Palliative care, public health and justice: setting priorities in resource poor countries.
Many countries have not considered palliative care a public health problem. With limited resources, disease-oriented therapies and prevention measures take priority. In this paper, I intend to describe the moral framework for considering palliative care as a public health priority in resource-poor countries. A distributive theory of justice for health care should consider integrative palliative care as morally required as it contributes to improving normal functioning and preserving opportunities for the individual. For patients requiring terminal care, we are guided less by principles of justice and more by the duty to relieve suffering and society's commitment to protecting the professional's obligation to uphold principles of beneficence, compassion and non-abandonment. A fair deliberation process is necessary to allow these strong moral commitments to serve as reasons when setting priorities in resource poor countries.
Blinderman
Craig
C
Palliative Care Service at Massachusetts General Hospital and Harvard Medical School, Palliative Care Service, Boston, MA 02114, United States. cblinderman@partners.org
D003906:Developing Countries; D004995:Ethics, Professional; D015276:Health Care Rationing / Q000941:ethics; D006282:Health Personnel / Q000941:ethics; D006295:Health Resources / Q000706:statistics & numerical data* / Q000600:supply & distribution; D006801:Humans; D028681:Moral Obligations; D010166:Palliative Care / Q000941:ethics*; D026684:Personal Autonomy; D011203:Poverty; D028662:Principle-Based Ethics; D011634:Public Health / Q000941:ethics; D012935:Social Justice; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D013727:Terminal Care / Q000941:ethics*