What do we owe each other? Moral Philosophy 101

Transcription

1 What do we owe each other? Moral Philosophy 101

2 Warren J. The Caries Epidemic in Native American Communities

3 The First Law Of Healthcare Improvement Every system is perfectly designed to achieve exactly the results it gets So If your results are consistent, but unsatisfactory, you need to redesign the system ( but first you have to realize you are in a system ). Donald Berwick,

4 Do we lack social cohesion? Collective efficacy is the glue that binds neighborhoods, cities, states, and countries together

5 Keriana Carll cries in pain nearly every day. Her mouth hurts. She doesn't eat much. No dentist in Sarasota or Manatee County was willing to treat her. The only dentist her publicly funded Medicaid insurance company found who was willing to help the child is 50 miles north, in central Tampa. I have had a change of heart. I now believe that Democrats are entirely responsible for the mess that Medicare is in today. If the people crying for more free stuff would just shut up and get a job, and stop smoking cigarettes, using crack, wasting their money on chips and beer, they would have enough money to provide health care for their children

6 Keriana Carll cries in pain nearly every day. Her mouth hurts. She doesn't eat much. No dentist in Sarasota or Manatee County was willing to treat her. The only dentist her publicly funded Medicaid insurance company found who was willing to help the child is 50 miles north, in central Tampa. If you have children there are expense and responsibilities, but in today's world those responsibilities are being transferred to the guy next door via government. Everyone has their hand out for a free ride. Its not that this child can't get free dental its that its inconvenient.

7 TWO decades ago, Republicans and Democrats in Congress came together to make historic changes to our nation s welfare program, working to strike the right balance between helping people in need while setting standards for personal responsibility.

8 Our excessive emphasis on individualism at the expense of communalism has produced poverty, homelessness, untreated mental illness--all of which can be mitigated by learning from societies where extreme disparities between highest and lowest income groups do not exist. The overwhelming perception of poverty as a state caused by failure to take responsibility has always informed failed efforts to ameliorate it. Kasich's article, full of phrases like "personal accountability" reeks of the usual Republican MO - first gently tune the rhetoric to make poverty seem the result of a moral failing or characterological deficit, then withdraw real and necessary support in the name of restoring bootstraps. Then frame the dismal results as the consequence of above-mentioned personal qualities or even better, as the inevitable failure of government intervention of any sort ("bureaucracy ").

9 Proper dental care should be a human right By Donald M. Berwick May 24, 2016 In Alaska, scores of tiny Alaska Native villages dot the landscape, some with only a few hundred inhabitants and many accessible only by bush planes. They may be short on some amenities, but many have superb dental care. That s thanks to a program called Dental Health Aide Therapist. Proper dental care is as much a human right and as smart an investment as is proper medical care.. Another give away. Who's gonna pay for it? Oh yes, a higher tax on millionaires. That's the solution. Calling dental care a human right does not make it so. It does not make more dentists appear from nothing. It does not make people get off their butts and go see a dentist. To suggest that dental care is a right is just dumb and does not contribute to solving the problems that Berwick mentions.

10 What does moral (political) philosophy" say about healthcare?

11 moral (political) philosophy More Liberty Libertarian More Utility Utilitarian Social Justice (contractual) More Fairness Robert Nozick Ayn Rand Milton Friedman Peter Singer Jeremy Bentham John Stuart Mill John Rawls Thomas Hobbs John Locke

12 moral (political) philosophy Libertarianism Libertarian Libertarian Main value: Liberty Holdings justly acquired are just Those with the holdings are under no obligation to distribute them to others Social Justice (contractual) Robert Nozick

13 moral (political) philosophy Peter Singer John Rawls More Utility Utilitarianism Social Justice (contractual) More Fairness

14 Utilitarianism Main value: Utility Peter Singer Strategy: Reduce suffering in the most effective manner possible (at the social level) avoiding pain developing one's abilities, satisfying basic needs for food and shelter Morality based on consequences But no universal application (no right to life) And engineering point of view

15 Social Justice (Contractualism) Main Value: Justice is Fairness Strategy: Establish social contract Original Position Veil of Ignorance Moral values are negotiated Distributed Justice Important Universal Application Social Justice (contractual) John Rawls

16 What are our obligations if we wish to live in a moral society?

17 Utilitarianism Peter Singer Paul Farmer, MD

18 Social Justice (Contractualism) "Medicine is a social science, and politics is nothing else but medicine on a large scale" John Rawls Rudolf Ludwig Carl Virchow ( ) Social Justice (contractual)

19 Social Justice (Contractualism) "Medicine is a social science, and politics is nothing else but medicine on a large scale" John Rawls Rudolf Ludwig Carl Virchow ( ) Social Justice (contractual)

20 Clinicians Public Health Policy Makers

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