D. Robert MacDougall: Guest Lecturer (Philosophy)
This (well, last) week we discussed health outcomes and health justice. During that class there were 3 different sets of material principles for understanding health inequalities and determining whether or not an inequality is unjust.
The first stated that for each individual an equal share of health, unless obtained using force or fraud. That is to say if a person’s health status is the result of force or fraud, than it is unjust.
The second material principle stated that for each individual an equal share of health, unless obtained by choice. That is to say that if a person’s health in unequal, or poor, due to their choices/behaviors that it is not unjust.
The third material principle expresses that for each individual an equal share of health even if it is the result is from one’s own choices/behaviors. This principle expressed that any inequality is an injustice regardless of why.
YOUR TASK: Please explain which of these 3 principles you feel our country should adopt for health care justice within the U.S. Consider the following: how might the principle affect detecting illness? Preventing illness? Treating illness? Explain your thinking behind your choice. I look forward to reading your responses.
Out of the three principles, I choose number three. I believe everyone should have access to health care no matter what unhealthy steps you took in the past. As a future nurse, I cannot see anyone being turned away from being treated based off of a poor decision they made. Behind each and every patient there is a history of illness. That illness can stem from mental to phiysical illness. Even though diseases such as hypertension from obesity or renal failure from alcoholism can be prevented, the patient could possibly be facing severe mental illness which lead then to these diseases in the first place.
Detecting an illness can not only be costly, it can be overwhelming and stressful on the patient. This is why I believe health care should be granted to everyone without a cost. No one should be turned away from being treated regardless of the medical issue.
Treating these illnesses are costly. As we see now in health care, several patients being diagnosed with diabetes can be prevented. I disagree with people who believe these patients should be denied Heath care because just recently has there been a real public health movement when it comes to obesity in America. Many people are simply uneducated about negative health behaviors. This means the funding should be granted in schools to educate children at a young age so they they can make healthy decisions as they grow into adulthood. Just recently schools have started to educate children who then carry the message home to their parents. Slowly I believe this is how the health and well being of people will change.
Another issue that I feel will arise if people are against principle number three is discrimination against for example obese people. This will not only make their negative thoughts such as depression worsen, but it will also have a large affect on patient care.
Overall, I believe each abs every person deserves to be treated equally no matter what illness they have. As health care professionals, our job is to prevent illness and injury ant treat illness and injury to the best of our abilities.
*** And not abs 🙂
I would like to say that I believe in the second material principle. I agree with the concept of equal share of health. The concept of equal is ideal however; let’s face it we don’t live in a perfect world. Life isn’t equal. Some people have better luck than others. Could we have an equal share of healthcare; equal access, resources, quality of care, and no racial barriers? We would like to think that racism doesn’t exist but it does. Healthcare professionals are forced to separate their political and emotional feelings aside from their profession. Their scope is to cause no harm to others. Sometimes that is very difficult such as, a white male physician having to treat and retain the life of the Boston marathon bomber or a nurse taking care of a serial killer that murdered several students in a school. These are very difficult situations to be in. This is why it may be difficult to use to concept of “equal share of health.”
Moving forward with “unless obtained by choice,” I would say I partially agree with this concept. We live in America, land of the free; freedom to make our own choices. If an individual wants to smoke three packs of cigarettes a week, then by all means it is not unjust. Some can argue that some of these behaviors are due to lack of knowledge! In some case this may be a true. However, it is no secret that smoking is bad for your health. There are many health advertisements attempt to help individuals to quit and even incentive programs. North shore LIJ hospital has compensation incentive programs for non-smoking employees. I do that individuals should be accountable for their actions. I also understand that many people are forced into bad habits, like bad eating habits due to the lack of money. There may be ways to better ones self, for instance, having less children, one less mouth to feed, more money to afford healthier food. I also understand that poverty neighborhoods don’t have access to healthier food. In these situations being accountable for your choices may actually be unjust. I strongly agree that we should take accountable for our actions when we have complete control over your choices.
