HIV/AIDS patients in the previous 6 months. The majority of HIV/AIDS patients received essential health services more often than the national standard goals estimation. Conclusions: After UHC implementation, the utilization rate of outpatients and inpatients services in HIV/AIDS patients was more than similar indices in the general population. In addition, HIV/AIDS patients received essential health services adequately. (shrink)

We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order (...) to argue how at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident. (shrink)

We reply to critics of the World Health Organisation's Report "Making Fair Choices on the Path to Universal Health Coverage". We clarify and defend the report's key moral commitments. We also explain its role in guiding policy in the face of both financial and political constraints on making fair choices.

This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.

Offers a commentary on the Report 'A Fair Path to Universal Health Coverage' from the perspective of the Director of the Ethiopian Ministry of Health.

Prophets and Their Teachings on the Universal Law of Balance in Nature -/- Throughout history, prophets and spiritual teachers from major religions have conveyed divine wisdom about the fundamental principles that govern human life and the natural world. One of the most essential and recurring themes in their teachings is balance—both within the self and in the universe. The idea of balance in nature is not just a scientific or philosophical concept; it is deeply embedded in religious teachings, where (...) it is often associated with justice, harmony, and divine wisdom. -/- This essay explores how the teachings of various prophets and religious figures align with the universal law of balance in nature, emphasizing how their guidance promotes equilibrium in human behavior, society, and the environment. -/- The Concept of Universal Balance in Religious Teachings -/- The universal law of balance in nature suggests that all aspects of existence are governed by equilibrium. When balance is maintained, harmony and sustainability prevail, but when it is disrupted, chaos and suffering follow. This idea is reflected in the teachings of prophets from different traditions, who have warned against excesses and guided humanity toward a balanced way of living. -/- 1. Prophet Muhammad and the Principle of Moderation (Islam) -/- In Islam, Prophet Muhammad (peace be upon him) emphasized the importance of balance in all aspects of life. The Quran states: -/- “Thus, We have made you a just community that you will be witnesses over the people.” (Quran 2:143) -/- This verse highlights the concept of a “middle path,” where believers are encouraged to avoid extremes in wealth, worship, and personal conduct. -/- Examples of Balance in Islam -/- Balance in Worship and Life Responsibilities: The Prophet discouraged excessive asceticism, saying, “Your body has a right over you, your family has a right over you, and your Lord has a right over you.” This means a person should not neglect their health or family in pursuit of religious devotion. -/- Balance in Economic Justice: Islam encourages wealth accumulation through lawful means but commands the wealthy to share with the poor through Zakat (charity) to prevent economic inequality. -/- Balance in Environmental Stewardship: The Prophet encouraged conservation, advising not to waste water even when performing ablution next to a river. -/- 2. Jesus Christ and the Balance Between Justice and Mercy (Christianity) -/- Jesus Christ (peace be upon him) taught about maintaining balance between justice and compassion. He emphasized love, forgiveness, and righteousness while also upholding moral responsibility. -/- Examples of Balance in Christianity -/- Balance in Judgment: Jesus upheld moral laws but also demonstrated compassion. When a woman was accused of adultery, he said, “Let he who is without sin cast the first stone.” (John 8:7). This shows the balance between enforcing justice and offering mercy. -/- Balance Between Wealth and Spirituality: Jesus taught that wealth should not dominate one’s heart. “It is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God." (Matthew 19:24). However, he did not reject wealth outright but taught that it must be used for good. -/- Balance in Love and Discipline: Jesus preached love but also emphasized accountability, reminding people that forgiveness does not mean the absence of justice. -/- 3. The Teachings of the Buddha on the Middle Way (Buddhism) -/- Although not considered a prophet in the Abrahamic sense, Siddhartha Gautama, known as the Buddha, emphasized balance through the doctrine of the Middle Way. This principle teaches that neither