Achieving Justice in the U.S. Healthcare System

This book focuses on justice and its demands in the way of providing people with medical care. Building on recent insights on the nature of moral perceptions and motivations from the neurosciences, it makes a case for the traditional medical ethic and examines its financial feasibility. The book starts out by giving an account of the concept of justice and tracing it back to the practices and tenets of Hippocrates and his followers, while taking into account findings from the neurosciences. Next, it considers whether the claim that it is just to limit medical care for everyone to some basic minimum is justifiable. The book then addresses finances and expenditures of the US health care system and shows that the growth of expenditures and the percentage of the gross national product spent on health care make for an unsustainable trajectory. In light of the question what should be changed, the book suggests that overdiagnosis and medicalizing normal behavior lead to harmful, costly andunnecessary interventions and are the result of unethical behavior on the part of the pharmaceutical industry and extensive ethical failures of the FDA. The book ends with suggestions about what can be done to put the U.S. health care system on the path to sustainability, better medical care, and compliance with the demands of justice.

Auteur

Arthur J. Dyck is Mary B. Saltonstall Professor Emeritus of Population Ethics in the School of Public Health, and a member of the Faculty of Divinity at Harvard University. He has written extensively on bioethics and the fundamental value of the availability of health care for all people.

Contenu

Introduction.- Chapter 1. What Justice Demands.- Chapter 2. The Cognitive Bases for Deciding When Policies Are Just.- Chapter 3. Advocating Basic Minimum Medical Care: A Case of Justice Denied.- Chapter 4. Overdiagnosing, Overtesting, and Overmedicalizing Physical Conditions.- Chapter 5. Overdiagnosing, Overtesting, and Overmedicalizing Behavior and Feelings.- Chapter 6. Practices and Policies in the U.S. Health Care System That Are Scientifically and Ethically Unjustifiable: They Should Not and Cannot Persist.- Chapter 7. Suggesting Policies and Practices for Increasing Justice and Assuring the Sustainability of the U.S. Health Care System.