Between the three principles I have to say I agree with the second one the concept of equal share of health. We live in a society today that many people have no control over their health due to hereditary components and genetics. So to hold people accountable for their health would be unjust. I also don’t agree with the “unless its obtained by choice” part because many people do things to themselves knowing what it can do to their health. I believe this part is unjust because it is basically saying that I can go out there and get myself sick because no matter what I will get the same care as someone who actually took care of themselves.
If the country adapts this principle they will certainly have to put restrictions because it can easily be abused but in a way the principle did it to itself. As Christina stated, workers in LIJ hospital get compensated for not smoking. This is fair because even though they are not abusing their health like others they are still getting something useful out of maintaining it.
Out of the three principles, I would pick the third principles. I believe that everyone should have access to health care. We as humans have the right to pursue happiness. If that happiness is smoking b/c it relieves your stress then so be it. You should have peace of mind knowing if something does happen to you that will be attended no matter what. We all do things that affect our health some more serious than others but we all should feel the security that we will receive help. Construction workers have a dangerous job but should we not help them if they get hurt b/c they knew that there was a “possibility” of injury and did it anyways? No matter what people do, whether its engaging in risky behavior or not we need to provide medical care.
I like to choose the principal three which demonstrates that everyone should have access to health care. It should not count that what people will do in future, i believe every single person has the right to have health care. There is no one who is perfect on everything; however the victim or affected person may learn their lessons from the mistakes. i remember an incident where one of my friend father died due to lung cancer and doctor mentioned that smoking was the one of the reason to his father death. After that he leaves smoking and this feel me that sometimes when people see the effect of their bad habits, they are more willing to leave it. Its my opinion that if people have access to health care, they can be aware about their bad habits which may cause them a lot. It also allows them to recover from their bad habits.
It was indeed a great discussion in class but also confusing because of the situations in which one scenario may be good for one principal over the other. In any case, I would choose the second material principle which is that for each individual an equal share of health, unless obtained by choice. That is to say that if a person’s health in unequal, or poor, due to their choices/behaviors that it is not unjust. Many people have many negative healthy choices and behaviors most of the time because they either do not have help or do not know where to look for it. We must learn to teach everyone that if they are acting in negative ways that is affecting their health, it must be resolved as soon as possible because there is no reason anyone should suffer alone. Now there are people whom put their own health at risk for different reasons and circumstances. They need to learn that these behaviors are not worth it and it can cause pain not only to the person but their family and friends if it turns out to be a life-threatening injury. If the person refuses to listen, that I would say to not give coverage because it seems that they refused to acknowledge the bad effects of their behaviors. Hmm……, Oh!, my response now sounds more like of an agreement with the first principle.
The concept is really interesting although I prefer to talk about the principal three which provides the health care for everyone. According to this principal, any inequality is unjust and it is not fair to create discriminate between the different races to provide the facility like healthcare. Anyone has their own rights to choose the decision between right or wrong. However, no matter what they have their rights to get their health facility to live a decent life. Well, there are many people who may argue that, if someone put their own life on risk due to bad habits has the right to get health facility or not. In this case, i believe they should have it, so that they can get the chance to make themselves correct and realize the different of their choices. There are many developed countries who has provide their citizen with health care and it is all free. These countries are following the principal three and they are making their decisions beyond any discrimination.
I feel our country should adopt the second material principle which states that for each individual an equal share of health, unless obtained by choice. That is to say that if a person’s health in unequal, or poor, due to their choices/behaviors that it is not unjust. I believe in this principle because for example if there are two people born with the same illness and person A takes care of himself and works out and person B sits on the couch and smokes and drinks i believe that the person who has been working hard and taking care of himself should receive more of the benefits then the one who has done nothing but worsen his case. I believe that this principle has no relation to detecting illnesses but might affect preventing illness. I believe that it can prevent some illnesses because if this illness is caught at the beginning and that person A is willing to put in the work to take car of himself and work with doctors her or she can prevent things from getting worse and can almost live a normal life. This process will directly affect treating illness due to only the one who takes care of him or her self being able to get the benefits of the treatment. In conclusion i believe that if you have an illness and you know that it can lead to death and you decide to not do the right things in taking care of yourself society should not go out of there way to help someone who will not help them selfs. This might sound a little harsh but in reality i do not believe that someone should have the same benefits for doing nothing and harming themselves more then a person who put in the work and disciplined himself in making right choices and sacrificing things in order to benefit himself in the longrun.
