[Evaluation of the health care system: pluralism of the concepts of justice].
Georgetown Mantra, recognized as sui generis credo of the principalism in the contemporary bioethics, introduces two radically new principles into medical ethics: observance of the patient's autonomy during the therapeutic process, and justice. The first of them, on the ground of post-modernistic individualism, seems to be well elaborated. The second one, which put attention on the community and its rights, is still not enough present in the contemporary medical ethics and in particular in regard to all those problems which are related to social institutions of health care, their existence and work. As a result of the critic of the post-modernistic thought, the societies are recognized no more as sets of individuals, but rather as composed of different moral communities. In such a way is redefined the term "pluralistic society". The existence of communities of people, which do not share the same concept of rationality and the system of ethic norms is assumed. The evaluation of the health care system presumed (in the formal and essential way, i.e. methods of choosing criteria and use of them) acceptance of the particular ethical system, with its conception of justice. The main aim of the paper is to present and classified different understandings of justice, which are recalled to evaluate health care systems in the sphere of Euro-American culture. At the end some practical conclusions are drawn in regard to ethical evaluation of the Polish health care system.
Zakładu Filozofii i Etyki Slaskiej Akademii Medycznej w Katowicach. lniebroj@poczta.onet.pl
Lesław T
LT
Niebrój
D003469:Culture; D004992:Ethics, Medical; D006304:Health Status; D006801:Humans; D009014:Morals; D028701:Patient Rights / Q000941:ethics*; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics; D011320:Primary Health Care / Q000941:ethics / Q000592:standards*; D012935:Social Justice; D012945:Social Values / Q000208:ethnology