John Dewey's concept of the good : a macro- and meso-application to the U.S. health system

This work stems from the debate about ethically reforming America's health system in response to the enduring scarcity of resources. There are at least three essential components to successfully instituting needed changes: a philosophicallydefensible guideline, effectively-designed programs or legislation, and political willpower. This dissertation represents the first component. Two distributive justice decisions are central to this dissertation. One decision is how to apportion resources among competing governmental programs such as Social Security, education, agriculture, and transportation. This is known as the macro-level. The other decision is how to apportion health-care resources to competing ailment or disease categories such as cancer, eye care, cystic fibrosis, and burns. This is known as the meso-level. An ethical criterion or standard is needed with which to make such important decisions. Some proposals choose a consequentialist criterion in terms of the benefits resulting from health while others use a Kantian-like criterion of right action. Still other proposals focus on the notion of a good human life. The criterion selected for this dissertation comes from the philosophical work of John Dewey, an influential American philosopher in the first half of the 1900s. This criterion precedes the aforementioned criteria: it is the concept of the good itself.