extreme asceticism nor indulgence leads to enlightenment; rather, a path of moderation brings harmony. -/- Examples of Balance in Buddhism -/- Balance in Desires: Before attaining enlightenment, the Buddha experienced both extreme luxury as a prince and extreme asceticism as a monk. Realizing both were harmful, he taught the Middle Way: living with neither indulgence nor deprivation. -/- Balance in Emotions: Buddhist teachings emphasize equanimity—staying balanced in both joy and suffering. This aligns with the law of nature, where all things are impermanent, and excessive attachment or aversion leads to suffering. -/- 4. Moses and the Laws of Justice and Order (Judaism) -/- Prophet Moses (peace be upon him) delivered divine laws that established balance in society. The Ten Commandments, given to guide human behavior, promote justice, honesty, and moral integrity. -/- Examples of Balance in Judaism -/- Balance in Law and Mercy: The principle of “an eye for an eye” (Exodus 21:24) is often misunderstood, but it fundamentally conveys the idea of proportionate justice—a principle that maintains societal balance. -/- Balance in Leadership: Moses was a strong leader but also a humble servant of God, showing that true leadership requires both authority and compassion. -/- Balance in Sabbath Observance: Judaism teaches that work is important, but rest and worship are equally necessary. The Sabbath (Shabbat) is a day of rest to maintain a balance between labor and spiritual rejuvenation. -/- 5. Laozi and the Taoist Concept of Yin and Yang (Taoism) -/- Laozi, the founder of Taoism, introduced the idea of Tao (the Way), which emphasizes balance in nature. His teachings focus on the Yin-Yang principle, where opposite forces (light and dark, strong and weak) are interconnected and necessary for harmony. -/- Examples of Balance in Taoism -/- Balance in Nature: Taoist philosophy teaches that trying to force control over nature disrupts harmony. For example, excessive deforestation leads to climate imbalance. -/- Balance in Leadership: Laozi emphasized wu wei—non-interference—where leaders should guide rather than control. This reflects the balance between action and patience in governance. -/- 6. Hinduism and the Concept of Dharma (Hinduism) -/- Hinduism emphasizes Dharma, which means duty, righteousness, and balance in life. The Bhagavad Gita teaches that every individual has a duty to maintain harmony in their personal and social life. -/- Examples of Balance in Hinduism -/- Balance in Life Stages (Ashramas): Hindu philosophy divides life into four stages—student life, householder life, hermit life, and renunciation—each stage balancing material and spiritual responsibilities. -/- Balance in Karma: The law of karma teaches that actions have consequences, emphasizing that ethical balance must be maintained to achieve spiritual liberation (moksha). -/- Balance in Diet and Health: Ayurveda, the traditional Hindu system of medicine, promotes Sattvic (pure) food and a balanced lifestyle for physical and mental well-being. -/- Modern Implications of the Universal Law of Balance -/- The teachings of these prophets and religious traditions demonstrate that balance is not only a natural law but also a moral and social necessity. -/- 1. Environmental Balance -/- Islamic teachings on conservation: Islam encourages environmental responsibility through teachings on sustainable living. -/- Christian teachings on stewardship: The Bible commands humans to care for God’s creation. -/- Hindu respect for nature: Rivers, mountains, and forests are considered sacred. -/- 2. Social and Economic Balance -/- Confucianism’s Social Harmony: Confucius emphasized that rulers must ensure economic balance by promoting fairness. -/- Islamic Finance: Islamic principles prohibit exploitative interest (riba) to prevent economic imbalance. -/- Buddhist Mindful Economics: Encourages reducing greed and promoting ethical business practices. -/- 3. Inner Balance and Mental Well-being -/- Jainism’s Ahimsa (Non-Violence): Jain teachings emphasize inner peace by avoiding harmful emotions like anger and greed. -/- Christianity’s Peace Teachings: Jesus taught that true peace comes from within, encouraging people to find balance between worldly duties and spiritual fulfillment. -/- Conclusion -/- The universal law of balance in nature is deeply embedded in the teachings of major religious traditions. Whether it is Islam’s call for moderation, Christianity’s balance between justice and mercy, Buddhism’s Middle Way, Hinduism’s Dharma, or Taoism’s Yin and Yang, all these teachings highlight the importance of equilibrium in life. -/- By applying these timeless principles, humanity can create a more just, sustainable, and harmonious world. -/- . (shrink)

