Phase-dependent justification: the role of personal responsibility in fair healthcare.
The main aim of this paper is to examine the fairness of different ways of holding people responsible for healthcare-related choices. Our focus is on conceptualisations of responsibility that involve blame and sanctions, and our analytical approach is to provide a systematic discussion based on interrelated and successive health-related, lifestyle choices of an individual. We assess the already established risk-sharing, backward-looking and forward-looking views on responsibility according to a variety of standard objections. In conclusion, all of the proposed views on holding people responsible for their lifestyle choices are subjected to reasonable critiques, although the risk-sharing view fare considerably better than the others overall considered. With our analytical approach, we are able to identify how basic conditions for responsibility ascription alter along a time axis. Repeated relapses with respect to healthcare associated with persistent, unhealthy lifestyle choices, call for distinct attention. In such situations, contextualised reasoning and transparent policy-making, rather than opaque clinical judgements, are required as steps towards fair allocation of healthcare resources.
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
Kristine
K
Bærøe
Department of Comparative Politics, University of Bergen, Bergen, Norway.
Cornelius
C
Cappelen
D002755:Choice Behavior / Q000941:ethics*; D003695:Delivery of Health Care / Q000592:standards*; D015276:Health Care Rationing / Q000639:trends; D006801:Humans; D008019:Life Style; D011050:Policy Making; D012935:Social Justice; D012941:Social Responsibility
Distributive Justice; Ethics; Political Philosophy; Public Policy