Jennifer Prah Ruger – författare

Societies make decisions and take actions that profoundly impact the distribution of health. Why and how should collective choices be made, and policies implemented, to address health inequalities under conditions of resource scarcity? How should societies conceptualize and measure health disparities, and determine whether they've been adequately addressed? Who is responsible for various aspects of this important social problem? In Health and Social Justice, Jennifer Prah Ruger elucidates principles to guide these decisions, the evidence that should inform them, and the policies necessary to build equitable and efficient health systems world-wide. This book weaves together original insights and disparate constructs to produce a foundational new theory, the health capability paradigm.Ruger's theory takes the ongoing debates about the theoretical underpinnings of national health disparities and systems in striking new directions. It shows the limitations of existing approaches (utilitarian, libertarian, Rawlsian, communitarian), and effectively balances a consequentialist focus on health outcomes and costs with a proceduralist respect for individuals' health agency. Through what Ruger calls shared health governance, it emphasizes responsibility and choice. It allows broader assessment of injustices, including attributes and conditions affecting individuals' "human flourishing," as well as societal structures within which resource distribution occurs. Addressing complex issues at the intersection of philosophy, economics, and politics in health, this fresh perspective bridges the divide between the collective and the individual, between personal freedom and social welfare, equality and efficiency, and science and economics.

Health and Social Justice provides a theoretical framework for health ethics, public policy and law in which Dr Ruger introduces the health capability paradigm, an innovative and unique approach which considers the capability of health as a moral imperative. This book is the culmination of more than a decade and a half of work to develop the health capability paradigm, with a vision of a world where all have the capability to be healthy. This vision is grounded in the Aristotelian view of human flourishing and also Amartya Sen's capability approach. In this new paradigm, not just health care, or even just health alone, but the capability for health itself is a moral imperative, as is ensuring the conditions that allow all individuals the means to achieve central health capabilities. Key tenets of health capability include health agency, shared health governance, where individuals, providers and institutions work together to create a social system enabling all to be healthy, and the use of theorized agreements and shared reasoning to guide social choice and shape health policy and decision-making. This book provides philosophical justification for the direct moral importance of health and the capability for health and follows a norms-based approach to health promotion. It employs a joint scientific and deliberative approach to guide health system development and reform, and the allocation of scarce health resources. The health capability paradigm integrates both proceduralist and consequentialist approaches to justice, and both moral and political legitimacy are critical.

This book focuses on two areas of substantial and growing importance to the human development and capability approach: health and disability. The research on disability, health and the capability approach has been diverse in the topics it covers, and the conceptual frameworks and methodologies it uses, beginning over a decade and a half ago in health and more than a decade ago in disability. This book shares a set of contributions in these two areas: the first set of chapters focusing on disability; and the second set focusing on health and the health capability paradigm (HCP), in particular. This book was originally published as a special issue of the Journal of Human Development and Capabilities.