What does it mean to be a "just" and "caring" society when we have only limited resources to meet unlimited health care needs? Do we believe that all lives are of equal value? Is human life priceless? Should a "just" and "caring" society refuse to put limits on health care spending?
In Just Caring, Leonard Fleck reflects on the central moral and political challenges of health reform today. He cites the millions of Americans who go without health insurance, thousands of whom die prematurely, unable to afford the health care needed to save their lives. Fleck considers these deaths as contrary to our deepest social values, and makes a case for the necessity of health care rationing decisions. The core argument of this book is that no one has a moral right to impose rationing decisions on others if they are unwilling to impose those same rationing decisions on themselves in the same medical circumstances. Fleck argues we can make health care rationing fair, in ways that are mutually respectful, if we engage in honest rational democratic deliberation. Such civic engagement is rare in our society, but the alternative is endless destructive social controversy that is neither just nor caring.
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"Justice is a slippery concept. It becomes especially complex and controversial when we try to conceive what justice entails in the allocation of health care. This bold volume explains the need for rationing health care and provides the reader with clear and accessible accounts of the medical science, economics, demographics, and philosophic concepts involved in the decisions that have to be made. Fleck also offers his own process of rational democratic deliberation as the means for achieving a just system of health care distribution based upon priorities that are publicly acknowledged and broadly accepted. Just Caring is a remarkably well-researched, scholarly achievement. It is a valuable resource and required reading for anyone who wants to grapple with the problems of allocating health care in today's world."--Rosamund Rhodes, PhD, Professor: Medical Education, Director: Bioethics Education, Mount Sinai School of Medicine, New York
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