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Norman Daniels |
Contact Information
Department of Population and International Health
Building 1
Room 1104C
665 Huntington Avenue
Boston, MA 02115
Phone: 617-432-2360, Assistant 432-2348
Fax: 617-566-0365
Email: ndaniels@hsph.harvard.edu
Norman Daniels is the Mary B. Saltonstall Professor of Population Ethics
Department of Population and International Health at the Harvard School
of Public Health. He was the Goldthwaite Professor and Chair of the
Philosphy Department at Tufts University and Professor of Medical Ethics
at Tufts Medical School from 1969–2002. He received his Ph.D.
in Philosophy in 1970 from Harvard University, B.A.(M.A.) in Philosophy
and Psychology in 1966 from Balliol College, Oxford, and an A.B., English
in 1964 from Wesleyan University.
He is a Fellow of the Hastings Center, Member of the Institute of Medicine,
a Founding Member of the National Academy of Social Insurance, Member
of the International Society for Equity in Health, International Bioethics
Advisory Board of PAHO, and a member of the Medicare Coverage Advisory
Commission.
His research encompasses issues of distributive justice and health policy,
philosophy of science, ethics, political and social philosophy, and
medical ethics. Publiations include Justice and Justification: Reflective
Equilibrium in Theory and Practice and Seeking Fair Treatment:
From the AIDS Epidemic to National Health Care Reform. He served on the Ethics
Working Group of the Clinton White House Health Care Task Force and
was a Faculty Fellow in Ethics in 1992–93.
Dr. Daniels’s ongoing research falls into these main areas
Moral Epistemolgy: The most recent statement of his views on justification
in ethics can be found in the Stanford Philosophy Encyclopedia entry
on reflective equilibrium. (Stanford Encyclopedia of Philosophy, on-line
edition, 2003. http://plato.stanford.edu/info.html ). A collection of
his papers on the topic can be found in his Justice and Justification
(CUP, 1996).
Theory of Justice: Dr. Daniels has in recent years been interested in
the complex form of egalitarianism represented by Rawls’s work
and the contrast between it and other recent work in egalitarian theory.
For a recent paper on just this issue, see his "Democratic Equality:
Rawls’s Complex Egalitarianism" in Sam Freeman (ed) Cambridge
Companion to Rawls (2003). He is currently working on a paper on equality
of capabilities. Dr. Daniels sees the work (described below) on a fair,
deliberative process for setting limits to health care (and for other
resource allocation or rationing efforts) as a needed legislative and
regulatory supplement to the kind of principled account of justice in
Rawls’s work.
Justice and Health: Theory of justice for health - Dr. Daniels is currently
writing Just Health, which began as a revision of his 1985 book Just
Health Care, but which now has the character of a new book. To the original
attempt to say why health care is of special moral importance because
of its connection to protecting opportunities for individuals, he now
adds a broader vision of the socially controllable factors that affect
population health and its distribution. This permits an answer to the
question, when are health inequalities unjust? He argues that Rawls’s
principles of justice as fairness capture the central social determinants
of health: conforming with them would flatten social gradients of health
as much as we can reasonably expect. He continues to have a special
interest in how our knowledge of health disparities affects our thinking
about general theories of justice, including the emphasis some such
theories place on notions of responsibility.
Setting Limits Fairly: Together with Jim Sabin, Dr. Daniels published
Setting Limits Fairly: Can We Learn to Share Medical Resources? (OUP,
2002). They are doing ongoing work on this topic with collaborators
in Canada, the United Kingdom, Norway, and elsewhere where fair process
has emerged as the key to priority and limit setting in universal coverage
systems. In the US, they continue to work on pharmacy benefits (see
our discussion of an "ethical template" in Health Affairs,
Jan-Feb 2002) and on independent review of insurance denials. Daniels
recently applied these ideas to patient selection in the WHO program
to deliver three million ARTs by 2005.
Ethics and Health Sector Reform (Benchmarks of Fairness):
Domestic: Dr. Daniels is interested in issues of access to the US system,
especially disparities that contribute to health disparities, and participated
on the subcommittee on social costs of the recent IOM publication on
uninsurance in the US. He recently co-authored a paper (with Meredith
Rosenthal) on the ethics of consumer driven health plans.
