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Personalized Medicine, Justice and Equality

Like some other texts, this paper embraces the idea that, because of the scarcity of resources on the one hand, and extended requests on the other, we need to set limits in health care. Likewise, the paper endorses the thesis that such limits must be fair. Further, it accepts and further develops the idea that limits must be set fairly through proper deliberative procedures. In addition, it defends and applies Rawls’s idea of public reason. This is the idea that, even in a fair procedure, proposals and decisions must be justified through public reasons, i.e. reasons that each agent can accept as reasonable to be legitimate. Mere majoritarian vote is not sufficient for legitimacy. Contrary to other proposals in health care justice that are immediately concerned with real world deliberation and do not attribute a proper function to the personal perspective, this paper endorses two levels of deliberation. The idealized level is needed to establish which are the strongest rights, which can be limited only if they conflict with each other, but not if they conflict with less important rights and values. Here, a set of eligible decisions is established for real life deliberation. Using the example of the methodology of justification, which considers the importance of the personal meaning of health care decisions, as well as of public reasons in ideal and in real life contexts, the thesis is defended that life prolonging therapies have a strong priority as rights

Equality, Justice, Personalized Medicine

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