HLTH 380 - Week 03 Distributive Justice

What does distributive justice focus on?

How limited resources are fairly distributed in society.

When does distributive justice matter most?

When resources are scarce and not enough for everyone.

What does distributive justice involve in societal institutions like healthcare?

The fair allocation of goods and services.

Give an example of distributive justice in healthcare.

Hospital beds, nursing home availability, and funding different healthcare programs.

Why must choices be made in distributive justice?

Because we cannot provide everything for everyone.

What are individual perspectives in society based on?

Common and conflicting interests.

What are common interests?

Things everyone benefits from, like safe water or the environment.

What are conflicting interests?

Situations where resources are limited and people want different things.

Give an example of a conflicting interest in healthcare.

Limited hospital beds or funding mental health vs. cancer treatment.

What does distributive justice require in the face of conflicting interests?

Fair decision-making.

At what three levels are healthcare resources allocated?

Macro, meso, and micro levels.

What is the macro level of healthcare allocation?

The government or policy level that makes top-level funding and policy decisions.

Give an example of macro-level allocation.

Deciding how much money goes to hospitals versus research.

What is the meso level of healthcare allocation?

Institutional level decisions within hospitals or regions.

Give an example of meso-level allocation.

A hospital deciding how to distribute staff between departments.

What is the micro level of healthcare allocation?

Patient-level decisions made by healthcare professionals.

Give an example of micro-level allocation.

Choosing who receives treatment first in an emergency department.

What are the main problems in resource allocation?

Conflicting interests and scarcity of resources.

Why do conflicting interests make allocation hard?

People have different opinions on who should get resources first.

What is an example of scarcity in healthcare coverage?

Ozempic being covered for diabetes but not for weight loss.

How does new technology create allocation problems?

It is expensive, so hospitals must decide whether to invest in it.

How do demographics affect resource allocation?

Aging populations and chronic diseases increase competition for resources.

Why can’t every new treatment be offered?

They require a lot of money and time to develop.

How do public attitudes affect healthcare allocation?

People expect good care, but costs and feasibility must be balanced.

Why is defining needs important?

It helps prioritize what should be publicly funded or insured.

What are the four main goals of medicine?

Relieve suffering, prolong life, improve quality of life, and prevent illness.

What does relieving suffering involve?

Reducing physical or emotional pain, e.g., pain management or palliative care.

What does prolonging life involve?

Helping people live longer through life-saving procedures.

What does improving quality of life focus on?

Making life better and more meaningful, not just reducing pain.

What does early screening and prevention aim to do?

Detect diseases early to improve outcomes.

What are the three types of medical needs?

Inherent, subjective, and socially induced.

What are inherent needs?

Essential for survival, like food, water, and basic care.

What are subjective needs?

Individual desires or psychological needs, like cosmetic surgery.

What are socially induced needs?

Needs important due to social expectations, like dental or vision care.

What does the market distribution model treat healthcare as?

A commodity that can be bought or sold.

Why is market distribution unfair?

It gives resources to those who can afford them, not those who need them.

Why is market distribution rare in developed countries?

Because most have universal healthcare systems.

Why are ethical approaches important in resource allocation?

They help guide fair decision-making.

Why do most high-income countries avoid market distribution?

Because healthcare is provided publicly regardless of ability to pay.

What is the main goal of the utilitarian approach?

Promote the greatest good for the greatest number of people.

What does the utilitarian approach support in healthcare?

Basic healthcare access for everyone.

What determines who gets scarce resources like organs?

Social worth.

What is the problem with using social worth in allocation?

It’s subjective and ethically questionable.

What principle guides the Kantian approach?

Equality and fairness — everyone is treated equally.

What are two common Kantian distribution methods?

First come-first served and random lottery.

Why is the random lottery method seen as fair?

Everyone has an equal chance to receive care.

What does virtue ethics focus on?

Being a good healthcare provider and focusing on medicine’s goals.

What does virtue ethics consider in decisions?

Social context and the realities of patients and providers.

What is the benefit of virtue ethics?

Encourages excellence and reflection in decision-making.

What is a problem with virtue ethics?

It’s subjective and hard to apply consistently.

What do feminist approaches emphasize in resource allocation?

Addressing marginalization and promoting social inclusion.

How can resource allocation lead to exclusion?

By unfairly discriminating against marginalized communities.

Who is prioritized in feminist healthcare approaches?

Equity-deserving or marginalized groups.

What does the liberal approach promote?

Equal access for everyone.

What are the key features of the liberal approach?

Equal access, transparency, and respect for autonomy.

Why is transparency important in liberal approaches?

It builds trust and ensures fair procedures.

What does Callahan’s proposal focus on?

Age, lifespan, and meaningful end-of-life care.

Why does aging increase healthcare costs?

Older adults require more care and resources.

What is Callahan’s view on death?

It’s natural, not a disease.

What cultural shift does Callahan suggest?

Reframing aging and dying as meaningful.

What is meant by a natural lifespan?

The normal expected age range for human life.

Who should receive life-extending technology, according to Callahan?

Those within their natural lifespan.

What is the critique of Callahan’s proposal?

The definition of “natural lifespan” varies by region.

What does the life-cycle allocation principle emphasize?

Viewing medical decisions in the context of one’s whole life.

Who gets higher priority according to this principle?

Young adults with more societal potential.

Why do babies and older adults have lower priority?

Babies have low societal investment, and older adults have already contributed.

Who gets priority in emergencies under this principle?

Physicians and essential public servants.

What is a problem with this principle?

It’s not fully egalitarian and undervalues babies.

What theory is Daniels’ account based on?

Rawls’ theory of justice.

What is healthcare’s purpose in Daniels’ view?

To ensure fair equality of opportunity by maintaining normal functioning.

What does “normal functioning” mean?

Age-appropriate capacities expected at each life stage.

Why must healthcare be spread across life stages?

Because lifespan is unpredictable.

How does Daniels view age in allocation?

As a fair way to distribute resources across all ages.

Why is natural lifespan hard to define in Canada?

Life expectancy varies across provinces.

Why do healthcare services differ across Canada?

Provinces have different resource availability.

Which theory prioritizes transparency in healthcare resource distribution?

Liberal approach.

Who argues that 20-year-olds should be prioritized over babies in saving lives?

Emanuel and Wertheimer.