Skip to main content

Advertisement

Log in

The Significance of the Concept of Disease for Justice in Health Care

  • Published:
Theoretical Medicine and Bioethics Aims and scope Submit manuscript

Abstract

In this paper, I want to scrutinise the value of utilising the concept of disease for a theory of distributive justice in health care. Although many people believe that the presence of a disease-related condition is a prerequisite of a justified claim on health care resources, the impact of the philosophical debate on the concept of disease is still relatively minor. This is surprising, because how we conceive of disease determines the amount of justified claims on health care resources. Therefore, the severity of scarcity depends on our interpretation of the concept of disease. I want to defend a specific combination of a theory of disease with a theory of distributive justice. A naturalist account of disease, together with sufficientarianism, is able to perform a gate-keeping function regarding entitlements to medical treatment. Although this combination cannot solve all problems of justice in health care, it may inform rationing decisions as well.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Arneson, R. J. (2002) Why Justice Requires Transfers to Offset Income and Wealth Inequalities. Social Philosophy & Policy 19(1):172–200.

    Article  Google Scholar 

  • Boorse, C. (1975) On the Distinction Between Disease and Illness. Philosophy and Public Affairs 5:49–68.

    Google Scholar 

  • Boorse, C. (1977) Health as a Theoretical Concept. Philosophy of Science 44:542–573.

    Article  Google Scholar 

  • Boorse, C. (1997) A Rebuttal on Health. In: J. M. Humber, R. F. Almeder. (eds) What Is Disease? Biomedical Ethics Reviews. Totowa, NJ, Humana Press, 3–134.

    Google Scholar 

  • Buchanan, A., D. Brock, N. Daniels, and D. Wikler. (2000) From Chance to Choice: Genetics & Justice. Cambridge, Cambridge U.P.

    Google Scholar 

  • Callahan, D. (1973) The WHO Definition of ‹Health. The Hastings Center Studies 1(3):77–87.

    Article  Google Scholar 

  • Callahan, D. (1992) Symbols, Rationality, and Justice: Rationing Health Care. American Journal of Law and Medicine 18(1–2):1–13.

    Google Scholar 

  • Casal, P. (2007) Why sufficiency is not enough. Ethics 117:296–326.

    Article  Google Scholar 

  • Crisp, R. (2002) Treatment According to Need: Justice and the British National Health Service. In: R. Rhodes, M. P. Battin, and A. Silvers. (eds) Justice and Health Care: Essays on the Distribution of Health Care. Oxford, Oxford U.P, 134–143.

    Google Scholar 

  • Daniels, N. (1985) Just Health Care. Cambridge, Cambridge U.P.

    Google Scholar 

  • Daniels, N. (2001) Justice, Health, and Healthcare. American Journal of Bioethics 1:2–16.

    Article  Google Scholar 

  • Dworkin, R. (2000) Sovereign Virtue: The Theory and Practice of Equality. Cambridge, Mass, Harvard U.P.

    Google Scholar 

  • Engelhardt, H. T. Jr. (1975) The Concepts of Health and Disease. In: H. T. Engelhardt Jr., and S. F. Spicker. (eds) Evaluation and Explanation in the Biomedical Sciences. Dordrecht, Reidel, 125–141.

    Google Scholar 

  • Frankfurt, H. G. (1987) Equality as a Moral Ideal. Ethics 98(1):21–43.

    Article  Google Scholar 

  • Khushf, G. (2007) An agenda for future debate on concepts of health and disease. Medicine, Health Care and Philosophy 10:19–27.

    Article  Google Scholar 

  • Powers, M., and F. Ruth. (2006) Social Justice: The Moral Foundations of Public Health and Health Policy. Oxford, Oxford U.P.

    Google Scholar 

  • Rawls, J. (1971) A Theory of Justice. Oxford, Oxford U.P.

    Google Scholar 

  • Reznek, L. (1987) The Nature of Disease. London and New York, Routledge & Kegan Paul.

    Google Scholar 

  • Schramme, T. (2007) A qualified defence of a naturalist theory of health. Medicine, Health Care and Philosophy 10:11–17.

    Article  Google Scholar 

  • Sedgwick, P. (1973) Illness - Mental and Otherwise. Hastings Center Studies 1:19–40.

    Article  Google Scholar 

  • Silvers, A. (1998) A Fatal Attraction to Normalizing: Treating Disabilities as Deviations from ‹Species-Typical’ Functioning. In: E. Parens (eds) Enhancing Human Traits. Washington, Georgetown U.P., 95–123.

    Google Scholar 

  • Thomson, G. (1987) Needs. London, Routledge & Kegan Paul.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thomas Schramme.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schramme, T. The Significance of the Concept of Disease for Justice in Health Care. Theor Med Bioeth 28, 121–135 (2007). https://doi.org/10.1007/s11017-007-9031-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11017-007-9031-3

Keywords

Navigation