Lifelong learning is becoming part of the philosophy of professional education. Continuing medical education is the responsibility of all personnel who are responsible for the delivery of components of the healthcare delivery system. Continuing education is becoming increasingly obvious for medical universities, hospitals, and health care providers. Pharmacists who practice in a community pharmacy and hospital, and who are participating in residency recognize that the traditional role of the pharmacist is changing. Over the last decades, a host of (...) new services have been identified as a function of the pharmacist [1]. A review of these services revealed a personal commitment to continuing education. It is the absolute need to develop a level of competence that will improve patient care. In Libya, pharmacists working in the community practice setting are pharmacists with a diploma of pharmacy or with a Bachelor of Pharmaceutical Science, Master of Science, and Doctor of Pharmacy (Pharm D). The main objective is that the graduates possess the knowledge and skills needed to optimally mange the pharmaceutical services [1, 2]. Patient's expectations from pharmacists are that the medicine should be effective, safe and affordable. (shrink)

The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair (...) disadvantage, equal moral concern, reciprocity, and instrumental value. These values are universal. None of the values are sufficient alone, and their relative weight and application will vary by context. In addition, there are procedural principles such as transparency, engagement, and evidence-responsiveness. Prioritising instrumental value and minimising harms during the COVID-19 pandemic led to widespread agreement on priority tiers to include health-care workers, first responders, people living in congregate housing, and people with an increased risk of death, such as older adults and individuals with medical conditions. However, the pandemic also revealed problems with the implementation of these values and priority tiers, such as allocation on the basis of population rather than COVID-19 burden, and passive allocation that exacerbated disparities by requiring recipients to spend time booking and travelling to appointments. This ethical framework should be the starting point for the allocation of scarce medical resources in future pandemics and other public health conditions. For instance, allocation of the new malaria vaccine among sub-Saharan African countries should be based not on reciprocity to countries that participated in research, but on maximally reducing serious illness and deaths, especially among infants and children. (shrink)

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effectDesign, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”.Results–Practitioners accept the relevance of (...) concepts widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment.Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

The circumstances that create the need for humanitarian action are rarely morally neutral. The extremes of deprivation and want that demand a humanitarian response are often themselves directly caused by acts of war, persecution or misgovernment. And even when the direct causes lie elsewhere—when suffering and loss are caused by natural disaster, endemic disease or poverty of natural resources—the explanations of why some people are afflicted, and not others, are not morally neutral. It is those without economic or political power (...) who starve in famines, those who inhabit the most marginal areas who are killed by floods and landslides, those without access to basic education and health care who die from easily preventable diseases. The societies in which these things can happen are unjust, and the injustice of disempowerment is both itself one of the universal afflictions of poverty and a condition of its many other vulnerabilities. (shrink)

Patient autonomy has a critical role in making decisions in medical practice and it is accepted by international conventions on health care and various national medical codes. However, pertaining to terminally ill patients, this right becomes very problematic in regards to end of life decisions. Utilitarian ethicists motivated by materialistic worldview and individualism have made patient autonomy based arguments for the permissibility of active euthanasia. An appraisal of pro-euthanasia arguments that include the best interest, golden rule, and autonomy (...) is made in this paper. The best interest and golden rule arguments are based on subjective moral judgment thus failing the universalization test. The argument from autonomy is unconvincing because of the confounded autonomy of the terminally ill patients. (shrink)

The purpose of this essay is to make the case that the ethical issues raised by the current U.S. practice of direct-to-consumer prescription drug advertising are worthy of study in philosophy courses, and to provide instructors with some ideas for how they might approach teaching the topic, despite the current relative scarcity of philosophical literature published on it. This topic presents a unique opportunity to cover ground in ethics, critical thinking, and scientific literacy simultaneously. As a case study, the practice (...) of DTC advertising is both theoretically rich and universally relevant to students’ lives. The nature of these ads—numerous, diverse, visually and thematically entertaining—makes them delicious fodder for in-class activities, small group work, discussion-based learning, creative projects, and customizable essay topics. I offer a set of suggestions for approaching the study of DTC drug ads that is informed by my own experience doing so in bioethics courses. Ultimately, including this topic on your syllabus not only contributes to students’ philosophical skills and knowledge, but also helps them become better informed as citizens and potential “consumers” of health care. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has (...) at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

