FE-Rec7&8 - Obligation to act? 2 (Problems in Population (cannot do…
FE-Rec7&8 - Obligation to act? 2
Public and Global Concern
Quinn’s Cal. Law Rev. Article
Need to know terminology for exams
PRemise: wanting to reform healthcare :
last century, medicare, medicaid
private insurance, to amortize end of life healthcare cost
managed care - to spread cost
healthcare research impacted by insurance
90s - addressing the relationship between managed care and healtcare space.
KNOW -- (a) clinton proposal (b) oregon plan
clinton plan 1994 -
idea of justice
if you shift something in government, you are saying it is "common good" - obligation of society for all members of society.
US we are liberalist -- tied in to individualism - and therefore inherently at odds with common good.
# landmark. -- .. why at the roots is the imit of individualism.
individualism vs communitarism
part 3 - has 3 definition of common good. 1. catholic version 2. Ross's view p289
common good "does not equal" common morality
common good - seeks a support of an overlapping consensus. For Ross -> the common good is what the consensus says it is.
majority is not the consensus. -- we tend to agree on, "when you lose the vote, you go along"
Governance - obligation of society for all members of society
notion of neutrality
p297 - review what liberal neutrality claim to be. view that public instution or law should not promote any particular view of a "good life". the right should be given priority over the good.
neutrality is something to question in liberalism. basic antagonism to communitarism.
p298. critics attack liberalism because it separates personal values from political ideals. "neutrality". should elected official bring their personal values to their vote?
communitarism -- why in deliberating about justice should we set aside our moral judgments that inform the rest of our lives? why must we bracket our moral and religious conviction? p298 is personal morality political? is our political morality personal? -- does have a physician have freedom of choice in their morality? is the president of the US free to enact his/her morality?
healthcare. but to answer that, we need to be more general. what should governance be? should it be law only?
gov should be more than legal. what should your law allow to cover? voting rights only? behaviour? social? action? healthcare?
“Viewing HC as a Common Good”
shift in economic perpsective
Problems in Population
cannot do dollar to dollar comparison. unfair.
can do percentage comparison
A public health ethics
Moral reasoning & deliberation
(we are not going to get questions answered by a set of rules) - human rights declaration can be damaging. sovereign state law do not solve the problem because it express only certain view of morality.
2.Principalism, casuistry, and other approaches.
Problem with Principalism - can be vague.
casuistry - case based approach to ethics. Need to apply moral reasoning. it is not going to answer itself.
3.Issues specific to public health
reducing risks across the public
surveillance, emergency response, regulation, monitoring
ethics of screening
if you don't have a solution. that is not a straight win win.
normative ethics - proscriptive
principelism - leaning towards normative
Infectious Diseases - biochemical variables that ignore nation state boundaries
burden of paying for health of people with behaviour you can't control
common good is how we operate
e.g. league of nation / UN is a common good
Constitution, Laws, form of government, form of market, rules -- how typically things have operated