Intuitions about Just Public Healthcare Versus Liberal Political Theory
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Abstract
I argue that strong intuitions about how the state ought to allocate healthcare are incompatible with quite influential autonomy-centric and neutral strains of liberal political theory. Specifically, I maintain that it is uncontroversial that we should routinely distribute medical treatments in public hospitals in ways that have little to no bearing on patients’ ability to pursue a wide array of ends and further that we cannot easily avoid making judgments of which ways of life are good (or bad) when making such distributions. These intuitions tell against the principles that the state in general should aim merely to protect individuals’ rights to choose their own ways of life and should not take sides on which lives are good (or bad) when adopting policy or law. I show that this tension, which has not been addressed in the literature, manifests in at least three types of healthcare decisions, viz., which types of treatments should be offered to patients, how to prioritize among types of treatments, and who should receive a certain type of treatment. I do not prescribe how to resolve the tension, that is, whether to reject autonomy-centric and neutral forms of liberalism or revise judgments about how public medical facilities should allocate healthcare, but instead I establish the point that one must choose between them.
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References
Ackerman B. (1980), Social Justice in the Liberal State, Yale University Press, New Haven (CT).
Arneson R.J. (2000), “Perfectionism and Politics,” Ethics 111 (1): 37–63.
Arneson R. (2003), “Liberal Neutrality on the Good: An Autopsy,” [in:] Perfectionism and Neutrality: Essays in Liberal Theory, G. Klosko and S. Wall (eds.), Rowman and Littlefield, Lanham (MD): 191–218.
Barry B. (1995), Justice as Impartiality, Oxford University Press, New York.
Brody B. (1993), “Liberalism, Communitarianism, and Medical Ethics,” Law and Social Inquiry 18 (2): 393–407.
Casal P., Williams A. (1995), “Rights, Equality, and Procreation,” Analyse and Kritik 17 (1): 93–116.
Daniels N. (1988), Am I My Parents’ Keeper?: An Essay on Justice Between the Young and the Old, Oxford University Press, Oxford.
Daniels N. (1992), “Liberalism and Medical Ethics,” Hastings Center Report 22 (6): 41–43.
DeGrazia D. (1991), “Grounding a Right to Health Care in Self-Respect and Self-Esteem,” Public Affairs Quarterly 5 (4): 301–318.
Dworkin R. (2000), Sovereign Virtue: The Theory and Practice of Equality, Harvard University Press, Cambridge (MA).
Dworkin R. (2003), “Liberalism,” [repr. in:] Perfectionism and Neutrality: Essays in Liberal Theory, G. Klosko and S. Wall (eds.), Rowman and Littlefield, Lanham (MD): 31–39.
Emanuel E.J. (1991), The Ends of Human Life: Medical Ethics in a Liberal Polity, Harvard University Press, Cambridge (MA).
Feinberg J. (1994), “Not with My Tax Money: The Problem of Justifying Government Subsidies for the Arts,” Public Affairs Quarterly 8 (2): 101–123.
Galston W.A. (1991), Liberal Purposes, Cambridge University Press, New York.
Gaus G. (2003), “Liberal Neutrality: A Compelling and Radical Principle,” [in:] Perfectionism and Neutrality: Essays in Liberal Theory, G. Klosko and S. Wall (eds.), Rowman and Littlefield, Lanham (MD): 137–165.
Gibson Q.H. (2021), “Rawlsian Contractualism and Healthcare Allocation,” Diametros 18 (68): 9–23.
Green R.M. (1976), “Health Care and Justice in Contract Theory Perspective,” [in:] Ethics in Health Policy, R. Veatch and R. Branson (eds.), Ballinger, Cambridge (MA): 111–126.
Johnston D. (1994), The Idea of a Liberal Theory, Princeton University Press, Princeton.
Kant I. (1797), The Metaphysics of Morals, trans. M. MacGregor, Cambridge University, New York, 1991.
Kymlicka W. (1989), Liberalism, Community, and Culture, Clarendon Press, Oxford.
Larmore C.E. (1987), Patterns of Moral Complexity, Cambridge University Press, Cambridge.
Lomasky L.E. (1987), Persons, Rights, and the Moral Community, Oxford University Press, New York.
MacIntyre A. (2007), After Virtue, 3rd ed., University of Notre Dame Press, Notre Dame.
Meijers T. (2020), “The Value in Procreation: A Pro-tanto Case for a Limited and Conditional Right to Procreate,” The Journal of Value Inquiry 54 (4): 627–647.
Metz T. (2007), “How to Reconcile Liberal Politics with Retributive Punishment,” Oxford Journal of Legal Studies 27 (4): 683–705.
Metz T. (2016), “The Nature of Poverty as Inhuman: Plausible but Illiberal?” International Journal of Applied Philosophy 30 (1): 1–14.
Metz T. (2024), “A Relational Theory of Dignity and Human Rights: An Alternative to Autonomy,” The Monist 107 (3): 211–224.
Nozick R. (1974), Anarchy, State, and Utopia, Blackwell, Oxford.
Nussbaum M. (2011), Creating Capabilities, Harvard University Press, Cambridge (MA).
Quong J. (2011), Liberalism Without Perfection, Oxford University Press, Oxford.
Rakowski E. (1993), Equal Justice, Oxford University Press, Oxford.
Rawls J. (1971), A Theory of Justice (1st ed.), Harvard University Press, Cambridge (MA).
Rawls J. (1975), “Fairness to Goodness,” The Philosophical Review 84 (4): 536–554.
Rawls J. (1988), “The Priority of Right and Ideas of the Good,” Philosophy and Public Affairs 17 (4): 251–276.
Rawls J. (1993), Political Liberalism, Colombia University Press, New York.
Rawls J. (2001), Justice as Fairness: A Restatement, Harvard University Press, Cambridge (MA).
Raz J. (1988), The Morality of Freedom, Oxford University Press, Oxford.
Richards D.A.J. (1989), Toleration and the Constitution, Oxford University Press, New York.
Sher G. (1997), Beyond Neutrality, Cambridge University Press, Cambridge.
Veatch R.M. (1981), A Theory of Medical Ethics, Basic Books, New York.
Vincent A. (1998), “Liberalism and the Environment,” Environmental Values 7 (4): 443–459.