Rawlsian Justice and Palliative Care

• Published in: Bioethics Vol. 29; no. 8; pp. 536 - 542
• Main Authors: Knight, Carl, Albertsen, Andreas
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.10.2015
• Subjects: allocating healthcare; Bioethics; Charities - utilization; Choice Behavior - ethics; Clinical Decision-Making - ethics; Daniels, Norman; distributive justice; Health care; Health Care Rationing - ethics; Humans; Justice; medical ethics; Medical treatment; Pain - etiology; Pain Management - ethics; pain relief ethics; Palliative care; Palliative Care - ethics; Patient Advocacy - ethics; Patient Care Planning - ethics; Patient Rights - ethics; political philosophy; Rawls; Social Justice - ethics; Stress, Psychological - prevention & control; Terminally Ill - psychology; Therapeutics - adverse effects; Therapeutics - ethics; allocating healthcare; medical ethics; political philosophy; distributive justice; palliative care; Rawls; pain relief ethics
• ISSN: 0269-9702; 1467-8519
• DOI: 10.1111/bioe.12156

Palliative care serves both as an integrated part of treatment and as a last effort to care for those we cannot cure. The extent to which palliative care should be provided and our reasons for doing so have been curiously overlooked in the debate about distributive justice in health and healthcare. We argue that one prominent approach, the Rawlsian approach developed by Norman Daniels, is unable to provide such reasons and such care. This is because of a central feature in Daniels' account, namely that care should be provided to restore people's opportunities. Daniels' view is both unable to provide pain relief to those who need it as a supplement to treatment and, without justice‐based reasons to provide palliative care to those whose opportunities cannot be restored. We conclude that this makes Daniels' framework much less attractive.