Global Health Priorities
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When are health inequalitites unfair?

In an recent debate in the American Journal of Bioethics research group member and post doc Gry Wester participate alongside well known philosophers as Norman Daniels and Jonathan Wolff in a debate on the social determinants of health framework.

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When are health inequalities unfair – and what should we do about them? In a recent paper in the American Journal of Bioethics, philosophers Adina Preda and Kristin Voigt discuss the social determinants of health framework and the answers that it provides to these questions. They make a number of critical observations about this body of literature, arguing that some of the normative underpinnings of the framework are not sufficiently supported, and that the policy recommendations they issue do not necessarily follow from the arguments provided.

In her commentary, Gry Wester argues that Preda and Voigt are wrong to attribute to the social determinants of health framework certain principled and specific claims about the unfairness of health inequalities that they then go on to criticize. She suggests that the social determinants of health literature does not always clearly distinguish between two distinct reasons for being concerned with health inequalities: that they are unjust, and that they are indicative of a potential for health gain. Thus, it is unclear to what extent this literature is advocating a reduction of health inequalities as a requirement of justice, as opposed to on the basis of a more general concern with health improvement.