Autonomy and Just Health

Abstract

In the last quarter of the 20th century medical ethics underwent a kind of renaissance:developments in biotechnology, in pharmacy, but, overall, increased possibilities in lifestylesand life-extension due to advanced technological approaches captured our attention and ledto a rehabilitation of ethics in general and medical ethics in particular. Initially these ethicsoperated with relatively simple principles. These principles, as they have been formulated byTom L. Beauchamp and James F. Childress (1994), sound like a mantra to our ears: ‘Autonomy’,‘Nonmaleficence’, ‘Beneficence’, and ‘Justice’. Compared to the other three, the last namedprinciple, ‘Justice’, has led and, until the present day, continues to lead a shadowy existence.The question of what ‘just healthcare’ means, and especially what ‘just health’ is, is hardly everraised. In addition to this, the social characteristics of ‘health’ have been forgotten in areprehensible way. A future medical ethics must deal with two key challenges. First, what isthe good of health and how is it constituted? Second, what can ‘just health’ mean if we view itagainst the background of the social causes of health and disease.