Full Description
Everyone knows the old adage, "an ounce of prevention is worth a pound of cure," but we seem not to live by it. In the Western world's health care it is commonly observed that prevention is underfunded while treatment attracts greater overall priority. This book explores this observation by examining the actual spending on prevention, the history of health policies and structural features that affect prevention's apparent relative lack of emphasis, the values that may justify priority for treatment or for prevention, and the religious and cultural traditions that have shaped the moral relationship between these two types of care.
Economists, scholars of public health and preventive medicine, philosophers, lawyers, and religious ethicists contribute specific sophisticated discussions. Their descriptions and claims lean in various directions and are often surprising. For example, the imbalance between prevention and treatment may not be as great as is often thought, and we may be spending excessively on many preventive measures just as we do on treatments compelled by the felt demands of rescue. A standard practice in health economics that disadvantages prevention, "discounting" the value of future lives, may rest on weak empirical and moral grounds. And it is an "apocalyptic" religious tradition (Seventh-day Adventism) whose members have put some of the strongest and most effective priority on long-term prevention.
Prevention vs. Treatment is distinctive in carefully clarifying the nature of the empirical and moral debates about the proper balance of prevention and treatment; the book pursues those debates from a wide range of perspectives, many not often heard from in health policy.
Contents
1. Introduction ; Part I. Evidence, Policy, and History ; 2. What Is Currently Spent on Prevention as Compared to Treatment? ; 3. Prevention vs. Cure: An Economist's Perspective on the Right Balance ; 4. Toward a More Evidence-Based Preventive Medicine: Issues in the Science of Clinical Prevention ; 5. Prevention and the Science and Politics of Evidence ; 6. Historical Perspectives on Structural Barriers to Prevention ; Part II. Philosophical and Legal Analysis ; 7. Our Alleviation Bias: Why Do We Value Alleviating Harm More than Preventing Harm? ; 8. Treatment and Prevention: What Do We Owe Each Other? ; 9. The Variable Value of Life and Fairness to the Already Ill: Two Promising but Tenuous Arguments for Treatment's Priority ; 10. The Slow Transition of U.S. Law Toward a Greater Emphasis on Prevention ; 11. Should the Value of Future Health Benefits Be Time-Discounted? ; Part III. Religious and Cultural Perspectives ; 12. Prevention vs. Treatment: How Do We Allocate Scarce Resources from Jewish Ethical Perspectives? ; 13. Cure vs. Prevention: Catholic Perspectives ; 14. Loving God and the Neighbor: Protestant Insights for Prevention and Treatment ; 15. Apocalypse and Health: Treatment and Prevention in the Seventh-day Adventist Tradition ; 16. Prevention vs. Treatment in Hong Kong: Constrained Utilitarianism with a Chinese Character ; Index
