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Ethical Evaluation of U.S. Health Care
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  1. Ethical Evaluation of U.S. Health Care • James A. Foster, Ph.D • Professor, Biological Sciences and Philosophy • Initiative for Bioinformatics & Evolutionary STudies (IBEST)

  2. How to analyze ethics? • Ask “normative” questions • Is the current U.S. health care system ethically acceptable? • Is the proposed U.S. health care system ethically acceptable? • Identify major affected parties • Score questions for each party with respect to major ethical categories • Well being and happiness • Liberty, autonomy, independence • Justice, fairness • Summarize results, identify caveats

  3. 2. Major affected parties • People • Americans with adequate insurance • Americans without adequate insurance • Health care providers (doctors, nurses, pharmacists, psychologists, etc.) • Institutions • Health delivery groups • The medical profession • Hospitals, care delivery centers • Economic groups • Employers/employees • Insurance companies • Pharmaceuticals/suppliers • Governments

  4. The full analysis

  5. 3. Score each item (extract) Is the current health care system in the US ethically acceptable? Conclusion: highly unethical unless business rights dominate

  6. 3. Score each item (extract) Is the proposedUS health care system ethically acceptable? Conclusion: moderately ethical unless corporate rights dominate

  7. Is the current health care system in the US ethically acceptable? NO (31) YES (11)

  8. Is the proposed US health care system ethically acceptable? YES (45) NO (16)

  9. 5. Summarize • Current system is clearly unethical • Proposed system is ethically superior to current system • Caveats: we are assuming that • Individual and small business liberty (“choice”) and well being are more important than other considerations • Individual liberty, well-being, and justice are more important than corporate autonomy • Insurance company well-being is not the most important consideration