Dr. Robert MacDougall: Health and Social Justice

D. Robert MacDougall: Guest Lecturer (Philosophy)

Powerpoint: health outcomes

DUE Thursday, March 3rd:

Please answer the following questions below:

  1. What is the difference between something being unequal vs. something being unjust? For example, two groups of people experience different qualities of health (one being more prone to death due to illness, the other group being more prone to illness than to death).  I am asking  you what the inequality is and I am asking you what an injustice is.  These two ideas are not the same.
  2. Thinking about the United States, which principle of health justice do you agree with most? Is it item 1? Item 2a? Or item 2b? Be sure to explain why you’ve made your selection.

 

25 thoughts on “Dr. Robert MacDougall: Health and Social Justice

  1. Unequal is something uneven and unjust it is something that is not fair. For an example: in health, base on gender, more men are diagnosed with lung cancer each year, but more women live with the disease. So this will be unequal, not unjust, because nobody is using force or fraud. Now, they are other way of getting lung cancer for an example: nonsmoking asbestos workers are five times more likely to develop lung cancer than nonsmokers not exposed to asbestos; if they also smoke, the risk factor jumps to 50 or higher. Environmental exposures also can increase the risk of lung cancer death. In this case I will say that nonsmoking asbestos workers who gets lung cancer due to environmental exposures are in an unjust situation, and yes we all have the options, maybe to change jobs, but I do not think so, many people do the job they do, because they has nowhere else to go, or they do not know how to do anything else, I mean not by choice but by necessity.
    Thinking about the United States, honestly I agree with principle 1 the most, because is good to let life take its course, what has to happen happens, as long as no second or third parties sabotaging the process of things, everyone should be healthy only if it’s for fraud or force, but I think the US is working with 2B, considering that the government expands its coverage of medical services to cover many more people, including children and the elderly when they created the Obama Care in 2010, which I also agree with the principle of everyone should be healthy no matter what.

  2. 1. If something is unequal it means that there is a natural force that is not in our hands to control or change. We do not have any option than to deal with it. While if something is being uniust, it means that something is unfair in our society. There is somebody forcing something onto people. The good thing if something is unjust, is that we still can do something about it in order to change it.

    2. I agree with the 2b principle of health justice because everyone deserves the same share of health no matter what choices we have made. it can be something unequal or something caused by our decisions but we all deserve a health care I think this principle is being applied in the United States.

  3. Something unequal is usually something we have no control over, and not because of fraud or force. No matter how hard we try to make things equal there will always be something’s outside off our control that are unequal.
    When something is unjust it is usually because of fraud or force, and that ends up affecting others in a negative way.

    I agree mostly with 2b because no one individual is perfect when it comes to health and health habits. 2a seems like more of an excuse to not help someone in need. Even though people engage in unhealthy behavior we should all have the opportunity to recover and make our health better, and we should all try to help those who need help.

  4. The difference between something being unequal vs something being unjust is that unjust is something that isn’t fair, and unequal is something we have no control of. For example, sending black kids to a lower income schools isn’t necessary unjust because they’re still providing an education but it is unequal. Jim crow laws (separate but equal) were obviously unequal in nature because the amenities for blacks and whites were simply not the same. Even the supreme court, in Plessy v. Ferguson, said that although the 13th amendment banned slavery and involuntary servitude, it did not mean to break the fundamental differences between whites and blacks and therefore “separate but equal” laws should be allowed. Injustice is something that is unfair especially by law, and injustice is something that is socially unfair. I agree with 2b, everyone deserves to be treated and cared for equally by health providers.

  5. The formal definition of justice is “treating equals equal”, which is precise when it comes to justice while it can be defined in the other way of treating unequals likewise. The difference in justice and equality is in the sense of a person how much someone feels opposed to an event and by those feelings, the person calls that event as an unjust.

    Thinking about the United States, the principle of health justice I agree with is 2a since it provides an equal share of health to each. The justice in acquired health is also defined by the first part as it provides equal health outcome to each person without using force or fraud. But the provision of justified health outcome to every individual is well defined by the part 2a. The inequalities in terms of health outcomes can be defined as the choices of the individuals what they make to acquire better health standard, but if the individual is not choosing the rationally wise option for his or her health, the difference in the health outcome cannot be justified. Each person should have an equal access to health care services that is what actually justice requires but equal access still cannot ensure equal health outcomes for these individuals.

  6. Well unequal means just that, things are not equal. Unjust is something that is not fair. Per the example we used in class, white people are more prone to cancer but are not more prone to dying from it. Where as african americans are less prone to getting cancer by are more prone to dying from it. In the question is this unequal or unjust? This is unjust, perhaps the reasons more african americans are dying from cancer than whites is lack of proper health care, including education and access.

