Johann Frick
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The Art of Saying No the Economics and Ethics of Healthcare Rationing
Linköping University Medical Dissertation No. 1215 The Art of Saying No The Economics and Ethics of Healthcare Rationing Gustav Tinghög Department of Medical and Health Sciences Linköping University, Sweden Linköping 2011 Edition 1:1 ISBN 978-91-7393-282-0 ISSN 0345-0082 @ Gustav Tinghög, 2011 Published articles have been reprinted with the permission of the copyright holder. Cover artwork and design: Marit Furn Webpage: www.maritfurn.se Printed in Sweden by LiU-Tryck, Linköping, Sweden, 2011 To the Tinghögs I’m gonna run to you – Bryan Adams Contents CONTENTS ABSTRACT .................................................................................................................. 4 LIST OF PAPERS ........................................................................................................ 5 ABBREVIATIONS ...................................................................................................... 7 INTRODUCTION ....................................................................................................... 9 Thesis Aim ........................................................................................................... 10 A Short Note on Disposition ........................................................................... 11 METHODOLOGICAL CONSIDERATIONS AND SPECIFICATION OF THE AIM .................................................................................................................... 13 A Population-Level View on Efficiency and Fairness ................................ 13 Economics and -
Weatherhead Center for International Affairs
WEATHERHEAD CENTER FOR INTERNATIONAL AFFAIRS H A R V A R D U N I V E R S I T Y two2004-2005 thousand four – two thousand five ANNUAL REPORTS two2005-2006 thousand five – two thousand six 1737 Cambridge Street • Cambridge, MA 02138 www.wcfia.harvard.edu TABLE OF CONTENTS INTRODUCTION 2 PEOPLE Visiting Committee 4 Executive Committee 4 Administration 6 RESEARCH ACTIVITIES Small Grants for Faculty Research Projects 8 Medium Grants for Faculty Research Projects 9 Large Grants for Faculty Research Projects 9 Large Grants for Faculty Research Semester Leaves 9 Distinguished Lecture Series 11 Weatherhead Initiative in International Affairs 12 CONFERENCES 13 RESEARCH SEMINARS Challenges of the Twenty-First Century 34 Communist and Postcommunist Countries 35 Comparative Politics Research Workshop 36 Comparative Politics Seminar 39 Director’s Faculty Seminar 39 Economic Growth and Development 40 Harvard-MIT Joint Seminar on Political Development 41 Herbert C. Kelman Seminar on International Conflict Analysis and Resolution 42 International Business 43 International Economics 45 International History 48 Middle East 49 Political Violence and Civil War 51 Science and Society 51 South Asia 52 Transatlantic Relations 53 U.S. Foreign Policy 54 RESEARCH PROGRAMS Canada Program 56 Fellows Program 58 Harvard Academy for International and Area Studies 65 John M. Olin Institute for Strategic Studies 74 Justice, Welfare, and Economics 80 Nonviolent Sanctions and Cultural Survival 82 Religion, Political Economy, and Society 84 Student Programs 85 Transnational Studies Initiative 95 U.S.-Japan Relations 96 PUBLICATIONS 104 ANNUAL REPORTS 2004–2005 / 2005–2006 - 1 - INTRODUCTION In August 2005, the Weatherhead Center moved In another first, the faculty research semester to the new Center for Government and leaves that the Center awarded in spring 2005 International Studies (CGIS) complex. -
Luck Egalitarianism, Harshness, and the Rule of Rescue
