Health and disability

14 important questions on Health and disability

What is difficult about the measures for determining the status of health systems?

Because different measures reflect different expectations. Also because a lot of things are being measured. We want to capture so many things that we do not know what we are measuring; it differs from physical things and more societal things

What critique does Wolff formulate against the use of the mostly used QALY-system to measure health?

1. It is all about the salvation, or letting go of the physical
2. Different individuals have different interests in health vs. Longevity
3. Pain is an essential/defining part of life

What are the 5 dimensions the the medical world has operationalised in the EQ-5D model to measure the quality of life?

1. Mobility
2. Self-care
3. Can you do the usual activities
4. Do you have pain
5. Do you have anxiety -> how you feel about life
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What determines the determinants of health?

1. Individual personality
2. Economy
3. State
4. Food
5. Road safety

What are the factors that Wolff links to poverty and its relation to health?

1. Labor conditions -> the less a job pays, the more hazardous the conditions are
2. Housing conditions -> the poorer you are, the less able you are to afford a good and safe house
3. Environmental justice

How do you determine why you are to blame when you fall ill?

Causal vs. Moral responsibility

What determines how far we go when we want to protect people from falling ill?

Look at the environmental factors: do we live in a nanny-state or in a state of irrationality

Why do we need to look at health security in stead of health care according to Wolff?

It is not only medicine that determines things, other factors have to be taken into account as well. We need a holistic view of society in order to find the best solution to the problem

Why is it that Wolff does not go against his first principle when he introduces his EQ-4D model to determine health security?

He values goal rationality in stead of value rationality. He just changes the way to get more effectively to the goal than the EQ-5D model

What are the four dimensions in Wolff's EQ-4D model to determine health security?

1. Vulnerability -> the conditions that determine the chance of falling ill
2. Control -> the strategies one can engage to stimulate or de-stimulate certain behaviour
3. Resilience -> the capacity to recover from the consequences of falling ill
4. Anxiety -> to control how people react to the risks of illness

Why should we reconceptualize our ideas about disability, as we did with health, according to Wolff?

Because the existing social justice theories are incorrect. Disability is too broad of a concept; we started to define everything as a disability when it was a deviation of the norm

What are Wolff's objections against Rawls' theory of justice and Dworkin's Island auction when distributing the resources to the disabled persons?

Philosophers are too radical for the real world. And because disability is a social construction. There is no universal definition that applies everywhere

What is Wolff's alternative to distribute the resources, when we also take into account the disabilities?

1. Distinguish the internal (equality of resources) and external (equality of opportunity) resources
2. Adapt individualised justice package to create overall equality of resources -> in which you should use four currencies

What are the four currencies that Wolff suggest we should use when we make a distribution of resources?

1. Personal enhancement
2. Money
3. Targeted resource enhancement
4. Status enhancement

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