    Honestly I was torn between 1 and 2a, but as a nurse I have come across all people and illnesses and I believe in 1 in that all people should get an equal share of health as long as its not though force or fraud. I used to think differently in that people with substance abuse problems or people choosing to abuse their bodies should not be able to abuse the health care system. Now I know substance abuse and over eating are illness too and those people deserve a fair share of health and help.

  7. when something is unequal it just means that it technically or biologically not equivalent. Unjust implies that there has been some wrongdoing to account for whatever difference is being evaluated. For example men biologically have the ability to build more muscle-mass and muscle density so in a weigh lifting contest against women the men would win more times than not this would be unequal but not unjust because there no wrongdoing. whereas black people getting arrested and convicted more for drug crimes even thought white people use and sell drugs at the same rate as black people would be unjust because the two parties are equal in the example when it comes to drugs but you still see a significant difference in arrested rate between the two parties for drug crimes.

  8. 1. What is the difference between something being unequal versus being unjust? An unequal experience is when society provides unequal treatment or rewards depending on the individuals social class or race. This is applicable in many facets of life whether it be healthcare, employment opportunities, education etc. When something is unjust it is an unfair act committed against an individual for example, providing less quality care due to someone’s race or social stature thus causing injury or harm to said person. The rights of this person or a group of people are being shunned.
    2. I align with 2b principle of health justice. Irrespective of your race or social stature we should all receive the equal quality health care we deserve. Even if it entailed an unequal element or it is through our fault of our own that we suffer from ill health, I believe it is society’s obligation to treat everyone fairly.

  9. 1. The difference between something being unequal and being unjust is that unequal would mean that whatever the situation, it is what it is, while something being unjust means it is unfair. For example, if there are 3 kids of different heights (let’s say- 5 feet, 4 feet, 3 feet) trying to reach the top shelf that is 6 feet high and they are given a box to stand on that is 2 feet high, only the first and second child will be able to reach the top but not the third. This situation is unequal-not unjust. All three kids were treated equally here by being given the same box to stand on, whether they can reach the top of the shelf or not does not matter. If the kids were given boxes of different height then one would have an unfair advantage or disadvantage and that would be considered unjust.

    2. I think the US follows the principle of 2B when it comes to healthcare and it is the best policy in my opinion- Everyone is treated equally and has access to healthcare regardless of if they became sick by choice or not.

  10. Well, when I see the involvement of the word “equal” I think quantitively. In this case, unequal means a group of individuals in society are different. Whether in the good or bad side of a given situation. This difference cannot be change because we have no control or decision over it. The graph of “life expectancy vs year born” of male and female was shown on the slides. We saw that females had a considerably higher life expectancy than males in the 1980’s. Although this could be seen as unequal, we have no control over it. On the other, I see the word “unjust” as something we have control over it. Society nowadays is full of it. Everyday fraud gets committed whether at a job interview, drugs approved by the FDA, court cases and the list goes on. Hence “unjust” is an idea we as humans have created.
    I strongly agree with 2a the most. Sometimes as humans we know the consequences of doing something that will affect our health in some way or another but yet, we still do it. I smoke “hookah”, as much as 5 times a week. I know and have read articles about how much worst is than smoking cigarettes, do I stop? No!! Thus I will probably develop a chronic respiratory disease in the future. Therefore, I will required more health care due to my own choices.

  11. The difference between unequal and unjust, in my opinion, has to do with the situation’s availability and avoid-ability. If something is available to everybody, but a choice can be made for or against, that situation is unequal (which can be good or bad, because again this is based on choice). If from the start only certain people have this choice available the situation is unjust, as there was never equality to begin with, and the limitations could have been avoided is society had not intervened.

    Thinking about the United States Health System, I’d most likely gravitate towards Item 1. If each person starts of with the same, from the start and without restriction, it will truly be their own choices that differentiate them from others. Difficult to do, but that would be equality And justice in my eyes

  12. The difference between unequal and unjust, in my opinion, has to do with the situation’s availability and avoid-ability. If something is available to everybody, but a choice can be made for or against, that situation is unequal (which can be good or bad, because again this is based on choice). If from the start only certain people have this choice available the situation is unjust, as there was never equality to begin with, and the limitations could have been avoided is society had not intervened.

    Thinking about the United States Health System, I’d most likely gravitate towards Item 1. If each person starts of with the same, from the start and without restriction, it will truly be their own choices that differentiate them from others. Difficult to do, but that would be equality And justice in my eyes

  13. -In my opinion, the difference between unequal and unjust that unequal means that there is no control over it, even if we do try to be equal, there is always an unknown force makes unequal. Unjust means something that is being forced onto people.
    -I seem to agree with 2b, I feel that everyone deserves the same equal share of health, even if it’s resulted from a person choices. I think that now in the USA everyone has access to health care system regardless of the health choices made.

