Jennifer Prah Ruger ^1*

¹ Yale University School of Medicine

^* To whom correspondence should be addressed. E-mail: jennifer.ruger{at}yale.edu.

	Abstract

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.

Key Words: Ethics, Health Care Facilities/Services, Insurance, Health Law, Health Policy, Access to Care

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]