The Journal of medicine and philosophy
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The treatment decisions of competent adults, especially treatment refusals, are generally respected. In the case of minors something turns on their age, and older minors ought increasingly to make their own decisions. ⋯ Their right to do so can best be justified in terms of the importance of preserving intimate family relationships, rather than in terms of the child's best interests, although the child's best interests will most often follow from this arrangement. Nevertheless, there are and ought to be legal, ethical, and financial constraints on parental decision making.
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Clouser and Gert's 'A Critique of Principlism' (1990) has ignited debate over the adequacy of substituting principlism for moral theory as a means for dealing with biomedical dilemmas. Clouser and Gert argue that this sort of substitution is not adequate to the task. I examine their argument in light of recent defences of principlism on this score, those of B. ⋯ These differing conceptions are motivated by antecedent epistemological commitments. The present debate over principlism is therefore inconclusive. Future discussion should focus on the underlying epistemological issues.
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This paper proposes an ethical framework for rationing publicly-financed health care. We begin by classifying alternative rationing criteria according to their ethical basis. ⋯ We submit that a just health care system will not limit basic health care to persons unable to pay for it. Furthermore, justice in health care requires limiting publicly-financed non-basic health care, striving for equality in access to basic health care, and relying on medical benefit to ration non-basic health care.