United States and Canadian approaches to justice in health care: A comparative analysis of health care systems and values

Nancy S. Jecker, Eric M. Meslin

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

The purpose of this study is to compare and contrast the basic ethical values underpinning national health care policies in the United States and Canada. We use the framework of ethical theory to name and elaborate ethical values and to facilitate moral reflection about health care reform. Section one describes historical and contemporary social contract theories and clarifies the ethical values associated with them. Sections two and three show that health care debates and health care systems in both countries reflect the values of this tradition; however, each nation interprets the tradition differently. In the U.S., standards of justice for health care are conceived as a voluntary agreement reached by self-interested parties. Canadians, by contrast, interpret the same justice tradition as placing greater emphasis on concern for others and for the community. The final section draws out the implications of these differences for future U.S. and Canadian health care reforms.

Original languageEnglish (US)
Pages (from-to)181-200
Number of pages20
JournalTheoretical Medicine
Volume15
Issue number2
DOIs
StatePublished - Jun 1 1994

Keywords

  • access to health care
  • allocation of resources
  • cost containment
  • health insurance reforms
  • justice
  • national health insurance
  • right to health care

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health

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