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  • Bioethics - Politics
      • RAWLS, Justice = Fairness, focus on social structure, liberal egalitarianism
        • Equal Liberty, Equal Opportunity, Primary Goods distributed in accordance with 'difference principle'
        • Daniels applies to Healthcare via difference principle
          • needs based distribution
            • issues = no responsibility, who 'worse off'?, cant resolve tension between primary goods
      • Luck Egalitarianism
        • Key moral concern, compensate inequalities 'not fault'
          • responsibility sensitive BUT 'fault' incredibly difficult to define
          • doesnt mitigate luck = lucky smokers
      • Equal opportunity = social structural v. brute luck view
      • INEQUITIES = unjust inequalities
        • Rawls account to identify injustice
          • social gradient of health therefore = address social structure
          • Avoids defining well-being
            • Inequity NOT becuase of deviation from some 'ideal health' but because of unjust social arrangements
    • Paternalism, proper state-citizen relationship in healthcare
      • Mill 'On Liberty' = Harm Principle, guide to avoiding paternalism in policy
        • Issues = account of harm, information, addication and nature of democracy problematising 'against his will'
      • Libertarian Paternalism = change choice architecture, nudges = chips and salad example
        • Permission claims =/ generate right claims, and some design choice needed
        • Basis = choices malleable, why respect choice?
      • Intuitively want  to avoid = concerns over limiting state action, liberty, autonomy
      • Extended anti-paternalism, against choice architecture
        • right to harm consenting third parties = selling cigarettes BUT obligation not to harm =/ permission to facilitate
    • Limiting State Intervention
    • How to Distribute
      • QALYs
        • Issues = no responsibility, no severity, no equality, subjectivity, age and uncertainty of future
      • Population v High-Risk
        • Roses fundamental axiom preventative medicine
          • Issues = severity and beneficence ignored, concentration of risk?
          • regression to mean, utilitarian
        • Intuition = worse off greatest claim to help


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