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Are clinical practice guidelines impartial?

Joshua Cohen1

  • 1Erasmus University. cohen@tufts.edu

International Journal of Technology Assessment in Health Care
|December 22, 2004
PubMed
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John Rawls's theory of justice requires unrealistic impartiality from policymakers. This study argues policymakers act as reasonably partial spectators, formulating rules from a justifiable, albeit partial, perspective, as seen in clinical guidelines.

Area of Science:

  • Political Philosophy
  • Public Policy
  • Ethics

Background:

  • John Rawls's influential "A Theory of Justice" posits that principles of justice require individuals to abstract from personal identities.
  • This ideal of impartiality is often impractical in real-world policy-making environments.
  • Existing frameworks for distributive justice may not fully account for the inherent partiality of policymakers.

Purpose of the Study:

  • To challenge the feasibility of Rawlsian impartiality in policy-making.
  • To propose an alternative model where policymakers function as "reasonably partial spectators."
  • To demonstrate the practical application of this partiality in policy development, using clinical practice guidelines as a case study.

Main Methods:

  • Conceptual analysis of John Rawls's theory of justice and its application to policy.
Keywords:
Analytical ApproachHealth Care and Public Health

Related Experiment Videos

  • Argumentation based on the practical realities of legislative and policy-making processes.
  • Case study analysis of the establishment and mediation of clinical practice guidelines by expert panels.

    • Main Results:

    • The demand for complete abstraction from personal identity is unrealistic for policymakers.
    • Policymakers, legislators, and rule-makers operate as "reasonably partial spectators" when developing social rules.
    • Expert panels mediating clinical practice guidelines exemplify this partiality, where actions are publicly justifiable despite not being fully impartial.

    Conclusions:

    • A more realistic approach to distributive justice acknowledges and accommodates the partiality of policymakers.
    • The "reasonably partial spectator" model offers a practical framework for understanding policy development.
    • Publicly justifiable partiality, rather than unattainable impartiality, may be the operative principle in effective policy-making.