Ethics in American Health 1: Ethical Approaches to Health Policy
Jennifer Prah Ruger,
Am J Public Health published 13 August 2008, 10.2105/AJPH.2007.121343
http://www.ajph.org/cgi/content/abstract/AJPH.2007.121343v1?papetoc
“…..I trace the evolution of ethical approaches to health policy in the
· First, fair resource-allocation procedures claim more attention than substantive and procedural principles.
· Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions.
· Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their tradeoffs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy….”
Ethics in American Health 2: An Ethical Framework for Health System Reform
Jennifer Prah Ruger,
Am J Public Health published 13 August 2008, 10.2105/AJPH.2007.114124
http://www.ajph.org/cgi/content/abstract/AJPH.2007.114124v1?papetoc
“…..I argue that an ethical vision resting on explicitly articulated values and norms is critical to ensuring comprehensive health reform. Reform requires a consensus on the public good transcending self-interest and narrow agendas and underpinning collective action for universal coverage. In what I call shared health governance, individuals, providers, and institutions all have essential roles in achieving health goals and work together to create a positive environment for health. This ethical paradigm provides
(1) reasoned consensus through a joint scientific and deliberative approach to judge the value of a health care intervention;
(2) a method for achieving consensus that differs from aggregate tools such as a strict majority vote;
(3) combined technical and ethical rationality for collective choice;
(4) a joint clinical and economic approach combining efficiency with equity, but with economic solutions following and complementing clinical progress; and
(5) protection for disabled individuals from discrimination.
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