Re-asserting the Specialness of Health Care

Is health care “special”? That is, do we have moral reason to treat health care differently from how we treat other sorts of social goods? Intuitively, perhaps, we might think the proper response is “yes.” However, to date, philosophers have often struggled to justify this idea—known as the “specialness thesis about health care” or STHC. In this article, I offer a new justification of STHC, one I take to be immune from objections that have undercut other defenses. Notably, unlike previous utility- and opportunity-based theories, I argue that we can find normative justification for STHC in what I term our special duty to assist those unable to help themselves. It is this duty, I argue, that ultimately gives us reason to treat health care differently from other sorts of goods (even other goods meeting health needs) and to distribute it independently of individuals’ ability to pay

Spinoza’s Analysis of his Imagined Readers’ Axiology

Before presenting his own account of value in the Ethics, Spinoza spends much of EIAppendix and EIVPreface attempting to refute a series of axiological ‘prejudices’ that he takes to have taken root in the minds of his readership. In doing so, Spinoza adopts what might be termed a ‘genealogical’ argumentative strategy. That is, he tries to establish the falsity of imagined readership’s prejudices about good and bad, perfection and imperfection, by first showing that the ideas from which they have arisen are themselves false. Many elements of this genealogy, however, remain unclear. First, both the nature of the metaethical prejudices Spinoza believes we have been labouring under, and the metaphysical prejudices that he takes to have given rise to them, continue to attract widespread disagreement. Although much less commented on, it is also not entirely obvious why Spinoza takes the one to have engendered the other. In this article, I attempt to clarify Spinoza’s reasoning in both of these respects, ultimately concluding that Spinoza offers us two accounts of how this process has occurred, the first beginning from an anthropocentric doctrine of divine providence, the second from more secular, perhaps more purely Aristotelian metaphysical tradition

Self-tests for influenza: an empirical ethics investigation

Background In this article we aim to assess the ethical desirability of self-test diagnostic kits for influenza, focusing in particular on the potential benefits and challenges posed by a new, mobile phone-based tool currently being developed by i-sense, an interdisciplinary research collaboration based (primarily) at University College London and funded by the Engineering and Physical Sciences Research Council. Methods Our study adopts an empirical ethics approach, supplementing an initial review into the ethical considerations posed by such technologies with qualitative data from three focus groups. Results Overall, we map a range of possible considerations both for and against the use of such technologies, synthesizing evidence from a range of secondary literature, as well as identifying several new considerations previously overlooked. Conclusions We argue that no single consideration marks these technologies as either entirely permissible or impermissible but rather tools which have the potential to incur certain costs and benefits, and that context is important in determining these. In the latter stages of the article, we explain how developers of such technologies might seek to mitigate such costs and reflect on the possible limitations of the empirical ethics method brought out during the study

Improving productive efficiency in hospitals::findings from a review of international evidence

AbstractAt present, health systems across Europe face the same challenges: a changing demographic profile, a rise in multi-morbidity and long-term conditions, increasing health care costs, large public debts and other legacies of an economic downturn. In light of these concerns, this article provides an overview of the international evidence on how to improve productive efficiency in secondary care settings. Updating and expanding upon a recent review of the literature by Hurst and Williams (2012), we set out evidence on potential interventions in the policy environment, hospital management, and operational processes. We conclude with five key lessons for policy makers and practitioners on how to improve productive efficiency within hospital settings, and identify several gaps in the existing evidence base.</jats:p