The circumstances that create the need for humanitarian action are rarely morally neutral. The extremes of deprivation and want that demand a humanitarian response are often themselves directly caused by acts of war, persecution or misgovernment. And even when the direct causes lie elsewhere—when suffering and loss are caused by natural disaster, endemic disease or poverty of natural resources—the explanations of why some people are afflicted, and not others, are not morally neutral. It is those without economic or political power (...) who starve in famines, those who inhabit the most marginal areas who are killed by floods and landslides, those without access to basic education and health care who die from easily preventable diseases. The societies in which these things can happen are unjust, and the injustice of disempowerment is both itself one of the universal afflictions of poverty and a condition of its many other vulnerabilities. (shrink)

This paper expands on another which focussed on Socrates’s question: ‘How should one live?’. The present paper also focusses on the ‘meaning of life’ and ‘meaning in life’ issues, and more on rights. To fully rationally answer Socrates’s question, we need to answer the epistemic question: ‘How can one know how one should live?’. This paper attempts to answer both. And knowing how one should live fundamentally involves knowing what values one should live by. This includes which rights one should (...) have and which rights others should have. So one’s values include how one should treat all persons (and (other) animals, the environment and so on.) All this relates to what one finds meaningful in life and the meaning or point of one’s life. In sum, all the notions in this paper’s title are interrelated. The issue of rationality is crucial here. Just one example here (qualified later) is that our rationality gives us cognitively meaningful notions. ‘Rationality’ here only concerns knowledge, e.g., ways to acquire scientific knowledge, and meta-knowledge concerning values. No values or rights as such are rational or knowledge. However:- Many factors are required for human rationality to exist and develop, e.g., life, mental health and evidence-based education. Human rationality’s need for those factors, hence their value to rationality, is rationally-unquestionable – and that applies to the practised values prescribing the prescribable factors. With this, there are rationally-unquestionable rights to those factors. Those prescribable factors require certain interrelated epistemic, moral, social, political, legal, educational and other values/rights to be practised. This implies a pro-rationality values-theory with one obligatory, general end – a uniquely rationally-unquestionable end. This end provides the basis for answering Socrates’s question as rationally (correctly) as is possible for values/rights. That end is fundamentally epistemic, namely ‘Be pro-rationality’, yet the theory has deeply-humanly-meaningful, universal applications. It has implications for current and all possible moral, social, political, legal, educational, environmental etc issues. E.g., the theory shows that human rationality crucially requires love and certain other emotions, health-care, education and upbringing. These require certain right to be respected and practised. With this, the paper discusses affection, free speech, journalism, psychotherapy, political and sexual consent, responsibilities, freedom and government. The theory’s general sub-values prescribe much prescribed by some other theories, e.g., broad and deep knowledge-acquisition (in certain areas), rationally-critical thinking, non-sexism, non-racism, general types of liberalism, holistic flourishing, happiness, unselfishness and fairness. However, all other values-theories lack pro-rationality theory’s maximum possible rational-unquestionability, internal coherence and coherence with rationality. The theory encourages (the right to) total freedom in a-rationality areas, areas irrelevant to its obligatory end. The theory inherently requires its advocates to be (self )critical, rationally viewing the theory’s necessarily human-suggested specifics as often fallible or unavoidably approximate. So the theory is a work-in-progress. (shrink)

