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From page 83... ...
These perspectives hold different ideas regarding the implications of social justice for health policy, research, and practice. While each school of thought has different definitions of social justice, there are shared concerns about how we ought to live together and what is fair, and that the manner in which resources and responsibilities are distributed and accessed can differ substantially.
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From page 84... ...
Our intent is to increase our understanding of ways multiple political philosophies implicitly or explicitly offer different definitions of health equity and thereby imply different strategies and approaches to address social justice in health. That we are providing a brief summary suggests that there are inevitably omissions of details and nuances.
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From page 85... ...
The modern rights movements recognize the conflict between individual freedom and the actual treatment of groups of people based on race, gender, sexuality, age, religion, and other natural or socially constructed characteristics. In regard to health discrepancies, modern liberalism views inequities in opportunity for healthy development as impediments to freedoms of some segments of society enjoyed by others (Sen, 2009)
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From page 86... ...
. Modern Liberalism Justice as Fairness Late-20th-century academic political philosophy, particularly in the United States, has been significantly influenced by John Rawls.
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From page 87... ...
The Capabilities Approach Martha Nussbaum, a senior member of the philosophy faculty at the University of Chicago, and Nobel Prize–winning economist Amartya Sen developed and use the capabilities approach "to provide the philosophical underpinning for an account of core human entitlements that should be respected and implemented by the governments of all nations, as a bare minimum of what respect for human dignity requires" (2007, p.
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From page 88... ...
The capabilities approach posits that social justice entails society offering all individuals the opportunity to develop, utilize, and put into effect these essential capabilities, regardless of happenstance of birth, including social standing or inherent abilities. This means that equity implies differential opportunity as needed to compensate for or minimize advantages and disadvantages of persons and stations.
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From page 89... ...
A major issue within health equity–definition discussions and in policies related to health care is shared interdependency -- how much health of the other is each person's concern and how health standing and health costs to the society are affected by recognizing that interdependency. Confucianism Confucianism, with its roots in Chinese feudal culture several centuries BCE, continues to have influence even after the remarkable political and economic revolutions in China during the last century (Rosemont, 1991)
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From page 90... ...
Perhaps most relevant to the health equity discussion in this country is the justification of less concern for particular individuals based on an implicit assumption that inequity may not translate to harm overall, whereas from an individual-oriented perspective, this would be seen as inhumane or discriminatory. Buddhism Buddhism is another philosophical perspective that may be informative for addressing social justice and health equity.
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From page 91... ...
Thieves then armed themselves to fight the king's men. So, from indifference to the poor grew theft, murder, runaway violence, and the shortening of life spans.
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From page 92... ...
Also, socialism remains a major political philosophy affecting the discourse about health care equity, here and in other countries. For example, in many Western industrialized countries, health care is a governmental service offered as part of the state social contract with the citizens.
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From page 93... ...
As there are many who think that health equity rests on movement to a single-payer state-supported approach, the implications of this philosophy for the means and ends related to health equity deserve careful consideration. Most fundamentally, it is the assumption that health care should not be a matter of personal economic exchange, but seen as a right of membership in society, with equity in access and quality as fundamental to social justice.
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From page 94... ...
How can innovative policies drawing on a wide range of cultural and philosophical traditions improve our discourse while fitting practically into our existing social and political context? How might research help determine which approaches to equity in health opportunities, access to care, quality of care, and life quality and longevity actually will provide improvements by bringing the status of disadvantaged groups up to that of the more privileged and thereby realize social justice?
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