title: The injustice of enforced equal access to transplant operations: rethinking reckless claims of fairness.
abstract: The globalizing or totalizing imposition of a particular understanding of justice, fairness, or equality, as seen, for example, in Canada's single health care system, which forbids the sale of private insurance and the purchase of better basic health care, cannot be justified in general secular terms because of the following limitations: (1) the plurality of understandings of justice, fairness, and equality, and (2) the inability to establish one understanding as canonical. The secular state lacks plausible moral authority for the coercive imposition of one such account on peaceable, consenting adults. This state of affairs, with regard to the weakness of human moral epistemological powers, means that the secular state fails to have the moral authority to forbid coercively the sale and purchase of organs. It further lacks the secular, moral authority to impose equal access to organ transplantations. Assertions of such authority amount to reckless claims of fairness, and for this reason, health care policy must be set within the constraints of limited, constitutional regimes.
authors.affiliation: Philosophy Department at Rice University, Houston, Texas, USA.
authors.forename: H Tristram
authors.initials: HT
authors.lastname: Engelhardt
mesh_terms: D006801:Humans; D009014:Morals; D016377:Organ Transplantation / Q000941:ethics*; D018579:Patient Selection / Q000941:ethics*; D010684:Philosophy; D012935:Social Justice