TY - BOOK AU - Fleck,Leonard M. TI - Just Caring: Health Care Rationing and Democratic Deliberation SN - 9780199722891 AV - RA410.53 -- .F62 2009eb U1 - 362.1/0425 PY - 2009/// CY - Oxford PB - Oxford University Press, Incorporated KW - Health care rationing -- Moral and ethical aspects -- United States KW - Public health -- Moral and ethical aspects -- United States KW - Health services accessibility -- United States KW - Right to health -- United States KW - Health care reform -- United States KW - Social justice -- United States KW - Electronic books N1 - Intro -- CONTENTS -- 1 JUST CARING: AN INTRODUCTION -- The "Just Caring" Problem: Core Argument -- Rationing Justly: The Moral Challenge -- Applications of the Deliberative Model -- 2 THE ETHICAL CHALLENGES OF HEALTH CARE RATIONING -- The Story of Coby Howard and Its Lessons -- Why Health Care Rationing Is Inescapable -- Renal Dialysis and the Medicare End-Stage Renal Disease (ESRD) Amendments -- The Totally Implantable Artificial Heart (TIAH) -- 3 PRICING HUMAN LIFE: GETTING BEYOND TRAGIC CHOICES -- Is Human Life Priceless? -- Tragic Choices or Tragic Disingenuousness? Invisible Rationing -- Invisible Rationing and the Publicity Condition -- Managed Care and Health Care Rationing -- 4 ELEMENTS OF HEALTH CARE JUSTICE -- Is Health Care Morally Special? -- Non-ideal Justice: A Moral Analysis and Defense -- Pluralism, Justice, and Rational Democratic Deliberation -- 5 RATIONAL DEMOCRATIC DELIBERATION: SCOPE AND STRUCTURE -- The Scope of Rational Democratic Deliberation -- Fair Health Care Rationing: Not Markets, Not Physicians, Not Bureaucrats -- Rational Democratic Deliberation: Taking Seriously the Tragedy of the Commons -- Rational Democratic Deliberation: Key Structural Features -- Rational Democratic Deliberation and Fair Health Care Rationing -- Wide Reflective Equilibrium and Just Health Care Rationing -- Priority Setting, Wide Reflective Equilibrium, and Rational Democratic Deliberation: Addressing the Stability Problem -- Facts, Wide Reflective Equilibrium, and Democratic Deliberation -- Constitutional Principles of Health Care Justice and Rational Democratic Deliberation -- Evaluating the Deliberative Process -- Objections and Responses -- 6 SETTING LIMITS FOR EFFECTIVE COSTLY THERAPIES -- Problem Introduction -- Setting Limits: Options in the ESRD Program -- Setting Limits: Options for HIV+/AIDS Patients; Setting Limits: The Case of Artificial Hearts -- Setting Limits: Concluding Comments -- 7 LAST-CHANCE THERAPIES -- Introduction: Scope of the Problem -- Why Last-Chance Therapies? Weak Moral Arguments -- Last-Chance Therapies and Rational Democratic Deliberation -- Futility and Last-Chance Therapies -- 8 RATIONING, CATASTROPHICILLNESS, AND DISABLED PATIENTS -- Introduction: The Scope of the Problem -- Needs Are Not Enough -- Effectiveness Must Matter -- The Oregon Plan and the Disability Critique -- Health Care Justice and the Disability Critique -- Defining the Disabled: Ethical Implications -- Conclusions -- 9 IS AGE-BASED RATIONING EVER "JUST ENOUGH"? -- Defining the Problem: Can We Accept Natural Limits to Life? -- Justice and Age-Based Rationing: Fair Innings -- The Prudential Life Span Account -- Age-Based Rationing: Major Objections -- Age-Based Rationing: Responses to Objections -- Age-Based Rationing and the Duty to Rescue -- Conclusions -- 10 DO FUTURE POSSIBLE CHILDREN HAVE A JUST CLAIM TO A SUFFICIENTLY HEALTHY GENOME? -- Framing the Issue -- Preimplantation Genetic Diagnosis (PGD): A Historical Side Note -- Does Justice Require Public Funding for Limited PGD? -- Concluding Comments: Justice and Genetic Enhancement -- 11 ORGAN TRANSPLANTATION: WHEN IS ENOUGH ENOUGH? -- Scope of the Issue -- The Maximization Argument: A Critical Moral Analysis -- The Pittsburgh Protocol: How Dead Must Donors Be? -- Organ Procurement and Financial Incentives: A Critical Assessment -- Presumed Consent/Duty to Donate: Critical Remarks -- Justice and Multi-Organ Transplants or Retransplants -- Concluding Comments -- 12 THE LIBERALISM PROBLEM -- Justice, Health Care Needs, and Morally Controversial Interventions -- Liberal Communitarianism: Is It Just Enough? Is It Liberal Enough? -- Resolving the Liberalism Problem: Public Reason and Public Interests; Concluding Reflections -- 13 THE ETHICAL CHALLENGES OF PRIORITY SETTING IN PUBLIC HEALTH -- Defining the Problem -- The Scope of Public Health: Challenges and Choices -- Health Care Justice and Public Health: When Is Enough Enough? -- Setting Public Health Priorities Justly: The Limits of Moral Theory -- 14 FINANCING HEALTH CARE FAIRLY -- Why National Health Insurance? -- Why Health Reform? -- Assessing Competing Proposals for Health Reform -- Health Savings Accounts: A Critical Assessment -- Health Care Vouchers: A Critical Assessment -- Single-Payer Reform: A Constructive Proposal -- Summary and Reflective Conclusions -- NOTES -- REFERENCES -- INDEX -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W -- X N2 - Should everyone with advanced heart disease have a 300,000 artificial heart? Should everyone with advanced cancers have 100,000 cancer drugs for extra months of life? How should a "just" and "caring" society with limited resources respond? This book addresses the central moral and political challenges of health reform today UR - https://ebookcentral.proquest.com/lib/orpp/detail.action?docID=2012762 ER -