Authors: Joseph M. Eble, John A. Di Camillo, Peter J. Colosi. --- NEWS RELEASE For Immediate Release February 27, 2024 Contact: Joseph M. Eble, MD Corresponding author 919-667-5206 -/- The statement, Catholics United on Brain Death and Organ Donation: A Call to Action (HTML), was published on February 27, 2024. It was prepared by Joseph Eble, a physician and President of the Tulsa Guild of the Catholic Medical Association; John Di Camillo, an ethicist of The National Catholic Bioethics Center; and (...) Peter Colosi, a philosophy professor at Salve Regina University. -/- Catholic United explains that the criteria for brain death establish only partial loss of brain function. This is now abundantly clear based on scientific studies, a recent effort to lower the legal standard for death, and updated brain death guidelines issued in October 2023. -/- Catholics United bridges a divide among faithful Catholics about whether the concept of brain death aligns with Church teaching. Some Catholics hold that brain death represents true death when there is complete and irreversible cessation of all brain activity, often called whole brain death. Others hold that brain death does not represent true death. Since the existing criteria establish only partial loss of brain function, all the endorsers—whether they accept or reject whole brain death as true death—agree that “the current brain death criteria in widespread use do not provide moral (prudential) certainty of death.” -/- Catholics United calls on health care professionals and institutions to cease organ harvesting that relies on the inadequate criteria, noting that 70% of all donors are declared dead using brain death criteria. “Given the lack of moral certainty of death whenever the current brain death criteria are used,” the statement affirms, “a clear majority of vital organ donors can be presumed alive at the time of organ harvesting.” Since the Catholic Church forbids removing vital organs when this would kill the patient, “it is therefore wrong to remove organs from patients declared dead using these inadequate criteria.” . (shrink)

A new series entitled Oxford Philosophical Concepts (OPC) made its debut in November 2014. As the series’ Editor Christia Mercer notes, this series is an attempt to respond to the call for and the tendency of many philosophers to invigorate the discipline. To that end each volume will rethink a central concept in the history of philosophy, e.g. efficient causation, health, evil, eternity, etc. “Each OPC volume is a history of its concept in that it tells a story about (...) changing solutions to specific philosophical problems” (xiii). The series presents itself as innovative along three main lines: its reexamination of the so-called “canon,” its reconsidering the value of interdisciplinary exchanges, and its encouraging philosophers to move beyond the current borders of philosophy. By engaging with non-Western traditions and carefully considering topics and materials which are not strictly philosophical, the collections from this series aim to render the history of philosophy accessible to a wide audience. -/- The first OPC volume to appear in print is “Efficient Causation – A History” edited by Tad Schmaltz. Using careful historical and philosophical analysis as well as interdisciplinary reflections this anthology proposes to tell the story of how efficient causation, equated nowadays with “causation” tout court, came to play its prominent role in our philosophical and scientific vocabulary. Eleven contributions cover the period from Ancient times (Aristotle and the Stoics), through the Middle Ages (both the Western and the Islamic traditions), passing through the Early Modern times (represented here by Descartes, Spinoza, Leibniz, Malebranche, Berkeley and Hume), all the way to Kant and finally contemporary philosophers (classified into two opposing camps: Humean and Neo-Aristotelian). There are also four reflections which explore the applications of the notion of efficient causation to areas different from philosophy, especially the arts (literature, music, painting, etc.). (shrink)

The truth about health care policy lies between two exaggerated views: a market view in which individuals purchase their own health care from profit maximizing health-care firms and a control view in which costs are controlled by regulations limiting which treatments health insurance will pay for. This essay suggests a way to avoid on the one hand the suffering, unfairness, and abandonment of solidarity entailed by the market view and, on the other hand, (...) to diminish the inflexibility and inefficiency of the control view. It suggests that the way to mitigate these problems is to recognize the malleability of motivation and the range of factors, in addition to financial incentives, that may influence the behavior of patients and especially physicians. (shrink)

When, if ever, can healthcare provider's lay claim to knowing what is best for their patients? In this paper, I offer a taxonomy of clinical disagreements. The taxonomy, I argue, reveals that healthcare providers often can lay claim to knowing what is best for their patients, but that oftentimes, they cannot do so *as* healthcare providers.

