Rawlsian justice in healthcare
A response to Cox and Fritz
Bibliographic Data
| ID | 21514836 |
|---|---|
| Authors | Abeezar I Sarela (0000-0002-7785-9732, Leeds Teaching Hospitals NHS Trust, corresponding author) |
| Year | 2022 |
| Volume | 48 |
| Issue | 6 |
| Pages | 413-415 |
| Publication date | 2022-06-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Journal of Medical Ethics (JOURNAL) |
| Journal identifiers | ISSN: 0306-6800 • E-ISSN: 1473-4257 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/medethics-2020-107144 |
| PMID | 33762297 |
| OpenAlex | W3138753355 |
| Language | EN |
| Citations received | 2 |
| References cited | 10 |
Cox and Fritz state the central problem as the absence of a framework for healthcare policy decisions; but, they overlook the theoretical underpinnings of public law. In response, they propose a two-step procedure to guide fair decision-making. The first step relies on Thomas Scanlon’s ‘contractualism’ for stakeholders to consider whether, or not, they could reasonably reject policy proposals made by others; then in the second step, John Rawls’s principles of justice are applied to these proposals; a fair policy requires to pass both steps. I argue that Cox and Fritz misinterpret Rawls. His theory has two stages: first, public reason is used to generate principles of justice; second, public reason is used to interpret and apply these principles. The second stage requires that proposals are based on the principles of justice from the first stage, and these proposals have to be acceptable to reasonable persons. Thus, Rawls’s theory does not need Scanlonian supplementation. Moreover, the application of Rawls’s theory in Cox and Fritz’s model is confusing. In any case, the problems with applying Rawlsian justice to healthcare can be located elsewhere. First, Rawls’s theory would treat healthcare simply as a ‘primary good’ or resource. Social justice ought to, instead, consider healthcare as an opportunity, in the manner conceived by Amartya Sen. Second, Rawlsian justice rests, ultimately, on the conception of a reasonable person; until and unless the characteristics of reasonable stakeholders are clarified, any model of health justice will remain hostage to the unreasonable
Contractualism · Economic Justice · Health care · Law and economics · Political science · Politics · Primary goods · Public reason · Reflective equilibrium · Sociology · Health Systems, Economic Evaluations, Quality of Life · Healthcare cost, quality, practices · Healthcare Policy and Management · Law
Just Health
The Quality of Life
Utilitarianism and Beyond
Contractualism and utilitarianism
Reconciliation Through the Public Use of Reason
Reconciliation Through the Public use of Reason
Integrating philosophy, policy and practice to create a just and fair health service
Political Liberalism and Public Reason
The Idea of Justice
| Citations per year | 0.5 |
|---|---|
| Citation span | 2022 - 2024 (3) |
| Highly cited | No |