"Following orders" as a critique on healthcare allocation committees: An anthropological perspective on the role of public memory in bioethical legitimacy.

The public perception of decision‐making procedures as fair processes is a central means for establishing their legitimacy to make difficult resource allocation decisions. According to the ethical framework of accountability for reasonableness (A4R, hereafter), which specifies conditions for fair he...

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Publicado en:Bioethics Vol. 35; no. 6; pp. 549 - 557
Autor principal: Assor, Yael
Formato: Artículo
Publicado: Wiley-Blackwell Jul2021
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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        10.1111/bioe.12890
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        atl: "Following orders" as a critique on healthcare allocation committees: An anthropological perspective on the role of public memory in bioethical legitimacy.
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        au: Assor, Yael
        affil: Department of Anthropology, University of California, Los Angeles California, , USA
      su:
        Memory
        Holocaust, 1939-1945
        Consumer attitudes
        Public health
        Medical technology
        Anthropology
        Responsibility
        Decision making
        Health care rationing
        Bioethics
        Committees
        Historical trauma
      sug:
        subj:
          Memory
          Holocaust, 1939-1945
          Consumer attitudes
          Public health
          Medical technology
          Anthropology
          Responsibility
          Decision making
          Health care rationing
          Bioethics
          Research and Development in the Physical, Engineering, and Life Sciences (except Biotechnology)
          Surgical Appliance and Supplies Manufacturing
          Medical, Dental, and Hospital Equipment and Supplies Merchant Wholesalers
          Surgical and Medical Instrument Manufacturing
          Health and Welfare Funds
          Committees
          Historical trauma
      keyword:
        accountability for reasonableness
        healthcare allocation
        Israel
        legitimacy
        post‐Holocaust ethics
        public memory
        accountability for reasonableness
        healthcare allocation
        Israel
        legitimacy
        post‐Holocaust ethics
        public memory
      ab: The public perception of decision‐making procedures as fair processes is a central means for establishing their legitimacy to make difficult resource allocation decisions. According to the ethical framework of accountability for reasonableness (A4R, hereafter), which specifies conditions for fair healthcare resource allocation, disagreements about what constitutes relevant considerations are a central threat to its perceived fairness. This article considers how an ethical principle grounded in the public memory of past traumatic events may become the topic of such disagreements. I demonstrate this through an anthropological case study of a recent public de bate concerning an Israeli healthcare allocation committee (HAC, thereafter), which determines state subsidies for new medical technologies as part of Israel's public healthcare system. Drawing upon ethnographic fieldwork about the HAC, I show how the public memory of Adolf Eichmann's trial constitutes a bioethical problem for the committee's legitimacy. Based on Arendt's and Bauman's writings that Nazi bureaucrats' manner of "following orders" was an ethical transgression, some patients contended that the committee has a historical responsibility to question its strict adherence to bureaucratic procedures. Since the committee did not have a direct link to the events of the Holocaust, other considerations seemed to them more relevant. I then present an offer that can settle this disagreement and maintain the HAC's legitimacy according to A4R. I conclude by discussing the contribution of empirical data to models of bioethical legitimacy.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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