Health care systems can positively influence our personal decision-making and health-related behavior only if we trust them. I propose a conceptual analysis of the trust relation between the public and a healthcare system, drawing from healthcare studies and philosophical proposals. In my account, the trust relation is based on an epistemic component, epistemic authority, and on a value component, the benevolence of the healthcare system. I argue that it is also modified by the vulnerability of the public (...) on healthcare matters, and by the system’s credibility. I apply my proposed analysis of public trust in health care systems to the phenomenon of vaccine hesitancy, a tendency to question vaccine policies, and to seek alternative vaccine schedules or to refuse vaccination. Understanding the role of trust and its components can be key to understanding the phenomenon. (shrink)

The advance of scientific approaches to life has recorded a plethora of successes as well as failures. Man being at the center of its experiment is tossed toe and fro by the result of its inquiry. Predictions are that in the nearest time, humanity might be living absolutely under the directives of Technology based on Artificial intelligence. At present, Technology based on Artificial Intelligence is quickly finding its way into various areas of life including health and social services. This (...) spread and or interplay connotes the relinquishing of health responsibilities from man to sensor technology as well as dependency on the data and result of this technology. This effort questions this unethical dependency as well as raises moral issues associated with the use of Technology base on artificial intelligence on psychiatric patient. It dabbles into medical values such as; autonomy of the patient cum consent, Kantian universal principle and its implication to implementing the universal usage of technology in mental health care services, and so on. The work of Patricia A. Arean (2016) titled Mobile Technology for Mental Health Assessment gave an in-depth analysis of the available approaches, doting advantages of sensor technology on psychiatric patient. The paper applied the analytic, descriptive and prescriptive method of philosophy to achieve its objective. To this end, it is in the view of this work imperative for the mental-medical community to consider reflectively these issues and the philosophic recommendations provided herein. (shrink)

To fully rationally answer Socrates’s question, ‘How should one live?’, we need to answer the epistemic question: ‘How can one know how one should live?’. This paper attempts to answer both. ` The issue of rationality is crucial here. ‘Rationality’ here only concerns knowledge, e.g., ways to acquire scientific knowledge, and meta-knowledge concerning values. No values as such are rational or knowledge. However:- Many factors are required for human rationality to exist and develop, e.g., life, mental health and evidence-based (...) education. Human rationality’s need for those factors, hence their value to rationality, is rationally-unquestionable – and that applies to the practised values prescribing the prescribable factors. Those prescribable factors require certain interrelated epistemic, moral, social, political, legal, educational and other values to be practised. This implies a pro-rationality values-theory with one obligatory, general end – a uniquely rationally-unquestionable end. This end provides the basis for answering Socrates’s question as rationally (correctly) as is possible for values. That end is fundamentally epistemic, namely ‘Be pro-rationality’, yet the theory has deeply-humanly-meaningful, universal applications. It has implications for current and all possible moral, social, political, legal, educational, environmental etc issues. E.g., the theory shows that human rationality crucially requires certain emotions, health-care, education and upbringing. With this, the paper discusses affection, free speech, journalism, psychotherapy, political and sexual consent, rights, responsibilities, freedom and government. The theory’s sub-values prescribe much prescribed by some other theories, e.g., broad and deep knowledge-acquisition (in certain areas), rationally-critical thinking, non-sexism, non-racism, general types of liberalism, holistic flourishing, happiness, unselfishness and fairness. However, all other values-theories lack pro-rationality theory’s maximum possible rational-unquestionability, internal coherence and coherence with rationality. The theory encourages total freedom in a-rationality areas, areas irrelevant to its obligatory end. The theory inherently requires its advocates to be (self )critical, rationally viewing the theory’s necessarily human-suggested specifics as often fallible or unavoidably approximate. So the theory is a work-in-progress. (shrink)

Thesis --University of Stellenbosch, 2004 Acceptance of the concept of medical futility facilitates a paradigm shift from curative to palliative medicine, accommodating a more humane approach and avoiding unnecessary suffering in the course of the dying process. This should not be looked upon as abandoning the patient but rather as providing the patient and family with an opportunity to come to terms with the dying process. It also does not entail withdrawal or passivity on the part of the health (...) care professional. In addition to medical skills, the treating physician is responsible for guiding this process by demonstrating sensitivity and compassion, respecting the values of patients, their families and the medical staff. The need for training to equip medical staff to take responsibility as empathetic participants in end-of-life decision-making is underscored. S Afr Med J 2008; 98: 284-286. (shrink)

