Efficiency, Justice and Care: Philosophical Reflections on Scarcity in Health Care
Denier, Yvonne 20070306 Springer-Verlag，326p.
last update:20110625
■Denier, Yvonne 20070306 Efficiency, Justice and Care: Philosophical Reflections on Scarcity in Health Care，Springer-Verlag，326p. ASIN:1402052138 ISBN-13:978-1402052132 USドル 209 [amazon]／[kinokuniya] ※ c04 dr01 nm08 sa07 rj04 j08 p03
■内容
内容説明
This book attempts to answer the question how health care can be incorporated into a comprehensive theory of justice, while realising an acceptable balance between efficiency, justice and care. It seems to be that we can have any two but not all three. Essentially, the central question addressed by this book is the following: how best to square the proverbial welfare circle.
■目次
Acknowledgements
General Introduction
Part I Just Health Care: Presuppositions & Objectives
Introduction to Part Ⅰ
Chapter1. Just Health Care: Core Issues
1.1 Public and Private: A Historical Outlook
1.1.1 Antiquity: A Cultivated Mind in a Disciplined Baby
1.1.2 Towards Institutionalisation of Health Care
1.1.3 Politics of Health in the Nineteenth Century
1.1.4 Contemporary Health Care: A Complex Framework
1.2 Levels, Actors, Institutions and Decisions
1.2.1 Four Levels
1.2.2 Various Actors
1.2.3 Diverse Institutions
1.2.4 Two Types of Decision-Making
1.2.4.1 Macro-Level Decisions
1.2.4.2 Micro-Level Decisions
1.2.4.3 Reflective Equilibrium
1.2.5 Private Concern and Public Passion
1.3 Distributive Justice: Circumstances, Principles and Theories
1.3.1 What is Justice?
1.3.1.1 Syyn Cuique Trubuere
1.3.1.2 The Circumstances of Justice
1.3.1.3 Bounded Society
1.3.1.4 Institutions
1.3.1.5 Agency
1.3.1.6 Formal and Material Principles of Justice
1.3.2 Why Behave Justly?
1.3.3 How to Determine What Justice Demands?
1.3.4 The Just and the Good
1.4 Four Objectives Two Paradigms
1.4.1 Four Objectives: The Internal Health-Care Trade-Off
1.4.2 The Pricate and the Public Paradigm
Chapter2. Scarcity, Finitude & the Normative Value of Health
2.1 On Scarcity of Health-Care Resources
2.1.1 Context: Scarcity as a Contemporary Facium
2.1.1.1 The Twofold Dynamics of Scarcity
2.1.1.2 Scarcity in Health Care
2.1.2 Setting Limits: Coping with the Gap
2.2 Combining Efficiency, Effectiveness and Equity
2.2.1 Increasing Health-Care Costs
2.2.2 Various Causes
2.2.2.1 Medical Technology: Exponential Increases
2.2.2.2 Modern Medicalsation of Life
2.2.3 Enhancing Efficiency and Effectiveness
2.2.3.1 Reduce Supply
2.2.3.2 Reducing the Demand for Care
2.2.4 While Perserving Equity
2.3 The Essence of Equity in Health Care
2.3.1 Equality of What? Defining the Focal Variable
2.3.1.1 Equal Liberty?
2.3.1.2 Equal Welfare?
2.3.1.3 Equal Health?
2.3.1.4 Equal Use for Equal Need?
2.3.1.5 Equal Access for Equal Need?
2.3.1.6 Equal Choice Set?
2.3.2 Needs and Preferences in Health Care
2.3.2.1 The Principle of Prudence
2.3.2.2 Needs in Philosophical Disrepute?
2.3.2.3 Scanlon's Proposal: Urgency
2.3.2.4 Frankfurt's Characterisation: Volition and Harm
2.3.2.5 Objective Truncated Scale of Well-Being
2.3.3 Basic Needs Primary Goods and Basic Capabilities
2.3.3.1 Basic Needs: An Antropological Foundation
2.3.3.2 Primary Social Goods: The "Thin" Strategy
2.3.3.3 The "Thick" Conception of Basic Capabilities
