Just Caring

1. Just Caring: An Introduction ; 1.1 The Just Caring Problem: Core Argument ; 1.2 Rationing Justly: The Moral Challenge ; 1.3 Applications of the Deliberative Model ; 2. Just Caring: The Ethical Challenges of Health Care Rationing ; 2.1 The Story of Coby Howard and Its Lessons ; 2.2 Why Health Care Rationing is Inescapable ; 2.3 Renal Dialysis and the Medicare End-Stage Renald Disease [ESRD] Amendments ; 2.4 The Totally Implantable Artificial Heart [TIAH] ; 3. Pricing Human Life: Getting Beyond Tragic Choice ; 3.1 Is Human Life Priceless? ; 3.2 Tragic Choices or Tragic Disingenuousness: Invisible Rationing ; 3.3 Invisible Rationing and the Publicity Condition ; 3.4 Managed Care and Health Rationing: ; 4. Elements of Health Care Justice ; 4.1 Is Health Care Morally Special? ; 4.2 Non-Ideal Justice: A Moral Analysis and Defense ; 4.3 Pluralism, Justice, and Rational Democratic Deliberation ; 5. Rational Democratic Deliberation: Scope and Structure ; 5.1 The Scope of Rational Democratic Deliberation ; 5.2 Fair Health Care Rationing: Not Markets, Not Physicians, Not Bureaucrats ; 5.3 Rational Democratic Deliberation: Taking Seriously the Tragedy of the Commons ; 5.4 Rational Democratic Deliberation: Key Structural Features ; 5.5 Rational Democratic Deliberation and Fair Health Care Rationing ; 5.6 Wide Reflective Equilibrium and Just Health Care Rationing ; 5.7 Priority-Setting, Wide Reflective Equilibrium, and Democratic Deliberation ; 5.8 Facts, Wide Reflective Equilibrium, and Democratic Deliberation ; 5.9 Constitutional Principles of Health Care Justice and Rational Democratic Deliberation ; 5.10 Evaluating the Deliberative Process ; 5.11 Objections and Responses ; 6. Just Caring: Setting Limits for Effective Costly Therapies ; 6.1 Problem Introduction ; 6.2 Setting Limits: Options in the ESRD Program ; 6.3 Setting Limits: Options for HIV/AIDS Patients ; 6.4 Setting Limits: The Case of Artificial Hearts ; 6.5 Setting Limits: Concluding Comments ; 7. Just Caring: Last Chance Therapies ; 7.1 Introduction: Scope of the Problem ; 7.2 Why Last Chance Therapies? Weak Moral Arguments ; 7.3 Last Chance Therapies and Rational Democratic Deliberation ; 7.4 Futility and Last Chacne Therapies ; 8. Just Caring: Rationing, Catastrophically Ill Patients, and Patients with Disabilities ; 8.1 Introduction: The Scope of the Problem ; 8.2 Needs Are Not Enough: Effectiveness Must Matter ; 8.3 The Oregon Plan and the Disability Critique ; 8.4 Health Care Justice and the Disability Critique ; 8.5 Defining the Disabled: Ethical Implications ; 8.6 Conclusions ; 9. Is Age-Based Rationing Ever 'Just Enough'? ; 9.1 Defining the Problem: Can We Accept Natural Limits to Life? ; 9.2 Justice and Age-Based Rationing: Fair Innings ; 9.3 The Prudential Life Span Account ; 9.4 Age-Based Rationing: Major Objections ; 9.5 Age-Based Rationing: Responses to Objections ; 9.6 Age-Based Rationing and the Duty to Rescue ; 9.7 Conclusions ; 10. Just Caring: Do Future Possible Children Have a Just Claim to a Sufficiently Healthy Genome? ; 10.1 Introduction ; 10.2 Framing the Issue ; 10.3 Preimplantation Genetic Diagnosis [PGD]: A Historical Side Note ; 10.4 Does Justice Require Public Funding for Limited PGD? ; 10.5 Concluding Comments: Justice and Genetic Enhancement ; 11. Organ Transplantation: When is Enough Enough? ; 11.1 Scope of the Issue ; 11.2 The Maximization Argument: A Critical Moral Analysis ; 11.3 The Pittsburg Protocol: How Dead Must Donors Be? ; 11.4 Organ Procurement and Financial Incentives: A Critical Assessment ; 11.5 Presumed Consent/Duty to Donate: Critical Remarks ; 11.6 Justice and Multi-Organ Transplants or Retransplants ; 11.7 Concluding Comments ; 12. Just Caring: The Liberalism Problem ; 12.1 Justice, Health Care Needs and Morally Controversial Interventions ; 12.2 Liberal Communitarianism: Is It Just Enough? Is It Liberal Enough? ; 12.3 Resolving the Liberalism Problem: Public Reason and Public Interests ; 12.4 Concluding Reflections ; 13. Just Caring: The Ethical Challenges of Priority Setting in Public Health ; 13.1 Defining the Problem ; 13.2 The Scope of Public Health: Challenges and Choices ; 13.3 Health Care Justice and Public Health: When is Enough Enough? ; 13.4 Setting Public Health Priorities Justly: The Limits of Moral Theory ; 14. Just Caring: Financing Health Care Fairly ; 14.1 Why National Health Insurance? ; 14.2 Why Health Reform? ; 14.3 Assessing Competing Proposals for Health Reform ; 14.4 Health Savings Accounts: A Critical Assessment ; 14.5 Health Care Vouchers: A Critical Assessment ; 14.6 Single-Player Reform: A Constructive Proposal