Justice in health care: the contribution of Edmund Pellegrino.
Edmund Pellegrino has pioneered work in medical ethics calling for a reconstruction of Hippocratic ethics. In particular, he has spoken of incorporating principles that concern justice and the common good. This article traces his commitment to the common good, concern for the poor, opposition to libertarianism, acknowledgement of the necessity of rationing, and reluctance to give clinicians social allocational tasks. It asks how Pellegrino relates distributive justice to the common good. Drawing on his theory relating autonomy to patient-centered beneficence (in which autonomy is one element of the good rather than a side constraint on the good), the author argues that Pellegrino appears to make justice one element of the common good rather than a distributional moral constraint on promoting the good. He suggests that Pellegrino stands in three consequentialist or teleological moral traditions: professional physician ethics, Aristotelianism, and Catholic moral theology, but that there are the makings of a more independent, more egalitarian theory of justice in his writings.
Kennedy Institute of Ethics, Georgetown University, Washington, DC 20057.
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D026686:Beneficence; D026689:Ethical Analysis; D028663:Ethical Theory; D004992:Ethics, Medical / Q000266:history*; D049673:History, 20th Century; D006806:Human Rights / Q000266:history*; D006801:Humans; D028681:Moral Obligations; D026684:Personal Autonomy; D010686:Philosophy, Medical / Q000266:history*; D040841:Resource Allocation; D012935:Social Justice / Q000266:history*; D012945:Social Values; D014481:United States; D028722:Virtues; D035862:Vulnerable Populations