Norman Daniels

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