Luck egalitarianism, harshness, and the rule of rescue Nir Eyal Abstract Luck egalitarians consider it somewhat fairer when relative disadvantage results from the disadvantaged party’s own choice or fault—when it is “option luck” not “brute luck”. The most famous objection to luck egalitarianism is the harshness objection. It points out that when someone is at grave risk through their own choice or fault, refusing to rescue them on the ground that they are responsible for their own plight would, intuitively, be too harsh. A strong version of the objection adds that intuitively it is harsh even to weigh her personal responsibility for her plight against rescuing her. In defense of luck egalitarianism, I point out that grave risk is known to bring out the so-called “rule of rescue” mentality, and related biases. These biases incline us to deny that there is any sound reason against rescuing the person identified as at grave risk. That fact, I propose, provides an alternative causal account of our intuition that rescue is mandated and that considerations of personal responsibility against rescue would be harsh and inappropriate. In support of this alternative account, when the propriety of holding people responsible for avoidable risk raking is assessed outside immediate rescue situations, our intuitions are far more accepting of the relevance of personal responsibility for disadvantage, and hence, of luck egalitarianism. Background: Luck-egalitarianism, the harshness objection, and democratic equality According to luck egalitarianism,i When deciding whether or not justice (as opposed to charity) requires redistribution, the egalitarian asks if someone with a disadvantage could have 1 avoided it.. -
Casebook on Ethical Issues in International Health Research
Casebook on Ethical Issues in International Health Research Editors: Richard Cash Daniel Wikler Abha Saxena Alexander Capron Casebook on Ethical Issues in International Health Research Editors: Richard Cash Daniel Wikler Abha Saxena Alexander Capron Associate editor: Reva Gutnick Editorial guidance provided by Astrid Stuckelberger and Philippe Chastonay, University of Geneva WHO Library Cataloguing-in-Publication Data Casebook on ethical issues in international health research / edited by Richard Cash … [et al]. 1.Ethics, Research. 2.Research - standards. 3.Health services research. 4.Research design. 5.Case reports. I.Cash, Richard. II.Wikler, Daniel. III.Saxena, Abha. IV.Capron, Alexander M. V.World Health Organization. ISBN 978 92 4 154772 7 (NLM classification: W 20.5) © World Health Organization 2009 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. -
International Association of Bioethics Formed More Than 300 Delegates Created the International Candidates
J Med Ethics: first published as 10.1136/jme.18.4.209 on 1 December 1992. Downloaded from FrankJI Leavitt 209 medical ethics 1991; 17: 62-69. (5) See reference (1): 63. (2) Aristotle. Nicomachean ethics, I7; 1098a: 18ff. (6) See reference (1): 64. (3) Spinoza B de. Ethics. v,23, scholium. (7) See reference (1): 62. (4) Quine W V. Methods of logic. London and Henley: (8) See reference (1): 67. (Italics in text) Routledge and Kegan Paul, 1974, 1978: 165ff. (9) See reference (1): 66. News and Notes International Association of Bioethics formed More than 300 delegates created the International candidates. The members of the board are predominantly Association of Bioethics at its inaugural meeting earlier this philosophers but also include doctors, lawyers, theologians year. The brain-child of Peter Singer and Helga Kuhse of and an historian. Monash University, Melbourne, Australia and Dan Wikler Board members are: Peter Singer, Australia (president); of the University of Wisconsin at Madison, Wisconsin, Helga Kuhse, Australia; Segun Gbadegesian, Nigeria; USA, the new association brings together members from Raanan Gillon, United Kingdom; Ms Kusum, India; Gamal various academic disciplines from some 34 countries who Serour, Egypt (treasurer); Daniel Wikier, USA (vice- share an interest in bioethics. The association is committed president); Alastair Campbell, New Zealand; Bartha to free, open and reasoned discussion of bioethical issues Knoppers, Canada; Maurizzio Mori, Italy; Ruth Chadwick, and will hold an international conference every two or three United Kingdom (secretary); Hernan Fuenzalida, Chile; years, varying its location. Its next conference is to be in Rahito Kimura, Japan; Juan Carlos Tealdi, Argentina (1994 Buenos Aires, Argentina. -