2.3.4 Health-Care Needs
2.3.4.1 Health-Care Needs and Normal Functioning
2.3.4.2 Health, Disease and Opportunity
2.3.4.3 Macro and Micro Level
2.3.5 A Human Right to Health Care?
2.3.5.1 What is a Human Right to Health Care?
2.3.5.2 The Basic of the Right to Health Care
2.3.5.3 The Scope of the Right to Health Care
2.4 Care and the Boundaries of Human Life
2.4.1 Scarcity as Expression of Finitude
2.4.2 Theefold Relevance of the Finitude Approach
2.4.2.1 Exponential Increases of Medical Technology
2.4.2.2 Focus on Normal Functioning
2.4.2.3 Tendency Towards Infinity
2.4.3 The Normative Value of Healthy Normal Functioning
2.4.3.1 Instrumental Valuation
2.4.3.2 Strong Intrinsic Valuation
2.4.3.3 Complex Valuation: Reassessing Finitude
2.4.4 A Contemporary Socratuc Perspective
2.4.4.1 Revaluation of the Limits of Human Extence
2.4.4.2 Reassessing Scarcity in Health Care
2.4.4.3 Equal Respect for the Dignity of All Persons
2.4.4.4 The Paradox of Scarcity and Abundance in Care
Conclusion of Part Ⅰ
Part Ⅱ Distributive Justice & Health Care
Introduction to Part Ⅱ
Chapter 3. Justice as Fairness:John Rawls
3.1 Some Basic Features of Rawl's Theory
3.1.1 Primary Goods and the Basic Structure of Society
3.1.2 The Principles of Justice
3.1.3 Reflective Equilibrium
3.1.3.1 Considered Judgements
3.1.3.2 The Original Position
3.1.4 Maximin
3.1.5 Four Important Qualities of Rawlsian Theory
3.1.5.1 The Inviolability of the Person
3.1.5.2 Objective Goods Theory
3.1.5.3 Strategic Role of the Primary Social Goods
3.1.5.4 Real Equality of Opportunity
3.2 Rawlsian Reflections on Just Health Care
3.2.1 Health as a Natural Primary Good
3.2.2 Ideal Theory
3.2.3 Income and Wealth
3.2.4 The Inflexibility Critique
3.2.4.1 Capabilities
3.2.4.2 Actual Choice
3.3 Extending Rawls to Normal Health Care
3.3.1 Health Care: An Additional Primary Social Good?
3.3.2 Fair Equality of Opportunity: Normal Daniels
3.3.2.1 The Special Moral Importance of Health Care
3.3.2.2 Which Health Inequalities are Unjust?
3.3.2.3 When are the Limits to Health-Care Fair?
3.3.3 Qualities of Daniel's Theory
3.3.3.1 The Objective and Small-Scale Moral Function
3.3.3.2 Answering the Inflexibility Critique
3.3.4 Problems and Challenges
3.3.4.1 A Thin Theory
3.3.4.2 Too Narrow-Too Vague-Too Strong
3.3.4.3 Inefficacious Health Care
Chapter 4. Nussbaum's Approach: a Non-Contractarian Account of Care
4.1 A Second Extension to Long-Term Care?
4.1.1 Beyond the Social Contract: Martha Nussbaum's Critique
4.1.1.1 A Kantian Concequence of the Person
4.1.1.2 Productive Reciprocity
4.1.1.3 Primary Goods
4.1.1.4 Implications
4.1.2 Important Qualities of Nussbaum's Critique
4.1.2.1 Continuity
4.1.2.2 Knowledge Inconsistency in the Original Position
4.1.2.3 Long-Term Care and the Difference Principle
4.1.2.4 Postponement is not Innocent
4.1.3 Reciprocity and the Problem of Justice: Possible Strategies?
4.2 Nussbaum's Capabilities Approach
4.2.1 Other Virtues?
4.2.2 Complementary Theory?
4.2.3 Sen and Nussbaum: Main Agreements
4.2.3.1 The Capabilities Space
4.2.3.2 Priority of Liberty
4.2.3.3 Distinctness of Persons
4.2.4 Nussbaum Differs: Towards Her Own Proposal
4.2.4.1 Commitment About Substance
4.2.4.2 A List of the Central Human Capabilities
