Health Justice for All

Do we all have a right to health care and — if we do — what does that right entail? This is the question that leading medical ethicist Norman Daniels attempted to answer during his lecture on Friday (April 15) in the Lavin-Bernick Center on the Tulane uptown campus.

At a lecture sponsored by the Center for Ethics and Public Affairs at Tulane, medical ethicist Norman Daniels asks if we all have a right to health care, what does that right entail? (Photo by Zack Smith)

In the lecture, Daniels said his own opinion on the distribution of health care is based heavily on philosopher John Rawls' Theory of Justice.

“My own take on this is that a right to health or health care should be thought of as a claim to a just distribution of the socially controlled factors that affect health,” Daniels said. “A right to health is a right to a socially just distribution of these determinants of health.”

Daniels, a professor of ethics and population health at the Harvard School of Public Health, is the author of 11 books, including Just Health: Meeting Health Needs Fairly.

He discussed some ethical dilemmas that may be encountered in modern health care. For example, he posed the question, “When do modest benefits for larger numbers of people outweigh significant benefits for fewer people?”

To resolve arguments about health care, Daniels proposed conditions for a fair process that would narrow disagreements between people about the policies towards allocation of healthcare resources. He called this an Accountability for Reasonableness (A4R).

Daniels concluded his lecture by discussing his experiences in Colombia when he was asked to make proposals about developing a fair procedure in the country's healthcare plan. He suggested his A4R plan as a solution to Colombia's problems.

“I'm not suggesting that this procedure I'm advocating is easy to implement or costless,” said Daniels. “But I think it would enhance legitimacy and fairness of people's perceptions of what they get in a health system and that's an important gain to have.”

The lecture was hosted by the Center for Ethics and Public Affairs of the Murphy Institute at Tulane.

Michael Celone is a sophomore student at Tulane majoring in public health.