‘Rationality’ here only concerns knowledge, e.g., ways to acquire scientific knowledge. Many factors are required for human rationality to exist and develop, e.g., life and evidence-based education. Rationality’s need for those factors, hence their value to rationality, is rationally-unquestionable. Those factors require certain educational, moral, political, social, health-care etc values to be practised. This implies a pro-rationality education-theory and related values-theory, with one obligatory, general end – a uniquely rationally-unquestionable end. That theory has deeply-humanly-meaningful, universal applications: the (...) theory has implications for current and all possible educational, moral etc issues. The theory’s sub-values prescribe much prescribed by some other theories, e.g., broad and deep knowledge-acquisition, critical thinking, non-sexism, non-racism, types of liberty, holistic flourishing, happiness, unselfishness and fairness. However, other theories lack pro-rationality theory’s maximum possible rational-unquestionability, internal coherence and coherence with rationality. The theory encourages freedom in a-rationality areas, areas irrelevant to its obligatory end. The theory inherently requires its advocates to be (self )critical, rationally viewing their human-suggested specifics as often fallible or unavoidably approximate. Similarly for students and educators. (shrink)

‘Rationality’ here only concerns knowledge, e.g., ways to acquire scientific knowledge. Many factors are required for human rationality to exist and develop, e.g., life and evidence-based thinking. Rationality’s need for those factors, hence their value to rationality, is rationally-unquestionable. Those factors require certain moral, political, social, legal, health-care etc values to be practised. This implies a pro-rationality values-theory, with one obligatory, general end – a uniquely rationally-unquestionable end. That theory has deeply-humanly-meaningful, universal applications: the theory has implications (...) for current and all possible moral, political etc issues. The theory’s sub-values prescribe much prescribed by some other theories, e.g., non-sexism, non-racism, types of liberty, happiness, peace, altruism and fairness. However, other theories lack pro-rationality theory’s maximum possible rational-unquestionability, internal coherence and coherence with rationality. The theory encourages freedom in a-rationality areas, areas irrelevant to its obligatory end. The theory inherently requires its advocates to be (self )critical, rationally viewing their human-suggested specifics as often fallible or unavoidably approximate. Kant’s, Rawls’s, Aristotle’s, Mill’s and certain others’ ideal societies or lives fundamentally require rationality. Rationality-required factors and associated practised values are needed here. All societies and lives are rationality-required to be based on achieving that rationally-unquestionable general end. (shrink)

Many assume that theories of distributive justice must obviously take people’s lifetimes, and only their lifetimes, as the relevant period across which we distribute. Although the question of the temporal subject has risen in prominence, it is still relatively underdeveloped, particularly in the sphere of health and healthcare. This paper defends a particular view, “momentary sufficientarianism,” as being an important element of healthcare justice. At the heart of the argument is a commitment to pluralism about justice, where theorizing about (...) just principles demands paying attention to the role particular goods play in our lives. This means that different approaches to the temporal subject—as well as other relevant issues—may be appropriate for different goods, including different goods within healthcare. In particular, the paper discusses two central goods targeted by healthcare: life-saving and pain relief. The view is offered as complementary to, rather than competitive with, lifetime approaches. As such, the paper finishes by considering how a pluralist approach, which engages both with people’s lives as a whole and with their states at particular moments, can reconcile the potentially competing claims in healthcare that emerge from these two perspectives. (shrink)

Citizens in wealthy liberal democracies are typically expected to see to basic needs like food, clothing, and shelter out of their own income, and those without the means to do so usually receive assistance in the form of cash transfers. Things are different with health care. Most liberal societies provide their citizens with health care or health care insurance in kind, either directly from the state or through private insurance companies that are regulated like (...) public utilities. Except perhaps for small co-pays or deductibles, citizens are not expected to see to their health needs out-of-pocket, at least for some basic level of care. Instead, when a citizen gets sick, the state or her insurance company foots the... (shrink)

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical (...) decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)