A FUNDAMENTAL QUESTION OF JUSTICE

As a matter of justice, what do we owe each other to promote and protect health in a population and to assist people when they are ill or disabled? I shall refer to this question about our social obligations as the “Fundamental Question” of justice for health.

My strategy for answering the Fundamental Question is to substitute for it three more specific “Focal Questions” (Daniels 2001):

1. Is health, and therefore health care and other factors that affect health, of special moral importance? To answer this question, we need to see how meeting health needs is connected with other goals of justice. Answering it may tell us whether we have obligations regarding health and its distribution within a population that do not apply to some other goods.

2. When are health inequalities unjust? To answer this question, we have to understand the factors and social policies that contribute to population health and health inequalities. The answer will help us understand which health inequalities it is most important to address.

3. How can we meet health needs fairly under resource constraints? Since health is not the only important good we pursue, resources are always limited. To answer this question, we must determine the source of our agreements and disagreements about priority setting. This will help guide policy under real-world conditions.