Situating care in mainstream health economics: an ethical dilemma?

Davis, J. B. and McMaster, R. (2015) Situating care in mainstream health economics: an ethical dilemma? Journal of Institutional Economics, 11(04), pp. 749-767. (doi: 10.1017/S1744137414000538)

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Standard health economics concentrates on the provision of care by medical professionals. Yet ‘care’ receives scant analysis; it is portrayed as a spillover effect or externality in the form of interdependent utility functions. In this context care can only be conceived as either acts of altruism or as social capital. Both conceptions are subject to considerable problems stemming from mainstream health economics’ reliance on a reductionist social model built around instrumental rationality and consequentialism. Subsequently, this implies a disregard for moral rules and duties and the compassionate aspects of behaviour. Care as an externality is a second-order concern relative to self-interested utility maximization, and is therefore crowded out by the parameters of the standard model. We outline an alternative relational approach to conceptualising care based on the social embeddedness of the individual that emphasises the ethical properties of care. The deontological dimension of care suggests that standard health economics is likely to undervalue the importance of care and caring in medicine.

Item Type:Articles
Glasgow Author(s) Enlighten ID:McMaster, Professor Robert
Authors: Davis, J. B., and McMaster, R.
College/School:College of Social Sciences > Adam Smith Business School > Management
Journal Name:Journal of Institutional Economics
Publisher:Cambridge University Press
ISSN (Online):1744-1382
Copyright Holders:Copyright © 2014 Millennium Economics Ltd.
First Published:First published in Journal of Institutional Economics 11(4):749-767
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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