4.2.4.3 Distinguishing Characteristics
4.2.5 Some Counterreactions
4.2.5.1 Democratic Deliberation
4.2.5.2 Freedom
4.2.5.3 Concerns of Pluralism
4.2.5.4 Paternalism
4.3 Resuming Long-Term Care
4.3.1 Add Care to the List
4.3.2 Redesign to a List of Capabilities
4.3.3 To a Richer Account of Primary Goods
4.3.4 Redesign the Political Concept of the Person
4.4 On the Contribution of Nussbaum's Capabilities Approach
4.4.1 Rich but Liberal
4.4.4.1 Broad But Not Conmprehensive
4.4.1.2 Embodied Liberalism
4.4.2 Complex Reciprocity
4.4.2.1 Human Functioning and Independence
4.4.2.2 Rich and Complex Reciprocity
4.2.2.3 Social Inclusion
4.4.3 All Human Beings
4.4.4 Self-Respect
4.4.5 Strong Connection with Human Experience and Sensibility
4.4.6 The Tragic and the Unjust
4.4.7 Scarcity and the Language of Limits
Chapter 5. Setting Limits: Dworkin’s Proposal
5.1 Two Intuitions on Limits
5.1.1 The General Liberal Intuitions
5.1.2 Personal Responsibility
5.2 The Dialogue with Ralws: Two Problems with the Second Principle
5.2.1 Natural Primary Goods
5.2.2 Choice and Ambition
5.3 Dworkin's Resource Egalitarianism
5.3.1 The Ambition-Sensitive Auction
5.3.2 Brute Luck, Option Luck and Insurance
5.3.3 Compensation before the Auction?
5.3.4 Reaching Endowment-Insensitivity: the Hypothetical Insurance
5.3.5 A Middle-Course Proposal
5.3.6 A Second-Best Theory?
5.4 On Health Care: Reconciling Quality, Equality, Liberty and Efficiency
5.4.1 Rethinking the Idela of Insulation
5.4.2 The Prudent Insurance Principle
5.4.3 Implications
5.4.3.1 A Limited Moral Right
5.4.3.2 Probably Not Including
5.4.3.3 But Prudently Providing
5.5 Toward Evaluation: Qualities and Deawbacks
5.5.1 Reassessing the Fact of Scarcity and the Issue of Limits
5.5.1.1 The Internal Health-Care Trade-Off
5.5.1.2 Efficiency and Long-Term Care
5.5.1.3 Additional Private Insurance
5.5.1.4 Reflective Equilibrium
5.5.2 Health: One Resource Among Others?
5.5.2.1 Conception of Just Health Care
5.5.2.2 The Argument of Fair Income Shares
5.5.2.3 Internal Incoherence
5.5.3 On Personal Responsibility and the Right to Health Care
5.5.3.1 Dworkin's Cut
5.5.3.2 Brute Luck and Option Luck
5.5.3.3 Luck-Egalitarianism: Relocating Dworkin's Cut
5.5.3.4 Practical Applicability
5.5.3.5 Overemphasising Moral Arbitarariness
Conclusion of Part Ⅱ
General Conclusion:Health Care & the Limits of Human Existence
Chapter 6. Just Health Care: Foundations & Prospects
6.1 Desoderata for Principles of Just Health Care
6.1.1 Embodied Liberalism
6.1.2 Strong Egalitarian Perspective
6.1.3 Which Health-Care Goods and Services?
6.1.4 The Moral Importance of Just Health Care
6.1.5 The Essence of a Truly Human Right to Health Care
6.1.6 A Forward-Looking Policy of Inclusion
6.1.7 Limited Scope
6.2 Refining the Contemporary Socratic Perspective
6.2.1 A General Moral Perspective
6.2.2 The Limits of Human Existence
6.2.2.1 Decent-Quality Basic Care
6.2.2.2 The External Question
6.2.2.3 The Internal Question
6.2.3 The Cardinal Virtues?
6.2.3.1 Temperance
6.2.3.2 Prudence
6.2.3.3 Fortitude
6.2.3.4 Justice
6.3 Resuming the Contemporary Debate
6.3.1 Access to Health Care
6.3.2 Health-Care Rationing
6.3.3 Rationing by Responsibility
6.3.4 Long-Term Care
Bibliography
Index
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