Is there a place for justice in medical ethics ?

References

Tom L. Beauchamp, James Childress: Les principes de l'éthique bio-médicale, French translation of the fifth edition (2001) by Martine Fisbach, coll. Médecine et sciences humaines, Les Belles Lettres, 2008, 645 p.

Raanan Gillon, Philosophical Medical Ethics, Wiley, 1992, p. 93-94

Dean Jamison et alii: Disease Control Priorities for Developing Countries, Oxford Medical Publications, Oxford University Press, 1993, 746 p.; second edition available at http://www.dcp2.org/page/main/Home.html; current work available at http://www.healthmetricsandevaluation.org/research/project/disease-control-priorities-network-draft; for WHO work, see http://www.who.int/choice/en/

J. Rawls: Théorie de la justice, translation by Catherine Audard, Seuil, 1987, 667 p.

Paul Ricoeur: Le juste, la justice et son échec, Paris, L'Herne, 2005, 76 p.

A.K. Sen: Global Justice, Beyond International Equity, http://them.polylog.org/3/fsa-en.htm, reprinted p. 116-125 in I. Kaul, I. Grunberg, M. Stern (eds): Global Public Goods, International Cooperation in the^21st Century, UNDP-Oxford University Press, 1999.

Joseph Brunet-Jailly

Joseph Brunet-Jailly obtained his doctorate in economics in 1967 and his agrégation in economics in 1970. He was an assistant at Strasbourg's Faculty of Legal, Political and Economic Sciences from 1962 to 1968, then a lecturer and later a senior lecturer at the Faculty of Economics in Aix-en-Provence, before being appointed Professor (1975) and then Dean (1979-1982). In 1986, at his own request, he was seconded to ORSTOM to head up a joint project between ORSTOM and the French Ministry of Cooperation in Bamako (Mali), aimed at training young Malian graduates in research in the social sciences of health (economics, sociology-anthropology, epidemiology). During the course of this project, which ran from 1986 to 1995, Professor Brunet-Jailly completed his training by acquiring in-depth knowledge of West African health systems, and chose to become Director of Research at ORSTOM (now Institut de Recherche pour le Développement - I.R.D.). In 1995, he was posted to Abidjan, where he remained until 2000, working on the economics of AIDS control, before returning to Bamako as IRD Representative (2000-2004). It was during his stay in Abidjan that he was confronted with the need to reflect on the medical ethics of public health decision-making. Since 2004, he has worked as an independent consultant (currently in conjunction with the Center for Global Development, Washington) and is a lecturer at Sciences-Po.

Public health decisions often come up against a certain conception of medical ethics, inherited from Antiquity and formulated by the intellectual elite of a slave society where health care was reserved for the free minority. Wouldn't one of the forms of knowledge to be developed today in the fight against poverty be an ethical knowledge that finally makes room for justice? This question leads us first of all to examine how justice comes into play in the traditionally recognized constructs of medical ethics, then to avoid certain avenues proposed in recent decades, in order to arrive at the choice of a conception of justice likely to enlighten national and international political decisions, before finally indicating how this conception can be implemented.