Precision Medicine and Distributive Justice: Wicked Problems for Democratic Deliberation

Description

Metastatic cancer and costly precision medicines generate extremely complex problems of health care justice. Targeted cancer therapies yield only very marginal gains in life expectancy for most patients at very great cost, thereby threatening the just allocation of limited health careresources. Philosophers have high hopes for the utility of their theories of justice in addressing the challenges of resource allocation; however, none of these theories can address adequately the "wicked" ethical problems that have resulted from these targeted therapies.What we need instead, bioethicist Leonard M. Fleck argues, is a political conception of health care justice, following Rawls, and a fair and inclusive process of rational democratic deliberation governed by public reason. His account makes the basic assumption that we have only limited health careresources to meet unlimited health care needs generated by emerging medical technologies. The primary ethical and political virtue of rational democratic deliberation is that it allows citizens to fashion autonomously shared understandings of how to fairly address the complex problems of healthcare justice generated by precision medicine. While ideally just outcomes are a moral and political impossibility, "wicked" problems can metastasize if rationing decisions are made invisibly--in ways effectively hidden from those affected by those decisions. As Fleck demonstrates, a fair andinclusive process of democratic deliberation could make these "wicked" problems visible, and subject, to public reason.

Get the book

Amazon.com

Search the book

eBay.com

Search the book

Similar books

• 

  Rationing in Health Care: The Theory and Practice of Priority Setting

  By Suzanne Robinson, Helen Dickinson, Iestyn Williams

  Gallego, G.,Taylor, SJ., McNeill, P. and Brien,J. (2007) 'Public views on priority setting for High Cost Medications in public hospitals in Australia', Health Expectations, vol 10, pp 224–35. Gallego, G., Haas, M.R., Hall,J.P. andViney, ...

• 

  Precision Medicine and Distributive Justice: Wicked Problems for Democratic Deliberation

  By Leonard M. Fleck

  "Wicked ethical problems have been generated by precision medicine due to both the wiliness of cancer and the fragmentation of health care financing in the United States.

• 

  Rationing Health Care: Hard Choices and Unavoidable Trade-offs

  By André den Exter, M. A. J. M. Buijsen

  'Medical need' is a factor in health care access decision-making, but merit-considerations are becoming important too. In the shortening of waiting time, priority arrangements are considered and/or introduced, based on non-medical criteria.

• 

  Rationing and Rights in Health Care

  By Joanne Lenaghan

  ... could result in a two - tier health service which is one of the reasons why we caution against blanket exclusions . As Bynoe has suggested , in the future the private health care sector may find it necessary or desirable to adopt ...

• 

  Proceedings of the 11th Toulon-Verona International Conference on Quality in Services

  By Jacques Martin, Rocco Moliterni

  controlled in the institutions, and thereafter, institutions can improve quality and adjust user services focusing ... Quality experts focus on two main areas, the technical needs of quality control and the human dimensions of quality ...

• 

  Who Shall Live?: Health, Economics and Social Choice

  By Karen Eggleston, Victor R Fuchs

  Since the first edition of Who Shall Live? (1974), over 100,000 students, teachers, physicians, and general readers from more than a dozen fields have found this book to be a reader-friendly, authoritative introduction to economic concepts ...

• 

  Ethics of Allocation of Health Care Resources

  By British Columbia. Ministry of Health and Ministry Responsible for Seniors, British Columbia. Minister's Advisory Committee on Ethical Issues in Health Care

  Discusses the ethics of health care resource allocation, based on the premise that society has an ethical obligation to ensure health care.