On Justice Of Medical Care

As the great progress on medical science has made, it shows justice of medical care more and more important. Justice of medical care is the core problem in every country all over the world at the present age. Above all, this thesis has analyzed systematically the problem about justice of medical care from follow three aspects such as the theoretical foundations on justice of medical care, material principle on justice, procedure principle on justice. Then, it has analyzed how to realize justice of medical care according to realities in China.1. The theoretical foundationThere are three theories: Utilitarian, Egalitarian, Libertarian, These theories are the theoretical foundation on justice of medical care,they guide justice of medical care.Utilitarian. It concern consequence of human activity. Whether human activity is right be judged by the consequence realize the maximal happiness of the majority. The happiness conducts from counting utility. It seeks the maximal welfare for human on medical care, and explores the patient's maximal benefit that by calculating the utility in medical care resources distributing. There are some defects in morality and technology on Utilitarian. But it can help to point out the scope and limit of medical care distributing, Therefore every country all over the world take Utilitarian as the theoretical foundation on justice of medical care.Egalitarian. It thinks that people's destiny is not controlled by oneself, and it is under the control of society. It is unfair if society lets all the people alone face poor and disease. When people's function is decrease by hurt and disability and disease. Society should make use of medical care resources to rectify this misfortune, to meet people's primary need of medical care, and to restore their opportunity or ability to pursue their goal. The determinant to improve health is how to improve the level of social equality. If it has not distributed medical care resources equally, the society could not carry out its obligations because of which all citizens own the rights of share resources, These opinion shows requirement about ability equality or need equality or opportunity equality in the field of medical care.Libertarian. It thinks that in the free market people work to get their benefits, at the same time, it could promote the benefit of other people in society too. People can enter or withdraw freely according to self-understanding to their benefit, so individual right has got guarantee. The theory thinks the government does not have responsibility for ensuring the social vulnerable group get sufficient medical care, the individual have responsibility for their health. The free market can resolve the distribution problems of medical care resources.All these theories have established theoretical foundations for medical care distribution. Every country chooses one theory as the guiding principle according to national condition, other theories play certain role all more or less. These theories have provided theoretical guard for material principle of justice and procedure principle on justice of medical care.2. Material principle of justiceMaterial principle of justice guides our practice by answer the question about choosing whom to serve, serving what and how to serve. The distribution of medical care resources includes the macroscopic and microcosmic distribution, the former pays attention to the style and range of fundamental medical care system, which compose the core of medical care system. the latter is the choice among individuals that who will get resource and how much to get. The cognition to people's health right and social responsibility decides that medical care should be settled by free market or by government. The free market is the choice of Libertarian, the government leading is the choice of Egalitarian.The limitation on justice of market setting. Because there is public attribute on medical care, it is inherent essential that medical care satisfy human primary need. the particular relationship between doctor and patient. Distribution of medical care resources can not assigned by free market. The government must intervene in the distribution of medical care resource to rectify market detects, to adjust the malfunction of market.Reasonable rationing. Not only free market but also the government leading system should consider the influence of moral risk, induced need and practical difference, because resource is limited. We have to carry out reasonable rationing . To carry out reasonable rationing must determine the life quality, life price and the limit of medical care and calculate the cost-effective of medical care.Microcosmic distribution. The principle of equality, the principle of responsibility and the principles of effectiveness plays important role in microcosmic distribution. Microcosmic distribution is carried out by the standard and the approach of distribution. The standard of microcosmic distribution includes social, medical and individual standard. The approach of microcosmic distribution includes productivity, impartial and particular setting.3. Procedure principle of justiceBoth procedure principle of justice and material principle of justice are the two side of justice. Their relationship is closely not separate. Procedure principle of justice is about principle and process which answers how to assign distribution of medical care. It is material principle of justice that pay attention to result of justice, while procedure principle of justice pay attention to both process and principle.The character. Those theories such as Utilitarian, Egalitarian and Libertarian play important role in procedure principle of justice. Procedure principle of justice is essential to carry out Material principle of justice. Although material principle of justice is more important than procedure principle of justice, but procedure principle of justice is important to carry out justice. Therefore, procedure principle of justice needs unite principle to guard. This principle must show social good, the decision must be such character as equality, all- round information, respect, and open opinion.The condition. Both regulations and way are indispensable to procedure principle of justice. Because distribution according to regulation will lead to ignore individuality, be short of stability and accuracy, lead to prejudice. Therefore, distribution should be decided by broad participation, the supervision from government and the news media.The process of decision making about the limit. It must have constraint for medical care resource is limit. Since people's value is pluralistic, it is difficult to reach consensus to decision making about the limit of medical care. Decision of the limit must be made by the procedure of democratic consultation. It is the most important that the decision accord with social good to prevent from accountability for under out of government. Therefore, the decision of limit must have the accountability for reasonableness, which must be public, and can be revised.4. Justice of Medical care in ChinaChina should take Egalitarian theory and Libertarian theory as guide, base on Utilitarian theory, walk along the administrative and market-oriented road, make good use of market and the government's role.The distribution style. The thesis suggests that at present Chinese justice of medical care is not the result of market-oriented, but is the result of"government's vacancy"and"government's offside". China should walk along the administrative and market-oriented road, make good use of market and the government's role.The effect of government. We should exert government's role in distribution on medical care. Government should ensure the broad cover of medical care, adjust the malfunction of market, carry out justice of medical care by the procedure of deliberative democratic. Government should ensure the broad cover of medical care through caring for the poor and strengthen primary medical care. Government should adjust the malfunction of market through eliminate obstacle of entering market and establish supervising mechanism. To realize justice of procedure by deliberative democracy need to reveal information and extensive participate.The core mission of this thesis is to design the approach to resolve Chinese justice of medical care by researching on basic theories on justice of medical care. Facing with this problem, we need to consider two contrary requests: on one hand, through pure theoretical research, prevent giving a barren conclusion; on the other hand, through the theory contacts with practice, prevent getting those conclusions of individual subjective and be short of rationality.The research on justice of medical care has directive function to system design to macroscopic and microcosmic distribution of medical care.