PROCEDURALIST AND CONSEQUENTIALIST COMPONENTS OF JUSTICE
Collaborative approach that emphasizes processes and outcomes
WHAT IS IT?
The health capability paradigm integrates both proceduralist and consequentialist components of justice. Proceduralism is a procedure-oriented perspective, whereas consequentialism is an outcome-oriented perspective. These concepts address goals of health capability by valuing outcomes and the manner by which those outcomes are achieved.
Flourishing people and societies are living the good life both by achieving individually and collectively valued ends and by doing so in good faith, fairly and equitably.
WHY IS IT IMPORTANT?
Flourishing people and societies embrace proceduralist and consequentialist components of justice. This encompasses health capability – health agency and health functioning. In a just, well-ordered, and well-functioning society, people seek good health and the good faith and ability to achieve it. Current approaches in health policy and public health don’t address both of these elements.
Proceduralist and consequentialist components of justice must be integrated in health policy and public health. These components ensure that decisions and actions are fair and include the voices, experiences, and perspectives of, and that they achieve positive outcomes for, everyone. It matters how decision-making processes and actions occur, because these factors are important in and of themselves and they influence overall outcomes for people.
WHAT DOES IT LOOK LIKE?
This approach integrates both health agency and health outcomes. It allows us to assess health situations, resources, and interventions and offers a just evaluation of health and public policies. A proceduralist and consequentialist approach is critical for ensuring inclusiveness, comprehensiveness, and effectiveness. It ensures that everyone’s lives matter equally in health policy and public health.
For example, the water crisis in Flint, Michigan showcases how people’s interests and experiences didn’t count and weren’t included. The decision-making process about water was heavily weighted against the health interests of certain groups, including the poor, disadvantaged, and minorities. This process thereby produced unfair and unjust outcomes. The process by which we got to these outcomes was unfair as were the final results.
Everyone needs to have their interests and experiences taken into consideration in health and public policies. Furthermore, when decision- and policy-making processes value the health agency and health outcomes of individuals and populations, we are better able to achieve more fair and more just outcomes.
For example, Medicare primarily provides health insurance for Americans ages 65 and older. This national health insurance program helps address their medical needs, covering essential costs and services for their care. Additionally, the developments of prosthetics and assistive technology have improved the lives of individuals with physical disabilities. As these resources enable this population to achieve greater independence and vibrant health, The Americans with Disabilities Act ensures individuals with physical disabilities have the same rights and opportunities as everyone else.
HOW DO WE DO IT?
Goals and policies in health should be both proceduralist-oriented and consequentialist-oriented. Governments and lawmakers should prioritize these approaches when evaluating and effectuating health and public policies. At the individual and societal level, we must respect both the health agency and health outcomes of individuals and populations.