responsibility for health-PHIL 321

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321

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Philosophy

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Apr 3, 2024

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Dr. Agnes Bolinska PHIL 321 November 17. 2022 The responsibility for health 1. What is luck egalitarianism, and what does it say about whether Patient A or B gets the heart transplant? - Luck egalitarianism in health holds that inequalities in health are unjust when and because they reflect the bad effects of brute luck (or when they reflect something other than choice). Luck egalitarianism in health is the view that it is unjust if some people are worse off than others in terms of health through no fault or choice of their own, and that as a matter of justice they should be compensated or 129 helped to overcome the bad effects of brute luck. - In the Patient A and B scenario, both have heart disease. The difference is that Patient A developed heart disease as a result of bad luck, but his condition is a result of option luck – that is, luck that he himself triggered. Therefore, A should be held responsible for this consequence because they are a heavy smoker. Patient B, on the other hand, also developed heart disease as a result of bad luck, but his condition is a result of bad brute luck, which he could not control. Therefore, according to luck egalitarianism, B should not be held responsible for the consequences of his luck. It is just to compensate B for his bad health by, for example, giving higher priority to his treatment. 2. What is all-luck egalitarianism? - Every outcome is a matter of luck – they all contain an element of chance. Thus, nobody should be held responsible for the bad effects of their luck, since there is an element of their choices that is out of their control. This view differs from the standard version of luck egalitarianism that we have been discussing in that it takes all luck to involve at least some brute luck. Ultimately, the view does not distinguish between brute and option luck – or at least, it downplays the importance of the distinction. 3. What is the fair equality of opportunity view? - It holds that health, and therefore health care, has special, strategic importance for people. Good health is a prerequisite for your pursuing and realizing what you value, and health care protects your ability to pursue and realize what you value. Therefore, health inequalities lead to disadvantages and broader social inequalities; because of this, health inequalities are unfair. The health care system should protect people’s fair opportunities in the same way that the prohibition of racial and gender discrimination in hiring and promotion protects everyone’s fair opportunities. Thus, every patient should be treated equally. The health care system should not discriminate between them when their health conditions are the same, regardless of their past behavior.
4. Are smokers really responsible for their bad health conditions? Why or why not? - Smokers are not responsible for their bad health conditions because risky behavior, such as smoking or excess drinking, is negatively correlated with income, education, and social status. People with lower socioeconomic status find it more difficult to conform to treatment regimens for diseases such as diabetes and high blood pressure. Thus, income, education, and social status predict the pattern of harmful behavior in the population. It is too harsh to place the burden of responsibility onto smokers, drinkers, obese people, and the like. 5. What is the social gradient in health? Do you think countries have a responsibility to reduce this gradient? Why or why not? - The social gradient in health is the issue of the relationship between people’s socioeconomic status and their health status. - Yes, because there is a strong correlation between inequalities in health and inequalities in socioeconomic status. Society should ensure that the playing field is equal for everyone to go about pursuing their life plan. Therefore, health equality itself is desirable and required by justice. 6. What questions or comments do you have about this reading? This can either be something you didn’t quite understand or a philosophical point. - Why is there any responsibility, isn’t it just all luck? Even in the Patient A and B scenario, risky behaviors such as drinking alcohol and smoking cigarettes are not illegal. In that case, wouldn’t the tobacco and liquor industries be held responsible? I know this is touched on in the reading but I didn’t quite understand the reasoning.  
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