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Research

The Centre for Philosophy, Justice and Health brings philosophers together with epidemiologists, health economists, lawyers, doctors and political scientists to examine the normative and practical problems we face in constructing health policies.

Our research falls into three main areas:

  • applied political philosophy - focusing in particular on the the fair distribution of health resources, the relationship between health and the good society, and the justifiability of risk imposition
  • bioethics - focusing in particular on research ethics, the justifiability of paternalism and the role and limits of consent
  • the nature of evidence and the feasibility and/or desirability of evidence-based policy making.

If you would like to apply to do a PhD, please contact Jonathan Wolff if your proposed topic is in straight philosophy, or Sarah Edwards or James Wilson if your proposed topic is in bioethics.


Here are the main projects that CPJH is currently working on.

Value of Life and Health

Jonathan Wolff and Shepley Orr were asked by the Inter-Departmental Group on the Value of Life and Health, which includes the Treasury, the Department of Health, the Department of Transport, NICE, and around ten over government departments, to provide a report on the value of life and health for the purposes of public policy decision-making. The central questions addressed concern how the quality adjusted life-year (QALY), used in health decision making relates to the value of preventing a fatality (VPF) uses in transport, and when it is, and is not, appropriate to use this values. Further issues discussed include the question of how questions of equity can be taken account of in public policy decision-making.
The report, submitted in July 2009, can be downloaded here.

Preference, Experience and Capability Measures of Health

This area of research concerns the question of how health should be measured for public policy purposes. Current measures use the quality adjusted life year (QALY) or disability adjusted life year (DALY). The QALY bases valuations of health on public preferences. But is it right to consult the public rather than professionals or patients? And should be base valuations on preferences, rather than 'experience' or 'capability' measures? And what difference does it make?

A paper on this topic has been prepared by Jonathan Wolff, Sarah Edwards, Shepley Orr, Sarah Richmond and Geraint Rees has now been published in Bioethics.


Fair Retirement

At present the standard retirement age in the UK is 65, although this will increasingly come under pressure, both in terms of economic sustainability and of the human rights of older people. However, it is rarely observed that the apparent equality of the ‘same age for all’ masks a much deeper multiple inequality. For a person who leaves school at the minimum leaving age (currently 16) will be in the workforce for 49 years, whereas those who undergo a lengthy training may well be in the workforce for substantially less. For example very few academics will work for the 40 years required to be entitled to a full USS pension.

It is also likely that those who are in the workforce from an earlier age will undertake physically more demanding and wearing manual roles, and their health may well suffer, for this and other reasons, for some time before retirement. On the other hand, however, work is often regarded as a valuable activity, and is thought to be good for mental health.

This research project will consider an alternative proposal that entitlement to full pension should be based on ‘years in the workforce’ rather than age. This would not preclude those who wished to remaining in work, on perhaps a part-time basis, and may, therefore, allow more flexible working towards the end of the working life. The proposal will be evaluated from the point of view of the questions:

a) Is it an improvement from the point of view of social justice?
b) Would it have beneficial health effects (and if so, for which groups)?
c) Would it be economically feasible?

A grant from the Crucible project has been awarded to fund preliminary research on this topic, and a paper on the topic, by Gry Wester and Jo Wolff, has been published in Public Health Ethics.

Health Inequalities

The Centre launch conference (December 2008) focused on Justice and the Social Determinants of Health. The papers from this conference are now published in  Public Health Ethics Volume 2 Issue 3. Other outputs from this project include Wilson J., "Not so Special After All: Daniels and the Social Determinants of Health", Journal of Medical Ethics 35(1) (2009), pp. 3-6; J. Wilson, "Towards a Normative Framework for Public Health Ethics and Policy", Public Health Ethics doi:10.1093/phe/php012; Venkatapuram S. and Marmot, M. (2009). Epidemiology and social justice in light of social determinants of health. Bioethics 23(2), 78-89.

Priority Setting and Value Based Pricing

Shepley Orr Steve Morris and Jo Wolff were commissioned by Pfizer to consider the question of what values could be included in a health priority allocation method under the new proposed system of value based pricing.

Their resulting report can be downloaded here