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Ethics.

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AIDS Serodiagnosis↗

Can an employer-based health insurance system be just?

It is America's distinctive practice to tie private health insurance to employment, and recent proposals have tried to retain this link through mandating that all employers provide health insurance to their employees. My primary approach to these issues is neither economic, nor historical, nor political but ethical. After a brief historical overview, I outline a general approach to evaluating the ethical significance of linking the distributions of distinct goods. I examine whether an unjust distribution of jobs spoils justice in the distribution of health insurance, taking as a central example gender inequities in employment and exploring their impact on job-based health insurance. Second, I explore the possibility that justly awarding jobs guarantees justice in employment-sponsored insurance. However, linking the distributions of different goods remains problematic, because such links inevitably undermine equality by enabling the same individuals to enjoy advantages in many different distributive areas. Finally, I examine recent proposals to reform America's health care system by requiring all employers to provide health insurance to their employees. I argue that such proposals lend themselves to the same ethical problems that the current system does and urge greater attention to alternative reform options.

Coercion↗

AIDS and the future of reproductive freedom.

The specter of pediatric AIDS fundamentally challenges elements of the liberal ideological basis of women's reproductive freedom. Many public health officials hold that preventing transmission of HIV from mother to fetus requires efforts to discourage pregnancy by infected women. For over two decades, however, genetic counselors, feminists, and medical ethicists have stressed the importance of nondirective counseling in the context of reproductive choice. The question now confronted by American society is whether it will be possible to frame an ideology of reproductive choice that recognizes the limits of liberal individualism, while preserving the basic features of reproductive freedom.

AIDS Serodiagnosis↗