HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.121350v1 98/10/1756    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ruger, J. P. Search for Related Content PubMed PubMed Citation Articles by Ruger, J. P. Related Collections Ethics Health Care Facilities/Services Insurance Health Law Health Policy Access to Care Health Reform

Jennifer Prah Ruger, PhD

Jennifer Prah Ruger is with the School of Medicine, Graduate School of Arts and Sciences, and Law School, Yale University, New Haven, CT.

Correspondence: Requests for reprints should be sent to Jennifer Prah Ruger, PhD, Yale University School of Medicine, 60 College St, PO Box 208034, New Haven CT 06520-8034 (e-mail: jennifer.ruger{at}yale.edu).

I argue that an ethical vision resting on explicitly articulated values and norms is critical to ensuring comprehensive health reform. Reform requires a consensus on the public good transcending self-interest and narrow agendas and underpinning collective action for universal coverage.

In what I call shared health governance, individuals, providers, and institutions all have essential roles in achieving health goals and work together to create a positive environment for health.

This ethical paradigm provides (1) reasoned consensus through a joint scientific and deliberative approach to judge the value of a health care intervention; (2) a method for achieving consensus that differs from aggregate tools such as a strict majority vote; (3) combined technical and ethical rationality for collective choice; (4) a joint clinical and economic approach combining efficiency with equity, but with economic solutions following and complementing clinical progress; and (5) protection for disabled individuals from discrimination.

This article has been cited by other articles:

				J. P. Ruger Ethics in American Health 1: Ethical Approaches to Health Policy Am J Public Health, October 1, 2008; 98(10): 1751 - 1756. [Abstract] [Full Text] [PDF]