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Personal responsibility in healthcare allocation can worsen health inequalities. This paper argues that the link between poor health and social disadvantages creates cycles that responsibilisation policies fail to address, potentially trapping individuals.

Keywords:
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Area of Science:

  • Bioethics
  • Distributive Justice
  • Health Policy

Background:

  • The concept of 'personal responsibility' is debated as a criterion for healthcare distribution.
  • This approach, termed 'responsibilisation,' may impose conditions or limit access based on an individual's health choices.
  • Luck egalitarianism, which justifies inequality based on free choices, is a prominent philosophical framework for responsibilisation.

Purpose of the Study:

  • To analyze how the relationship between health and social goods exacerbates the 'harshness objection' to responsibilisation.
  • To demonstrate that standard responses to the harshness objection are insufficient to address this exacerbated problem.
  • To explore potential solutions for mitigating the negative impacts of responsibilisation.

Main Methods:

  • Philosophical analysis of distributive justice principles.
  • Examination of the interplay between health status and socioeconomic factors.
  • Critique of existing arguments concerning the harshness objection in healthcare ethics.

Main Results:

  • The bidirectional relationship between health and social goods intensifies the harshness objection.
  • Poor health can limit opportunities, leading to further poor health and reinforcing cycles of disadvantage.
  • Existing solutions to the harshness objection do not adequately account for these reinforcing cycles.

Conclusions:

  • Responsibilisation policies risk trapping individuals in cycles of poor health and limited opportunity.
  • The exacerbation of the harshness objection by health-social good interdependencies requires novel solutions.
  • Further consideration of alternative approaches to healthcare allocation is necessary.