Center for Ethics
The Edmond J. Safra Foundation Harvard University CENTER FOR ETHICS ANNUAL REPORT 2005–2006 THE EDMONDREPORT J. SAFRA OF THEFOUNDATION ACTING DIRECTOR CENTER FOR ETHICS Harvard University University Faculty Committee Frank Michelman (Law) Edmond J. Safra Foundation Arthur I. Applbaum Mark H. Moore (Government-KSG) Center for Ethics (Government-KSG) Lynn Sharp Paine (Business) Taubman Building Joseph L. Badaracco, Jr. (Business) Thomas R. Piper (Business) 79 John F. Kennedy Street Martha Minow (Law) Mathias Risse (Government-KSG) Cambridge, MA 02138 Michael J. Sandel (Government) Marc J. Roberts (Public Health) Tel.: 617-495-1336 Thomas M. Scanlon (Philosophy) Fax: 617-496-6104 Walter M. Robinson (Medicine) E-mail: [email protected] Dennis F. Thompson (Chair) Nancy Rosenblum (Government) Website: www.ethics.harvard.edu Robert D. Truog (Medicine) James Sabin (Medicine) Elaine Scarry (English) Dennis F. Thompson Faculty Associates Frederick Schauer Director Derek Bok (Interim President) (Government-KSG) Arthur I. Applbaum Allan M. Brandt Amartya Sen (Economics and Director of Graduate Fellowships (History of Science) Philosophy) Troyen Brennan (Medicine) Tommie Shelby (Philosophy and Staff Dan W. Brock (Medicine) African-American Studies) Jean McVeigh Alfred D. Chandler, Jr. (Business) Carol Steiker (Law) Administrative Director Norman Daniels (Public Health) Lloyd Weinreb (Law) Shelly Coulter Leon Eisenberg (Medicine) Daniel Wikler (Public Health) Financial Consultant Catherine Z. Elgin (Education) David B. Wilkins (Law) Stephanie Dant Einer R. Elhauge (Law) Assistant to the Director Richard H. Fallon, Jr. (Law) Advisory Council Lachlan Forrow (Medicine) Eugene P. Beard Magdalena Halford Charles Fried (Law) Bradley Bloom Staff and Research Assistant Howard E. Gardner (Education) Nonnie Steer Burnes Erica Jaffe Marc Hauser (Psychology) Michael A. -
BROCHER SUMMER ACADEMY in GLOBAL POPULATION HEALTH 2010 Geneva, Switzerland, 12Th July - 16Th July
BROCHER SUMMER ACADEMY IN GLOBAL POPULATION HEALTH 2010 Geneva, Switzerland, 12th July - 16th July Measurement and Ethical Evaluation of Health Inequalities Deadline May 7th 2010 Application form is available at : http://www.brocher.ch/pages/programme.asp Organized by THE BROCHER FOUNDATION, THE HARVARD UNIVERSITY PROGRAM IN ETHICS & HEALTH, & THE UNIVERSITY OF GENEVA INSTITUTE FOR BIOMEDICAL ETHICS SUMMER SCHOOL PROGRAMME The Brocher Summer Academy in Global Population Health aims to introduce graduate students and researchers to population-level bioethics. The Academy hopes to stimulate high-level academic work on ethical issues in population health and global health and to bring ethical dimensions of population and global health to the attention of policy makers and practitioners. The Academy’s seminars will draw on the resources of many disciplines to identify the key ethical issues, and to apply a variety of problem-solving strategies to their resolution. Ethical analysis and reasoning thus joins the methods of the social and biological sciences in contributing to the global project of relieving the burden of disease. The 2010 Academy in Global Population Health will focus on “Measurement and Ethical Evaluation of health Inequalities”. A substantive focus will be given to the following topics: • How should we rank distributions of health across populations in order of inequality? • What are the ethical implications of using different measures of health inequalities? • Which -if any- of the common measures of economic inequality are informative when applied to health? • Are all health inequalities morally objectionable or unjust? Should we measure health inequalities across groups, across individuals, or both? · What priority should reduction in health inequalities have among prominent goals of health policy? SPECIAL EVENT, BROCHER LECTURE Thursday, July 15th Measuring health inequality and health inequity Prof. -
