Theoretical Medicine and Bioethics

, Volume 28, Issue 2, pp 121–135 | Cite as

The Significance of the Concept of Disease for Justice in Health Care

  • Thomas SchrammeEmail author


In this paper, I want to scrutinise the value of utilising the concept of disease for a theory of distributive justice in health care. Although many people believe that the presence of a disease-related condition is a prerequisite of a justified claim on health care resources, the impact of the philosophical debate on the concept of disease is still relatively minor. This is surprising, because how we conceive of disease determines the amount of justified claims on health care resources. Therefore, the severity of scarcity depends on our interpretation of the concept of disease. I want to defend a specific combination of a theory of disease with a theory of distributive justice. A naturalist account of disease, together with sufficientarianism, is able to perform a gate-keeping function regarding entitlements to medical treatment. Although this combination cannot solve all problems of justice in health care, it may inform rationing decisions as well.


disease justice rationing egalitarianism sufficientarianism naturalism normativism 


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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  1. 1.School of Health Science, Centre for Philosophy, Humanities, and Law in Health CareUniversity of Wales SwanseaSingleton ParkUnited Kingdom

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