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Moral Justice and Legal Justice in Managed Care: The Ascent of Contributive Justice

Published online by Cambridge University Press:  01 January 2021

E. Haavi Morreim
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Extract

Several prominent cases have recently highlighted tension between the interests of individuals and those of the broader population in gaining access to health care resources. The care of Helga Wanglie, an elderly woman whose family insisted on continuing life support long after she had lapsed into a persistent vegetative state (PVS), cost approximately $750,000, the majority of which was paid by a Medi-gap policy purchased from a health maintenance organization (HMO). Similarly, Baby K was an anencephalic infant whose mother, believing that all life is precious regardless of its quality, insisted that the hospital where her daughter was born provide mechanical ventilation, including intensive care, whenever respiratory distress threatened her life. Over the hospital's objections, courts ruled that aggressive care must be provided. Much of Baby K's care was covered by her mother's HMO policy. In the 1993 case of Fox v. HealthNet, a jury awarded $89 million to the family of a woman whose HMO had refused, as experimental, coverage for autologous bone marrow transplant in treating her advanced breast cancer.

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Article
Information
Journal of Law, Medicine & Ethics , Volume 23 , Issue 3 , Fall 1995 , pp. 247 - 265
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Copyright © American Society of Law, Medicine and Ethics 1995

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References

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“Interpreting insurance contracts as mutual contracts rather than as contracts of adhesion would by no means require that courts abandon their equitable responsibilities. It would require, however, that they refuse to honor unreasonable expectations and refuse to find advantages where none exist. It would require, in short, the curtailment of judge-made insurance.” See Kalb, , supra note 40, at 1125.Google Scholar
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