Global: Together with collaborators in a dozen countries on three continents,
Dr. Daniels is working to demonstrate the utility of an evidence-based
policy tool for evaluating the fairness—the equity, accountability,
and efficiency—of health sector reforms in developing countries
and to improve capacity in those countries to carry out research on
the fairness of reform activities. Together with collaborators from
Cameroon, Thailand, and Guatemala, he presented some recent results
at the November 2003 APHA meeting in San Francisco. The current work
(forthcoming in Bulletin of WHO, 2005) is an attempt to develop country-specific
adaptations of the generic benchmarks reported on in the Bulletin
of WHO in June 2000.
Select Publications
Thomas Reid's`Inquiry': the Geometry of Visibles and the Case for
Realism (1974; Stanford, 1989); Reading Rawls (1975; Stanford, 1989); Just
Health Care (Cambridge, 1985); Am I My Parents' Keeper? An
Essay on Justice Between the Young and the Old (Oxford, 1988); Seeking
Fair Treatment: From the AIDS Epidemic to National Health Care Reform (Oxford, 1995);
Justice and Justification: Reflective Equilibrium in Theory and
Practice (Cambridge University Press, 1996); (with Donald Light and Ronald Caplan)
Benchmarks of Fairness for Health Care Reform (Oxford, 1996); (with
Allen Buchanan, Dan Brock, and Dan Wikler) From Chance to Choice:
Genetics and Justice (Cambridge, 2000); (with Bruce Kennedy and Ichiro Kawachi) Is
Inequality Bad for Our Health? (Beacon Press, 2000); and (with James
Sabin) Setting Limits Fairly: Can We Learn to Share Medical Resources? (Oxford, 2002).
Recent Journals, Chapters, and Editorials
Daniels N. Justice, Health and Health Care. American Journal of
Bioethics 2001 1:2:3-15.
Sabin JE, Daniels N. Strengthening Consumer Voice in Managed Behavioral
Care: III. The Philadelphia Consumer Satisfaction Team. Psychiatric
Services 2002; 53: 23-23; 29.
Sabin JE, Daniels N. Strengthening Consumer Voice in Managed Behavioral
Care: IV. The Leadership Academy Program. Psychiatric Services 2002;
53: 405-406; 411.
Sabin JE, Daniels N. Strengthening Consumer Voice in Managed Behavioral
Care: V. Helping Professionals Listen. Psychiatric Services 2002; 53:
805-806; 811.
Daniels N, Kennedy B, Kawachi I. Justice, Health, and Health Policy.
In Danis M, Clancy C, (eds.) Integrating Ethics and Health Policy. New
York: Oxford University Press, 2002.
Daniels, Teagarden R., and Sabin J., An Ethical Template for Pharmacy
Benefits. Health Affairs, January/February 2003; 22:1:125-137.
Teagarden R, Daniels N, Sabin J. A Proposed Ethical Framework for Prescription
Drug benefit Allocation Policy. Journal of the American Pharmaceutical
Association, January/February 2003;43:1:69-74.
Daniels N. Chevron v Echazabal: Protection, Opportunity, and Paternalism.
American Journal of Public Health, April 2003; 93:4:545-549.
Daniels N. Democratic Equality: Rawls’s Complex Egalitarianism.
in Freeman S, (ed.) Pp. 241-277 The Cambridge Companion to Rawls. Cambridge
University Press, 2003.
Daniels N, Kennedy B, Kawachi I. Social Determinants of Health Inequalities:
Why Justice is Good for our Health. In Anand S, Peter F, (eds.) Volume
on Equity in Health, Oxford (in press).
Sabin, JE, Daniels, N. Ethical Issues. Chapter in Feldman, S (ed.) Managed
Mental Health Services. Second Edition. Charles C. Thomas, (in press).
Sabin JE, Granoff K, Daniels N. Strengthening Consumer Voice in Managed
Behavioral Care: VI. Initial Lessons from Independent External Review.
Psychiatric Services 2003: (in press)
Web Sites
Benchmarks of Fairness - The Benchmarks of Fairness project, a system
for assessing the fairness of health sector reform in developing countries.
Norman
Daniels’ website - Norman Daniels' personal website
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