title: Ethics in American health 1: ethical approaches to health policy.
abstract: I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy.
authors.affiliation: Yale University School of Medicine, Graduate School of Arts and Sciences, and Law School, 60 College St, PO Box 208034, New Haven, CT 06520-8034, USA. jennifer.ruger@yale.edu
authors.forename: Jennifer Prah
authors.initials: JP
authors.lastname: Ruger
mesh_terms: D003362:Cost-Benefit Analysis / Q000941:ethics; D003709:Democracy; D034462:Dissent and Disputes; D026689:Ethical Analysis; D028663:Ethical Theory; D005610:Freedom; D018166:Health Care Reform / Q000941:ethics*; D006291:Health Policy; D006297:Health Services Accessibility / Q000941:ethics; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000941:ethics; D006801:Humans; D008389:Marketing of Health Services / Q000941:ethics; D011050:Policy Making; D028662:Principle-Based Ethics; D019057:Quality-Adjusted Life Years; D040841:Resource Allocation / Q000941:ethics; D012935:Social Justice / Q000941:ethics*; D012945:Social Values; D014481:United States; D019472:Universal Health Insurance / Q000941:ethics