Social Justice: The Moral Foundations of Public Health and Health Policy (Issues in Biomedical Ethics) [Paperback]

Madison Powers (Author), Ruth Faden (Author)

Book Description

ISBN-10: 0195375130 | ISBN-13: 978-0195375138 | Publication Date: September 25, 2008 | Edition: 2

In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy.

Editorial Reviews

Review

"Powers and Faden have given us a powerful and lucid theory that gives us the tools to unify our work in such disparate areas as bioethics, public health, global justice, and human rights. All of us who work in this area are in their debt.--John D. Arras, Porterfield Professor of Biomedical Ethics, University of Virginia

"Most moral theorists think about what principles of justice would govern an ideal world. Such ideal theories do not necessarily guide us well in our non-ideal world. Powers and Faden make a powerful case for moving from ideal to non-ideal theory, and ably show how to do it in the field of justice in health care. This book makes an important advance in making moral theory more empirically responsible."--Elizabeth Anderson, John Rawls Collegiate Professor of Philosophy and Women's Studies, University of Michigan, Ann Arbor

"Faden and Powers have produced a compelling and important argument regarding what social justice requires of states and the various social institutions they facilitate. One can only hope that their articulation of this very good constitutional idea--that as a very fundamental, constitutional matter states ought to promote social justice and that what that means is that states must provide for human well-being along those six crucial dimensions--will receive a wide readership, not only by public health professionals or the lay public, but also by constitutional lawyers and theorists."--Robin L. West, DePaul Journal of Health Care Law, Frederick J. Haas Chair in Law and Philosophy, Georgetown Law Center

"Social Justice is one of the most important books to come out in bioethics, and health policy ethics, in the last decade. It challenges us to think more broadly about what bioethics brings to the table when we evaluate health policies and public health practices. Its combination of rigor and clarity is uncommon."--Peter A. Ubel, M.D., Director, Center for Behavioral and Decision Sciences in Medicine, Ann Arbor

"Powers and Faden articulate a distinct theory of social justice emphasizing a threshold of sufficiency in six different dimensions of well-being. Their original, robust, well defended theory, combined with their subsequent application of the theory to a sensibly chosen set of health policy issues, make Social Justice...an unmistakably prominent book in the field."--Paul T. Menzel, Professor of Philosophy, Pacific Lutheran University

"In this excellent book, Madison Powers and Ruth Faden set out to define the essential dimensions of well-being that should guide a theory of justice, and then to show how such a theory can be applied to important issues in public health and health policy."--Hastings Center Report

"With Social Justice: The Moral Foundations of Public Health and Health Policy, the multidisciplinary writers' team of Madison Powers and Ruth Faden have delivered an interesting and compelling answer to the questions of how much inequality in health a just society can tolerate and which inequalities matter most."
--Metapsychology

About the Author

Madison Powers is Professor of Philosophy and Senior Research Scholar, Kennedy Institute of Ethics, Georgetown University.

Ruth Faden is Wagley Professor of Biomedical Ethics, and Director, Berman Bioethics Institute, Johns Hopkins University.

Product Details

• Paperback: 248 pages
• Publisher: Oxford University Press, USA; 2 edition (September 25, 2008)
• Language: English
• ISBN-10: 0195375130
• ISBN-13: 978-0195375138
• Product Dimensions: 9.1 x 6.1 x 0.8 inches
• Shipping Weight: 14.4 ounces (View shipping rates and policies)
• Average Customer Review: 4.0 out of 5 stars  See all reviews (3 customer reviews)
• Amazon Best Sellers Rank: #181,212 in Books (See Top 100 in Books)

More About the Author

Discover books, learn about writers, read author blogs, and more.

Customer Reviews

Most Helpful Customer Reviews

16 of 17 people found the following review helpful:

5.0 out of 5 stars Book that should prove influential, October 2, 2006

By 

Robert M. Cook Deegan "BCD" (Durham, NC) - See all my reviews
(REAL NAME)   

This review is from: Social Justice: The Moral Foundations of Public Health and Health Policy (Issues in Biomedical Ethics) (Hardcover)

This book by Madison Powers of Georgetown University and Ruth Faden of Johns Hopkins should prove influential in theories of justice, particularly those applying to health and health care. Powers and Faden move beyond Rawls, and accept many but not all of the ideas espoused by Martha Nussbaum and Amartya Sen. They differ from those authors in focusing on six factors that need to be attained in sufficient measure to enable the pursuit of lives with a meaningful range of choices and opportunities. Some of these are capacities and others are met only by actual outcomes (particularly in the case of children). It is the job of justice to ensure that these six thresholds are exceeded, and this book lays out the theory to perform that work.

This theory is more easily applied to health because the parameters map to real-world interventions. The notion of human rights is embedded in several of the parameters, but the theory moves away from a pure rights framework and toward a "sufficiency" criterion of well-being. The final chapters apply the theory to specific problems, such as advantages and limitations of formal quantitative methods for assessing health benefit, and the problem of access to health care (via health care financing). The extra weight accorded to ensuring the six parameters of justice are satisfied for children is explained in a developmental theory, resting on the fact that once developmental windows close, the later adult cannot compensate. Unjust disadvantages from childhoold thus accumulate and reinforce one another irreversibly, limiting future choices and opportunities.

The theory is much more tractable for addressing health and health care than the twists and turns needed to accommodate Rawls. Powers and Faden take up many of the ideas of Sen about "development as freedom" and ensuring sufficiency of capabilities, but differ from him in focusing on actual outcomes rather than mere capacities for some parameters.

This is not beach reading, but it is important and extremely useful.

4 of 5 people found the following review helpful:

5.0 out of 5 stars Important contribution to field, April 17, 2009

By 

JMc "Philosophy Prof" - See all my reviews

This review is from: Social Justice: The Moral Foundations of Public Health and Health Policy (Issues in Biomedical Ethics) (Paperback)

This is a crucial addition to the conversation about social justice. Having read Daniels, Nussbaum, Sen & Rawls, I found this text to be contributing to the larger conversation in interesting and new ways. Not light reading, but neither are the other important folks in this field.

In particular, Powers & Faden are putting forward a non-ideal theory, viewing theories of social justice as crucially concerned with remedying unjust situations.

I've assigned this in an undergraduate course and the students are challenged by it but don't find it inaccessible. They are interested and keeping up with the reading.

2.0 out of 5 stars Close examination reveals flaws, October 13, 2011

By 

Kidney - See all my reviews

Amazon Verified Purchase

This review is from: Social Justice : The Moral Foundations of Public Health and Health Policy (Issues in Biomedical Ethics) (Kindle Edition)

You should keep in mind that this book is based on a care ethics model that does not fit with all people. There are some good starting points to work off of but the conclusions drawn are not fully thought out. The arguments are circular and have little solid support outside of "it works because we say it will". Be careful in just taking everything written as truth and remember to always critically evaluate what you are being told.