  14. From the moment we are born there are inequalitites. Most of us do not get to choose our race, gender or social status. Health is often related to these factors and can therefore be unequal. Does this inherently mean that these differences are unjust?

    Justice means “treating equals equally.” I believe that we have an obligation in this country to make sure that everyone has access to the possibility of success. Success is not guaranteed. One has to be motivated to work hard to achieve it. This too applies to health.

    However for the very young and elderly who are unable to fend for themselves, they require a caring society to ensure their wellbeing.

    As a home care nurse I see that motivation is key. A patient has to want to be healthy and be willing to put in the hard work to achieve that goal.

  15. I have an automatic response to the word “philosophy”, which is to “shut off my brain”, I can recall being a complete Zombie in that class lecture even though i was sitting in the first row. As much as i love psychology, i have an opposite feeling for philosophy. having said that, what i understood or what stood out was the phrase “treat equals equally” and the example of grading students on the bases of correct answers on the test over the amount of hours they spend on preparing for the test. other than that, i had no idea, so after reading some of the responses above and some research, i found the source of Dr. Robert’s lecture at:
    Sreenivasan, Gopal, “Justice, Inequality, and Health”, The Stanford Encyclopedia of Philosophy (Fall 2014 Edition), Edward N. Zalta (ed.), URL = .

    After trying to read some of the text, i went further into the worm whole, but i will use a quote to express my delirium :
    “Intuitively, if a given inequality in life expectancy is inevitable, then it is not unjust. A plausible necessary condition, that is, on a particular inequality’s being unjust is that the inequality in question is avoidable. To the extent, for example, that some biological necessity underlies the widely observed inequality in life expectancy between men and women, this particular gender inequality in health does not qualify as an injustice. (Indeed, Sen 1992 famously relies upon an estimate of some such biologically necessary inequality, as part of an argument criticizing the treatment of women in countries where the inequality in life expectancy actually favours men). A first step, therefore, in analysing the possible injustice of an inequality in health is to establish that the inequality is avoidable. This, in turn, requires some understanding of the underlying determinants (or causes) of health.”

    also, “More specifically, it requires an understanding of the subset of determinants of health that are socially controllable. Some very important determinants of health — notably, biology and luck — are not socially controllable; and precisely for that reason, inequalities in health caused by biology or luck are unavoidable (and hence, not unjust). Most of the empirical literature concentrates on what are known as ‘the social determinants’ of health. In this context, a social determinant of health is a socially controllable factor outside the traditional health care system that is an independent partial cause of an individual’s health status. Candidate examples include income, education, occupational rank, and social class.”

    so to finish this up, i say dido to what suzanne arthur said :
    “Unequal is something uneven and unjust it is something that is not fair.”

    2. I agree with item 1, because not all circumstances of our life under our own control.

  16. inequality is based on social aspects, and races. It can definitely affects people in their life. inequality can be economic, politic, and so on.inequality is everywhere. For unjust, it depends on your conscious
    i Choose 2 B, as Michelle stated everybody should be able to get health care. USA should have free health care coverage, they don’t have to look on your income status.

  17. An unequal act is when an individual doesn’t like things based on their personal preferences. Or maybe it is something out of their control. Unequal act be can changed or modified to some but not all. Unjust act is an existing imbalance of power in society. Unjust is harder to change or fix because of the level of power involved by high class. It is being forced on the people and no fair too all.

    I agree with 2b. In the USA we all make mistakes in life. Mostly when it comes to our health. Think about every drug and disease the USA has allowed to enter the country. All different types of people entering the country from another country. The USA has open windows to many unhealthy things. As people of this country we don’t control what is allowed and what is not. How can we be blamed for things that are accessible to us. No matter the age, race, color, height or life choices, when it comes to health and choosing life or death everyone deserves the same equal share of health. As humans we all deserve a chance to stay alive.

  18. I believe something being unequal refers to a situation where it is not controllable by the human power. An example of this is if someone is unable to do, or achieve something such as one person having access to a doctor while the other individual does not have access to doctor in his her community, it is not equal as they both don’t have the same opportunity. It is then unjust if they are two individuals both applying for the same job, but the employee doesn’t give one person a chance due to his race, address or even last name.
    I would agree with 2b due to the fact that i believe every one should be able to get access to the same treatment regardless if they made it from their own decisions or not. United States for one uses this method to provide health care which allows smokers and non smokers among others able to receive the health care and treatment they deserve.