CHV 333/ Phi 344: Bioethics: Clinical and Population-Level Spring Semester 2015/16
CHV 333/ Phi 344: Bioethics: Clinical and Population-Level Spring semester 2015/16 Instructor: Johann Frick Classroom: 101 Marx Hall Office: 203 Marx Hall Office Hours: Mondays, 4:30-6:30pm. Email: [email protected] Brief Course Description: This seminar aims to introduce you to a range of philosophical debates in clinical and population-level bioethics. Among the topics in clinical bioethics that we will discuss are • The ethics of killing and the badness of death • Abortion • Physician-assisted suicide and euthanasia • Pre-commitment in bioethics • Genetic enhancement. In population-level bioethics, questions we will discuss include • The measurement and valuation of health • Cost-effectiveness and disability-discrimination • Treatment vs prevention in the fight against HIV/AIDS • Health inequalities and justice • Personal and social responsibility for health • Paternalism, nudges, and incentives • Standards of care in clinical trials in the US and abroad. Course Requirements and Grading This course will be held in a seminar format. Seminars will take place Mondays, 1:30- 4:20pm in 101 Marx Hall. You will submit two short response papers (4-5 double-spaced pages) during the semester (30% of your grade); the first of these papers is due on February 28, the second on April 17. In addition, each student will serve as lead-discussant for one seminar meeting during the semester (10% of your grade). A further 30% of your grade will be for oral participation in seminars. The final 30% of your grade will be determined by a final exam. Readings Readings should be done before the seminar indicated. There are two required books for this course: 1 Jeff McMahan, The Ethics of Killing: Problems at the Margins of Life (Oxford: Oxford University Press, 2003). -
Casebook on Ethical Issues in International Health Research
Casebook on Ethical Issues in International Health Research Editors: Richard Cash Daniel Wikler Abha Saxena Alexander Capron Casebook on Ethical Issues in International Health Research Editors: Richard Cash Daniel Wikler Abha Saxena Alexander Capron Associate editor: Reva Gutnick Editorial guidance provided by Astrid Stuckelberger and Philippe Chastonay, University of Geneva WHO Library Cataloguing-in-Publication Data Casebook on ethical issues in international health research / edited by Richard Cash … [et al]. 1.Ethics, Research. 2.Research - standards. 3.Health services research. 4.Research design. 5.Case reports. I.Cash, Richard. II.Wikler, Daniel. III.Saxena, Abha. IV.Capron, Alexander M. V.World Health Organization. ISBN 978 92 4 154772 7 (NLM classification: W 20.5) © World Health Organization 2009 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. -
Ethics at Harvard 1987–2007 Edmond J
Designed by Ciano Design Photography by Harvard News Office, Carol Maglitta, Stu Rosner and Martha Stewart Printed by Kirkwood Printing Ethics at Harvard 1987–2007 Edmond J. Safra Foundation Center for Ethics Designed by Ciano Design Photography by Harvard News Office, Carol Maglitta, Stu Rosner and Martha Stewart Printed by Kirkwood Printing Ethics at Harvard 1987–2007 Edmond J. Safra Foundation Center for Ethics Ethics at Harvard 1987–2007 Edmond J. Safra Foundation Center for Ethics Dennis F. Thompson University Faculty Committee Christine M. Korsgaard Director Arthur I. Applbaum Philosophy Arthur I. Applbaum Government-KSG Lisa Lehmann Director of Graduate Fellowships Joseph L. Badaracco, Jr. Medicine Jane Mansbridge Staff Business Martha Minow Government-KSG Jean McVeigh Law Frank Michelman Administrative Director Michael J. Sandel Law Shelly Coulter Government Mark H. Moore Financial Consultant Thomas M. Scanlon Government-KSG Stephanie Dant Philosophy Lynn Sharp Paine Assistant to the Director Dennis F. Thompson Business Erica Jaffe Government Thomas R. Piper Assistant to Professor Applbaum Robert D. Truog