In discussing access to health care, Brody and Engelhard question, “To what extent and at what cost ought a society attempt to provide equal health care for all?” (296). “Does the pursuit of such a goal violate rights to property and free association?” (Brody & Engelhard, 297). There are various cases, in addition to the scenarios Brody and Engelhard mention, that illustrate the inequality of health care and bring notions of justice into question. These cases exemplify the challenges in providing affordable and accessible health care to all citizens. In considering the accessibility, affordability, and quality of medical services, my Medical Sociology class discussed how health care falls short of fulfilling all three dimensions simultaneously. There is often a give and take in structuring health care to provide “the greatest good for the greatest number”, but this does not morally justify the disparity facing individuals. Equitably providing accessible, affordable, and quality medical services promotes nonmaleficence and beneficence. However, autonomy can be viewed in conflict with health policy. Health care is viewed as a privilege in the eyes of many, but in regards to morality, adequate health care should be viewed as a right without infringing upon personal liberties.

Beauchamp and Childress discuss how the principle of justice is engaged in the distribution of health policy. The principle of justice is more closely linked with legality and freedom than the other principles we have discussed in class. Beauchamp and Childress define distributive justice as referring to “fair, equitable, and appropriate distribution of benefits and burdens determined by norms that structure the terms of social cooperation” (Beauchamp & Childress, 250). This definition is somewhat ambiguous because it does not clearly articulate the issue of how justice ought to be fairly and appropriately distributed. Beauchamp and Childress further their discussion of justice by distinguishing between traditional and recent theories of justice. In analyzing these theories and how they apply to the cases posed by Brody and Engelhard, I noticed strengths and weakness in each theory. I will focus my attention towards analyzing the traditional theories of justice.

Utilitarian theories maximize welfare and assert that, “justice is the name for the paramount and most stringent forms of obligation set by the principle of utility” (Beauchamp & Childress, 254). The theory further articulates that, “human rights and principles of obligation have no other basis than utility maximization” and rights have a “tenuous foundation when they rest on the overall utility maximization” (Beauchamp & Childress, 254). I argue that by focusing on society as a whole, this theory neglects to address the individuality and uniqueness of autonomous humans; human beings are not cogs in a machine. Libertarian theories claim that, “any distribution of goods, including public health measures and health care, is just and justified if and only if individuals in the relevant community freely choose it” so long as they do not violate the rights of others (Beauchamp & Childress, 256). This theory does not view health care as a right, which in turn deprives some individuals of receiving adequate medical attention. Egalitarian theories advocate that, “the allocation of health care resources…should be structured to ensure justice through fair equality of opportunity” (Beauchamp and Childress, 257). This theory stresses the notion that, “each member of society, irrespective of wealth or position, would have equal access to an adequate, although not maximal, level of health care” (Beauchamp and Childress, 257). Is it better to provide adequate health care to all citizens or maximal health care to a select few? The provision of accessible, adequate health care for all citizens promotes the principle of nonmaleficence, however, individuals should have the opportunity to exercise liberty in obtaining a maximum level of care. Beauchamp and Childress address the communitarian policy of organ removal when discussing the communitarian theory. I do not think that individuals have an obligation to donate organs for the good of society even if the removal of cadaveric organs comes at no cost to the patient. An absence of an objection does not elicit or justify action. Organ donation promotes the principle of beneficence, but it does not necessitate the routine removal of organs since informed consent was not obtained. An action that promotes a good in society is not always best for the individual; the common good does not always justify erosion of individual rights.

Works Cited

Beauchamp, T. L., and James F. Childress. Principles of Biomedical Ethics. New York:

Oxford UP, 2009. Print.