Camb Q Healthc Ethics. 2021 Jan;30(1):90-102. doi: 10.1017/S0963180120000596.

Autonomy, Coercion, and Public Healthcare Guarantees: The Uptake of Sofosbuvir in Germany.

Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees

Afschin Gandjour

PMID: 33371914 DOI: 10.1017/S0963180120000596

Abstract

Health insurance coverage for incarcerated citizens is generally acceptable by Western standards. However, it creates internal tensions with the prevailing justifications for public healthcare. In particular, a conceptualization of medical care as a source of autonomy enhancement does not align with the decreased autonomy of incarceration and the needs-based conceptualization of medical care in cases of imprisonment; and rejecting responsibility as a criterion for assigning medical care conflicts with the use of responsibility as a criterion for assigning punishment. The recent introduction of sofosbuvir in Germany provides a particularly instructive illustration of such tensions. It requires searching for a refined reflective equilibrium regarding the scope, limits, and justifications of publicly guaranteed care.

Keywords: autonomy; responsibility; right to healthcare; universal coverage

Substances

• Sofosbuvir

MeSH terms

• Coercion*
• Delivery of Health Care
• Germany
• Humans
• Sofosbuvir*

Publication Types

• Journal Article