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Health and Social Justice$
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Jennifer Prah Ruger

Print publication date: 2009

Print ISBN-13: 9780199559978

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780199559978.001.0001

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Health and Human Flourishing

Health and Human Flourishing

(p.45) 2 Health and Human Flourishing
Health and Social Justice

Jennifer Prah Ruger (Contributor Webpage)

Oxford University Press

This chapter lays the philosophical foundation for the book's theoretical framework, drawing on moral and political philosophy to argue that Aristotle's theory and Sen's capability approach provide the philosophical basis for the special moral importance of health capabilities as a central focal variable for assessing equality and efficiency in health policy. Both take a universal view of humans' capability to flourish as an end of moral and political philosophy and provide an analytical framework for addressing questions of justice and human rights in a way other philosophical schools do not. The capability approach considers human heterogeneity when assessing equality, and uses the capability to achieve valuable functionings as the main variable for evaluation. It also respects the central importance of freedom and reason in enabling humans to make choices. This is a departure from more Rawlsian resource‐based evaluation frameworks that measure equality according to the attainment of tangible rewards such as wealth, income and health care. This chapter highlights the important contributions of these philosophical theories to the author's own thinking, while at the same time recognizes their limitations and demonstrates how the health capability paradigm can address such drawbacks in the specific context of the development, organization, and delivery of health systems and policy.

Keywords:   Aristotle, human flourishing, functioning, Amartya Sen, capability approach, heterogeneity, freedom, choice, moral and political philosophy

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