An enquiry concerning justice in health, or what ethical account best informs health policies aimed at tackling health inequalities.

Abstract

The present thesis investigates the role of justice when informing health policies such as the reforms of health systems or those aimed at tackling health inequalities. I set the problem as a case study derived from the reforms of the Chilean health system and the inequalities in health, especially those related to access and financing of healthcare and those derived from the pervasive inequalities in the determinants of health. Departing from the challenge that inequalities in health represent for us, I explore some of the alternative accounts that inform the debate regarding the organisation of the health system in Chile and continue my research questioning the concept of justice that will inform an account of justice in health. The outcome of this research is the development of a virtue-based account of justice in health that rescues the important role of virtuous agents to carry out just actions regarding health. Specifically, recognises the role of institutions as primary agents of justice in health, and the necessity to perfect their capacities to deliberate and act accordingly to render what they owes to the people they serve, i.e. to accomplish their right to health.