Theoretical Medicine

, Volume 10, Issue 4, pp 301–310 | Cite as

Just health care (II): Is equality too much?

  • Leonard M. Fleck


In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1].

Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than strong egalitarian lines. Further, given the empirical complexity associated with the distribution of contemporary health care, I argue that what we really need to address the relevant policy issues adequately is a theory of health care justice, as opposed to an all-purpose conception of justice. Daniels has made an important start toward that goal, though there are some large policy areas which I discuss that his account of health care justice does not really speak to. Finally, practical matters of health care justice really need to be addressed in a ‘non-ideal’ mode, a framework in which philosophers have done little.

Key words

egalitarian justice fair equality of opportunity health care justice non-ideal justice 


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Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Leonard M. Fleck
    • 1
  1. 1.Medical Humanities Program, C-201 East Fee HallMichigan State UniversityEast LansingUSA

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