Business Melissa Towne Medicine Mathias Risse Staff and Research Assistant Government-KSG Kimberly Tseko Faculty Associates Marc J. Roberts Publications and Derek Bok Special Events Coordinator Public Health Interim President Nancy Rosenblum Allan M. Brandt Government Deborah E. Blagg History of Science James Sabin Dan W. Brock Writer, Ethics at Harvard 1987-2007 Medicine Medicine Elaine Scarry Alfred D. Chandler, Jr. English Business Frederick Schauer Norman Daniels Government-KSG Public Health Amartya Sen Leon Eisenberg Economics and Philosophy Medicine Tommie Shelby Catherine Z. Elgin Philosophy and African Education American Studies Einer R. Elhauge Carol Steiker Law Law Richard H. -
Making Fair Choices on the Path to Universal Health Coverage: Applying Principles to Difficult Cases Article (Accepted Version) (Refereed)
A. Voorhoeve, T. Tan-Torres Edejer, L. Kapiriri, O. Frithjof Norheim, J. Snowden, O. Basenya, D. Bayarsaikhan, I. Chentaf, N. Eyal, A. Folsom, R. H. Tun Hussein, C. Morales, F. Ostmann, T. Ottersen, P. Prakongsai, C. Saenz, K. Saleh, A. Sommanustweechai, D. Wikler, A. Zakariah Making fair choices on the path to universal health coverage: applying principles to difficult cases Article (Accepted version) (Refereed) Original citation: Voorhoeve, Alex and Edejer, Tessa T. T. and Kapiriri, Lydia and Norheim, Ole Frithjof and Snowden, James and Basenya, Olivier and Bayarsaikhan, Dorjsuren and Chentaf, Ikram and Eyal, Nir and Folsom, Amanda and Hussein, Rozita Halina Tun and Morales, Cristian and Ostmann, Florian and Ottersen, Trygve and Prakongsai, Phusit and Saenz, Carla and Saleh, Karima and Sommanustweechai, Angkana and Wikler, Daniel and Zakariah, Afisah (2017) Making fair choices on the path to universal health coverage: applying principles to difficult cases. Health Systems & Reform, 3 (4). ISSN 2328-8604 DOI: 10.1080/23288604.2017.1324938 Reuse of this item is permitted through licensing under the Creative Commons: © 2017 The Authors CC BY 4.0 This version available at: http://eprints.lse.ac.uk/75183/ Available in LSE Research Online: September 2017 LSE has developed LSE Research Online so that users may access research output of the School. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. You may freely distribute the URL (http://eprints.lse.ac.uk) of the -
Productive Justice
LUCAS STANCZYK Productive Justice i Every tenth or so woman to undergo labor will need a cesarean. Her prospects are bleak if she lives in Malawi, where half of all births go medically unattended. Most of the twenty-one district hospitals have only one doctor. The entire country of fifteen million has fewer than three hundred doctors. The rest have emigrated to greener pastures, or else stayed in Malawi but quit doctoring. Without them, providing wide- spread obstetric care is simply impossible.1 Stories like this, which are by no means limited to developing coun- tries, implicate an important topic in the study of the value of social justice. The topic is signaled by the following questions. How are the goods whose distribution justice governs to be produced in the first place? By whom, in what quantity, and on what terms? To distinguish it from distributive justice, I will call this topic justice in production, or productive justice. In this article, I shall argue that we need but do not have a satisfactory theory of this topic. There has been significant debate concerning whether every able citizen can be expected to work. However, if justice requires societies to ensure the For criticisms of earlier versions of the argument, I would like to thank Arthur Applbaum, Eric Beerbohm, James Brandt, Jonathan Bruno, Daniela Cammack, Glenn Cohen, Elizabeth Coup, Norman Daniels, Michael Frazer, A. J. Julius, Matthew Landauer, Adam Lebovitz, Yascha Mounk, Joe Muller, Eric Nelson, Michael Rosen, Nancy Rosen- blum, Emma Saunders-Hastings, S. Andrew Schroeder, Dennis Thompson, Andrea Tivig, Don Tontiplaphol, Dan Wikler, Bernardo Zacka, and several audiences at MIT and Harvard.