PH_as_Social_Justice.pptMarket Justice vs Social Justice
- “Our public ethics do not fit our public problems”
- “solving or minimizing (our most intractable public problems) requires painful losses, the restructuring of society and acceptance of new burdens by the most powerful and the most numerous on behalf of the least powerful or the least numerous”
Market Justice/Social Justice
- Example:
- “the automotive industry, the tobacco industry, the coal industry and the medical care industry have an unequal responsibility to bear the costs of reducing death and disability since their actions have far greater impact than those of individual citizens”
Iatrogenic
- There are about 6,000 deaths due to errors for every 1 million patient interventions (and this does not include patient injury, which according to some studies may be as high as 25% of interventions1). The goal, of course, is to have no injuries or deaths due to medical errors.
- Gandhi TK, et al. Adverse drug events in ambulatory care. BMJ. 2003;348:1556-64
Access to technology
- “Our fundamental attention in public health should not be directed toward a search for new technology, but rather toward breaking existing ethical and political barriers to minimizing death and disability”
Market Justice / Social Justice
- Individual Priority
- Entitlement by Effort
- Protected by Rules
- No Obligation to protect others
- Collective Priority
- Entitlement- provide for everyone
- Regulations Control risk
- Re-Distribution of Wealth
Dominant Market Justice
- American social experience is within the “market justice” and “free market economy” system
- Another system in Western liberal tradition is “social justice” based on community good as a priority
- Risk Assessment
- Precautionary Principle