  19. Inequality is an unfair situation in society when some people have more opportunities than other people. Unjust behavior is unfair or partiality.
    I agree with 2b where Michele specified everybody should receive health care and treatment what they reserve in United States. there should be a equal share of health for everyone.

  20. When something is out of our control is unequal. Example is gender and men getting prostate cancer. That’s just nature. Unjust is just not being fair or morally right. An example is having the cure to a disease and not giving it to a certain group based on their “race”.

    I agree with #1 everyone has the right to health if they obtain it without force or fraud. It makes the most sense to me. Although part of me agrees with 2a but many loopholes to consider. If a person chooses not to better themselves then they should get no health. It’s pointless to waste it on someone that doesn’t want to improve.

  21. 1. WHAT IS THE DIFFERENCE BETWEEN UNEQUAL AND UNJUST?

    If something is unequal, its differences are caused by things that we have no control over, such as biological factors. However, if it is unjust, it’s because society has a direct effect on the differences and the power to fix them.
    For example, studies show that males are more likely to develop disabilities due to the fact that genetically, they are comprised of only one X-chromosome. With that being said, if males are more prone to defects, it is unequal because society can’t alter the DNA of males to carry two X-chromosomes.
    Now if you say that males with disabilities are dying at a faster rate than females with disabilities, it may be due to an unjust cause. Many factors can shape this outcome such as a lack of medical resources or social expectations of males, etc.

    2. WHICH USA HEALTH PRINCIPLE DO YOU AGREE WITH MOST?

    I agree most with 2A: the idea that everyone should have an equal share of health even if inequalities result from a person’s own choices.
    For example, let’s look at a situation where two women of the same age, height and weight, are both diagnosed with breast cancer. I’ll give them names: Ava and Betty. Both women exercise regularly and eat healthy. However, Ava smokes and Betty does not.
    Ava has Medicaid while Betty has Blue Cross Blue Shield insurance and while both are receiving treatment for their cancers, we both know that Betty will get the better treatment as she is better insured.
    In my opinion, even though Ava smokes (by choice), she still faced the same odds of developing cancer as her counterpart who des not smoke. Therefore, with that being said, Ava should still be treated for her cancer with equal care. Regardless of if it was her choice to knowingly participate in an activity that may or may not have caused her cancer, it is unjust to deny a sick person available resources.

  22. 1.The difference between something being unequal vs something being unjust is that when something is unequal it means that two or more things are not comparable in some way. If something is unjust it means that it is immoral. In the example. the inequality would be that the first group is more prone to death and the second group is more prone to illness. The injustice is that neither of the groups may have had control over their situation, things such as being denied health insurance, or not having enough health insurance to cover medical bills etc are examples of injustices they may experience.

    2. I agree with principle 2A, because I feel like everyone should have an equal opportunity to be healthy and the resources to do so. However, I also believe that, for the most part, we are all born with the opportunity to be healthy (keeping in mind and excluding some are born with illnesses or develop illnesses that are beyond their control) and that we are responsible for making healthy choices in order to keep ourselves healthy. If you choose to smoke for 10 years and therefore develop lung cancer, you knew the risk associated with smoking so you decided to take that risk. You decided to make unhealthy choices, and in return you have consequences to deal with for those choices.

  23. 1.The difference between something being unequal vs something being unjust is that when something is unequal it means that two or more things are not comparable in some way. If something is unjust it means that it is immoral. In the example. the inequality would be that the first group is more prone to death and the second group is more prone to illness. The injustice is that neither of the groups may have had control over their situation, things such as being denied health insurance, or not having enough health insurance to cover medical bills etc are examples of injustices they may experience.

    2. I agree with principle 2A, because I feel like everyone should have an equal opportunity to be healthy and the resources to do so. However, I also believe that, for the most part, we are all born with the opportunity to be healthy (keeping in mind and excluding some are born with illnesses or develop illnesses that are beyond their control) and that we are responsible for making healthy choices in order to keep ourselves healthy. If you choose to smoke for 10 years and therefore develop lung cancer, you knew the risk associated with smoking so you decided to take that risk. You decided to make unhealthy choices, and in return you have consequences to deal with for those choices.

  24. 1)I think that the word Unequal means that you have no control over a situation and perhaps you are born into it. Such as a hereditary disease. I think that Unjust is something that society has dominated or have haven away from you such as freedom.

    2) I agree with principle 2b because an individual deserves an equal share of health furthermore, If that person’s choice puts them in harms way they still deserve to have the choice. Often, I believe, people make specific choices for different reasons. Physicians have one Job to do , which is to provide the maximum output of health care. If a fire fighter gets burned from a fire, knowing that the job is dangerous, OF COURSE they should be treated. Everyone deserves a chance of life and a lesson to be brought out of it( smoker, substance abuser)

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