Justice and Health Care
Bioethics is a discipline still not fully explored in spite of its rather remark able expansion and sophistication during the past two decades. The prolifer ation of courses in bioethics at educational institutions of every description gives testimony t
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PHILOSOPHY AND MEDICINE
Editors:
H. TRISTRAM ENGELHARDT, JR. Kennedy Institute of Ethics, Georgetown University, Washington, D.C., U.S.A.
STUART F. SPIeKER University of Connecticut. Health Center, Farmington, Conn., U.S.A.
VOLUME 8
JUSTICE AND HEALTH CARE Edited by
EARL E. SHELP Institute of Religion and Baylor College of Medicine, Houston, Texas, U.S.A.
D. REIDEL PUBLISHING COMPANY DORDRECHT : HOLLAND / BOSTON: U.S.A. LONDON: ENGLAND
library of Congress Cataloging in Publication Data Main entry under title: Justice and health care. (Philosophy and medicine; v. 8) Includes bibliographies and indexes. I. Medical ethics. 2. Justice. 3. Medical policy. 1. Shelp, Earl E., 1947[DNLM: I. Delivery of health care. 2. Philosophy, Medical. W3 PH609 v. 8 / W 61 196] 174'.2 80-26152 R724.187 ISBN-13: 978-90-277-1251-6 e-ISBN-13: 978-94-009-8392-2 DOl: 10.1007/978-94-009-8392-2
Published by D. Reidel Publishing Company, P.O. Box 17,3300 AA Dordrecht, Holland. Sold and distributed in the U.S.A. and Canada by Kluwer Boston Inc., 190 Old Derby Street, Hingham, MA 02043, U.S.A. In all other countries, sold and distributed by Kluwer Academic Publishers Group, P.O. Box 322, 3300 AH Dordrecht, Holland. D. Reidel Publishing Company is a member of the KIuwer Group.
All Rights Reserved Copyright © 1981 by D. Reidel Publishing Company, Dordrecht, Holland and copyright holders as specified on appropriate pages within Softcover reprint of the hardcover I st edition 1981 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner
T ABLE OF CONTENTS
EARL E. SHELP I Introduction
vii
SECTION 1/ HISTORICAL AND CONCEPTUAL BACKGROUND ALLEN BUCHANAN I Justice: A Philosophical Review MARTIN P. GOLDING I Justice and Rights: A Study in Relationship FREDERICK S. CARNEY I Justice and Health Care: A Theological
Review
3 23 37
LAURENCE B. McCULLOUGH I Justice and Health Care: Historical
Perspectives and Precedents
51
SECTION II / ISSUES OF MICRO·ALLOCA TION ERIC J. CASSELL I Do Justice, Love Mercy: The Inappropriateness
of the Concept of Justice Applied to Bedside Decisions MARC LAPPE I Justice and Prenatal Life ALBER T R. JO NSEN I Justice and the Defective Newborn MICHAEL D. BA YLES I Justice and the Dying
75 83 95 109
SECTION III / ISSUES OF MACRO·ALLOCA TION H. TRISTRAM ENGELHARDT, JR. I Health Care Allocations:
Responses to the Unjust, the Unfortunate, and the Undesirable
121
JAMES F. CHILDRESS I Priorities in the Allocation of Health Care
Resources
139
BARUCH BRODY I Health Care for the Haves and Have·nots:
Toward a Just Basis of Distribution KIM CARNEY I Cost Containment and Justice KAREN LEBACQZ I Justice and Human Research
151 161 179
T ABLE OF CONTENTS
vi
RONALD M. GREEN / Justice and the Claims of Future Generations EARL E. SHELP / Justice: A Moral Test for Health Care and Health
Policy
