Abstract:
:Over the past 10 years, John Harris has made important contributions to thinking about distributive justice in health care. In his latest work, Harris controversially argues that clinicians should stop prioritising patients according to prognosis. He argues that the good or benefit of health care is providing each individual with an opportunity to live the best and longest life possible for him or her. I call this thesis, opportunism. For the purpose of distribution of resources in health care, Harris rejects welfarism (the thesis that the good of health care is well-being) and argues that utilitarianism in general may lead to de facto discrimination against groups of people needing health care. I argue that well-being is a superior theory of the good of health care to Harris' opportunism. Harris' concerns about utilitarianism can be better addressed by: (i) relating justice more closely to reasons for action; (ii) by conceptualising the relationship between reasons for action and the value of the consequences of those actions as a plateau rather than scalar relationship. Justice can be understood as satisfying as many equally rational claims on resources as possible. The rationality of a person's claim on health resources turns on the strength of that person's reasons to promote certain health-related states of affairs. I argue that the strength of that reason does not track the expected value of that state of affairs in a fully scalar fashion. Rather a person can have most reason to promote some state of affairs, even though he or she could promote other more valuable states of affairs. Thus there can be equal reason for a distributor of public resources to save either of two people, even though one will have a better and more valuable life. This approach, while addressing many of Harris' concerns about utilitarianism, does not imply that doctors should give up prioritising patients according to prognosis altogether, but it does allow that patients with lower but reasonable prognosis should have a share of public resources.
journal_name
Bioethicsjournal_title
Bioethicsauthors
Savulescu Jdoi
10.1111/1467-8519.00109subject
Has Abstractpub_date
1998-07-01 00:00:00pages
212-35issue
3eissn
0269-9702issn
1467-8519journal_volume
12pub_type
杂志文章相关文献
BIOETHICS文献大全abstract::The ethical aspects of placebo control in clinical trials have been extensively and controversially debated in the last decade. However, a thorough analytical comparison of the different existing international regulations, their terminologies and their ethical principles concerning placebo, is still missing. The centr...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2007.00587.x
更新日期:2008-01-01 00:00:00
abstract::In this paper I analyse the ethical implications of the two main competing methodologies in genomic research. I do not aim to provide another contribution from the mainstream legal and public policy perspective; rather I offer a novel approach in which I analyse and describe the patent-and-publish regime (the propriet...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2009.01723.x
更新日期:2009-09-01 00:00:00
abstract::Political communities across the world have recently sought to tackle rising rates of vaccine hesitancy and refusal, by implementing coercive immunization programs, or by making existing immunization programs more coercive. Many academics and advocates of public health have applauded these policy developments, and the...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12645
更新日期:2019-11-01 00:00:00
abstract::This paper considers what should be done about offers of organs for transplant that come with racist strings attached. Saving lives or improving their quality seem powerful reasons to accept the offer. Fairness, justice, and rejecting racism seem like powerful reasons against. This paper argues that conditional alloca...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2007.00526.x
更新日期:2007-02-01 00:00:00
abstract::Several recent articles have weighed in on the question of whether moral philosophers can be counted as moral experts. One argument denying this has been rejected by both sides of the debate. According to this argument, the extent of disagreement in modern moral philosophy prevents moral philosophers from being classi...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12173
更新日期:2016-03-01 00:00:00
abstract::Warnock, chair of Britain's Committee of Inquiry into Human Fertilisation and Embryology, discusses the implications of the "artificial family" for children born through the use of reproductive technologies. She considers both treatment of infertility and the possible use of assisted reproduction to enable persons ot...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.1987.tb00023.x
更新日期:1987-04-01 00:00:00
abstract::Peter Singer has argued that nothing done to a fetus before it acquires consciousness can harm it. At the same time, he concedes that a child can be harmed by something done to it when it was a non-conscious fetus. But this implies that the non-conscious fetus can be harmed. The mistake lies in thinking that, since ex...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/1467-8519.00158
更新日期:1999-07-01 00:00:00
abstract::Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end-of-life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English-speaking Japanese Americans, 29 Japane...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2007.00551.x
更新日期:2007-06-01 00:00:00
abstract::Fulford has argued that (1) the medical concepts illness, disease and dysfunction are inescapably evaluative terms, (2) illness is conceptually prior to disease, and (3) a model conforming to (2) has greater explanatory power and practical utility than the conventional value-free medical model. This 'reverse' model em...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2011.01902.x
更新日期:2013-02-01 00:00:00
abstract::Respect for confidentiality is firmly established in codes of ethics and law. Medical care and the patients' trust depend on the ability of the doctors to maintain confidentiality. Without a guarantee of confidentiality, many patients would want to avoid seeking medical assistance The principle of confidentiality, how...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2008.00654.x
更新日期:2008-08-01 00:00:00
abstract::This paper analyses the concept of empirical ethics as well as three meta-ethical fallacies that empirical ethics is said to face: the is-ought problem, the naturalistic fallacy and violation of the fact-value distinction. Moreover, it answers the question of whether empirical ethics (necessarily) commits these three ...
