Access, equity and the role of rights in health care

Modern health care rhetoric promotes choice and individual patient rights as dominant values. Yet we also accept that in any regime constrained by finite resources, difficult choices between patients are inevitable. How can we balance rights to liberty, on the one hand, with equity in the allocation of scarce resources on the other? For example, the duty of health authorities to allocate resources is a duty owed to the community as a whole, rather than to specific individuals. Macro-duties of this nature are founded on the notion of equity and fairness amongst individuals rather than personal liberty. They presume that if hard choices have to be made, they will be resolved according to fair and consistent principles which treat equal cases equally, and unequal cases unequally. In this paper, we argue for greater clarity and candour in the health care rights debate. With this in mind, we discuss (1) private and public rights, (2) negative and positive rights, (3) procedural and substantive rights, (4) sustainable health care rights and (5) the New Zealand booking system for prioritising access to elective services. This system aims to consider: individual need and ability to benefit alongside the resources made available to elective health services in an attempt to give the principles of equity practical effect. We describe a continuum on which the merits of those, sometimes competing, values-liberty and equity-can be evaluated and assessed.

Evaluation of negative photo-patternable PDMS for the encapsulation of neural electrodes

This communication examines the suitability of a photo-patternable polydimethylsiloxane (PP-PDMS) elastomer as an insulating material for implantable microelectrodes. PP-PDMS is produced by mixing a photoinitiator (2-hydroxy-2-methylpropiophenone) with the PDMS base and curing agent. Subsequent exposure to UV radiation and development of the elastomeric “photo-resist” allows for the definition of well-defined openings within the PP-PDMS film. The dielectric constants of PP-PDMS and PDMS are similar (ε ≈ 2.6, f <;1MHz). Gold film microelectrodes patterned on glass or a PDMS substrate are encapsulated with PP-PDMS, while recording sites as small as 104 μm2 can be obtained in the PP-PDMS layer. The cytotoxicity of the PP-PDMS was preliminary tested in vitro by culturing 3T3 fibroblasts in PP-PDMS extracts. No adverse effects were observed in cultures exposed to PP-PDMS films initially leached in isopropanol solvent for 48h.

The buck passing account of value: assessing the negative thesis

The buck-passing account of value involves a positive and a negative claim. The positive claim is that to be good is to have reasons for a pro-attitude. The negative claim is that goodness itself is not a reason for a pro-attitude. Unlike Scanlon, Parfit rejects the negative claim. He maintains that goodness is reason-providing, but that the reason provided is not an additional reason, additional, that is, to the reason provided by the good-making property. I consider various ways in which this may be understood and reject all of them. So I conclude that buck-passers cannot reject the negative claim.