I think America should adopt principle 3 for health care justice because I believe no one should be turned down, especially because of their health or ignorance. A lot of people just don’t know or have the resources to live a healthy life. Should they be punished for it? No. We should be helping one another. Some things are out of our control and it would be unfair to deny someone health care because of it. Granted, many of us make poor decisions, but that’s what life is about, making mistakes and learning from it. If someone chose to live a life smoking cigarettes and was later diagnosed with lung cancer, who gives us the right to let them suffer? We should help them. We don’t know why this person chose to smoke all their life. People do it for different reasons therefore we shouldn’t judge. When treating illness, it may be harder to treat an illness because of their poor choices, however at the end of the day it was their choices that got them their. That is something they will have to live with. If someone chose to live a healthier life compared to someone who didn’t and they were both diagnosed with the same illness, is it fair to only treat the one who lived a healthier life? If it were you, would you be OK with the doctors not helping you because you made some unhealthy choices? Even if you didn’t know you were doing it? I know I wouldn’t. In my opinion this only contributes to inequality and discrimination.
Each of these principles bring up strong points, but for our country, the third principle is the most adequate one. Everyone should have the right for equal healthcare regardless of their economic situation.
It is not fair for someone who lives the same lifestyle as another person to be denied of equal health opportunities. If the U.S. adopts this principle, then illnesses would become easier to detect. It would also provide better healthcare to people since doctors are exposed to illnesses more frequently. As the medical field collects more data from different patients, illnesses become more common and are therefore easier to prevent. The innovation of technology will continue to prevent such illnesses from affecting the population. As a result, our techniques for treating illnesses are also improving because health professionals are more informed about them. An equal opportunity for healthcare will help prevent and treat these illnesses.
I choose the 2nd factor “for each individual an equal share of health, unless obtained by choice. That is to say that if a person’s health in unequal, or poor, due to their choices/behaviors that it is not unjust.” It is true that everyone is born the with same ability and health more or less. It is only us and how we choose to maintain a lifestyle during our later ages. Suppose you have person A and person B who are born very health and fit. Person A leads his or her life based on a health diet and exercises on a regular base. However on the other hand person B eats a lot of calories more than his or her body requires on a daily base, but does not exercise. In this case person B has a greater chance to develop obesity, cholesterol, diabetes, high blood pressure, and many medical disease. So in an over view general it is exactly how a person leads his or her life. So how can we preventing these illness and treat them in a health way. First we have to be educated on how our body functions. With that understanding we can then proceed to what food we should be eating on a daily base and what type of exercise we should be performing regularly. Just by these two simple things we can actually get to action by doing what we should be doing such as eating right and exercising. The results will be automatic and one will see just how much their health has improved just within a few months.
I choose the third principle for our country to adopt, why? Everyone should be entitled health care disregarding their financial income, their past, or their future. People are going to be willing to change once a near death situation comes along. No they should not have to wait until then to realize how precious their life is to them but given the situation that free healthcare will benefit them and they will learn their lesson. Everyone learn differently it takes something to happen before someone learns from their mistake. Not only just by learning from mistakes, someone people are born with illness and it will be unfair (which of course life is unfair) however someone that is ill is already stressing about being sick and then on top of being sick they will be stressing about the medical bills (which are not cheap). Imagine being ill laying in the hospital bed not only thinking something is wrong with you but also have to think about the bill that you have to pay? Will you be you able to afford it? This will only stress a patient more and cause them to become more ill. No one should be turned down medical health.
Professor McDougall’s lecture on Health Policy and its Effects on Health was very educating, interesting and factual from a philosophical approach. Educating in a way that he used three diagrams to explained some inequalities related to race and health base on a research conducted by The Whitehall Study. People perceived to be low on socioeconomic ladder have high mortality rate as compared to the elite , also blacks have high infant mortality rate as compared to other race and lastly women live longer on average of four years than men.
It is interesting to found out that despite all these racial health inequalities confronting us, we still have ways and means to stay healthy. I learnt that most of these inequalities are base on the choices that we make , our actions and inactions and also our level of exposure to the environment not neccessaritly race.