journal_title:Bioethics
pub_type: 杂志文章,评审
doi:10.1111/j.1467-8519.2009.01710.x
更新日期:2009-05-01 00:00:00
abstract::This paper explores the legal and ethical concept of human subject research in order to determine whether genetic research with already available biosamples and data falls within this concept. Although the ethical concept seems to have evolved to recognize research based on data as human research, from a supranational...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12475
更新日期:2019-03-01 00:00:00
abstract::Following Bernheim,(1) we examine aspects of 'felicitometrics,'(2) the measurement of the 'quality' term in Quality of Life (QOL). Bernheim argued that overall QOL is best captured as the Gestalt(3) of a global self-assessment and suggested that the Anamnestic Comparative Self Assessment (ACSA) approach, in which subj...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2008.00642.x
更新日期:2008-07-01 00:00:00
abstract::It has been claimed in several places that the new genetic technologies allow humanity to achieve in a generation or two what might take natural selection hundreds of millennia in respect of the elimination of certain diseases and an increase in traits such as intelligence. More radically, it has been suggested that t...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2008.01703.x
更新日期:2010-10-01 00:00:00
abstract::The discussion on ethical issues, it is said, should not be confined to experts but should be extended to patients and local communities, because of the real need to engage stakeholders and non-stakeholders alike not only in carrying out any biomedical research project, but also in the drafting and legislation of bioe...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2005.00464.x
更新日期:2005-10-01 00:00:00
abstract::When applying moral principles to concrete cases, we assume a background shared understanding of the boundaries of the persons to whom the principles apply. In most contexts, this assumption is unproblematic. However, in end-of-life contexts, when patients are receiving 'artificial' life-support, judgments about where...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2006.00481.x
更新日期:2006-04-01 00:00:00
abstract::Is it ethical to market complementary and alternative medicines? Complementary and alternative medicines (CAM) are medical products and services outside the mainstream of medical practice. But they are not just medicines (or supposed medicines) offered and provided for the prevention and treatment of illness. They are...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12226
更新日期:2016-02-01 00:00:00
abstract::Rebecca Bennett, in a recent paper dismissing Julian Savulescu's principle of procreative beneficence, advances both a negative and a positive thesis. The negative thesis holds that the principle's theoretical foundation - the notion of impersonal harm or non-person-affecting wrong - is indefensible. Therefore, there ...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2010.01870.x
更新日期:2012-10-01 00:00:00
abstract::Antibiotic resistance is one of the most pressing public health problems humanity faces. Research into new classes of antibiotics and new kinds of treatments - including risky experimental treatments such as phage therapy and vaccines - is an important part of improving our ability to treat infectious diseases. In ord...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12596
更新日期:2019-09-01 00:00:00
abstract::This article introduces questions in psychiatric ethics regarding the substantial field of qualitative and quantitative research into 'posttraumatic growth', which investigates how, after devastating experiences, individuals can come to feel that they have developed warmer relationships, increased spirituality, or a c...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12164
更新日期:2015-11-01 00:00:00
abstract::In 2015, the Chinese pharmacologist, Tu Youyou, was awarded the Nobel Prize for Physiology or Medicine for the discovery of artemisinin. Traditional Chinese medicine (TCM) was the source of inspiration for Tu's discovery and provides an opportunity for the world to know more about TCM as a source of medical knowledge ...
journal_title:Bioethics
pub_type: 传,历史文章,杂志文章
doi:10.1111/bioe.12456
更新日期:2020-02-01 00:00:00
abstract::Western studies of national differences in pain have indicated that pain tolerance is higher in white than in Asian patients. The authors' clinical experiences in China seem to contradict this conclusion, and they have investigated the incidence or prevalence of some pain syndromes and have made comparisons with West...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.1989.tb00343.x
更新日期:1989-07-01 00:00:00
abstract::Human beings are essentially vulnerable in the view that their existence qua humans is not given but constructed. This vulnerability received basic protection from the State, expressed in the form of the universal rights all citizens are meant to enjoy. In addition, many individuals fall prey to destitution and depriv...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/1467-8519.00361
更新日期:2003-10-01 00:00:00
abstract::Germline genome editing is often disapproved of at the international policy level because of its possible threats to human dignity. However, from a critical perspective the relationship between this emerging technology and human dignity is relatively understudied. We explore the main principles that are referred to wh...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12607
更新日期:2020-01-01 00:00:00
abstract::The ethical concept of responsiveness has largely been interpreted in the context of international clinical research. In light of the increasing conduct of externally funded health systems research (HSR) in low- and middle-income countries (LMICs), this article examines how responsiveness might be understood for such ...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12138
更新日期:2015-07-01 00:00:00
abstract::This article will explore whether the law should allow people with anorexia nervosa to refuse nutrition and hydration with special reference to the English decision in Re E (Medical Treatment: Anorexia). It argues that the judge in that case made the correct decision in holding that the patient, who suffered from seve...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12593
更新日期:2019-10-01 00:00:00
abstract::This paper considers Habermas' model of a post-secular political order in the light of the debate on male circumcision that arose in Germany after a court ruled that male circumcision was an unjustifiable act of bodily harm. Central to this model is the idea that religious reasons can only become effective in central ...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12526
更新日期:2019-05-01 00:00:00
abstract::The systems approach is a widely accepted method for addressing healthcare adverse events. However, when adverse events are behavioral in nature, such as self-injury or aggression, a systems approach can restrict patient autonomy. We propose guidelines for balancing safety and autonomy considerations when developing s...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12804
更新日期:2021-02-01 00:00:00
abstract::Fatness stigma is pervasive. Being fat is widely regarded a bad thing, and fat persons suffer numerous social and material disadvantages in virtue of their weight being regarded that way. Despite the seriousness of this problem, it has received relatively little attention from analytic philosophers. In this paper, I s...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/bioe.12560
更新日期:2019-06-01 00:00:00
abstract::CIOMS has been criticised for not adequately consulting stakeholders about its revised ethical guidelines regarding medical research. Political and logistical issues that arise in democratic processes and open exchange of information probably contributed to this exclusion. What might CIOMS have done to be more inclusi...
journal_title:Bioethics
pub_type: 杂志文章
doi:10.1111/j.1467-8519.2004.00395.x
更新日期:2004-06-01 00:00:00