Publication: Una teoría de la justicia sobre el derecho a la asistencia sanitaria: validez, eficacia, fundamento, concepto y justiciabilidad
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2021-10
Defense date
2022-02-24
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Abstract
Esta tesis tiene por objeto efectuar un análisis crítico de las principales teorías de la justicia en materia de asistencia sanitaria con el propósito de identificar sus elementos estructurales y las consecuencias de su aplicación en materia de política pública y producción normativa. Partiendo de un estudio sobre el surgimiento, desarrollo y expansión del derecho a la salud establece las características que subyacen en su conceptualización y que han orientado la fundamentación del deber contribuir en la financiación de un sistema de asistencia para la mitigación, el tratamiento o la cura de las enfermedades o los problemas de salud, así como para la inclusión de las personas con diversos grados de diversidad funcional en la sociedad.
En sentido similar, tiene el propósito de identificar los razonamientos que proponen algunas escuelas de pensamiento concernientes al deber de restricción de los Estados para ejercer una función redistributiva de recursos o convertirse en un motor de justicia social, de conformidad con algunas doctrinas liberales neoclásicas y libertarias. De esta manera, presenta y evalúa argumentos a favor y en contra del reconocimiento de un derecho a la asistencia sanitaria de cobertura universal, que tenga como propósito brindar las condiciones de atención en salud y de inclusión necesarias para el desarrollo de capacidades humanas básicas.
A partir de ello, formula una teoría de la justicia que establece que la asistencia sanitaria no es un servicio público, sino un derecho con obligaciones específicas por parte del Estado, las cuales pueden ser exigibles ante los tribunales nacionales y supranacionales con fundamento en las normas de derecho internacional público. Aunado a ello, establece la necesidad de establecer enfoques presupuestales diferenciales y la formulación de principios que sirvan de insumos para la producción normativa, para la resolución de controversias, antinomias, lagunas normativas y colisiones de principios, relacionados con el derecho a la asistencia sanitaria.
Finalmente, establece la necesidad de crear acuerdos sustantivos y procedimentales, que sirvan de fundamento para la reestructuración de las jerarquías normativas existentes basadas en la idea del egoísmo, para dar paso a una sociedad incluyente, bajo la égida de una razón práctica orientada al reconocimiento de la diversidad como condición humana y que se adapte a las necesidades de una sociedad global que debe entender que la vida, la muerte, la enfermedad y la diversidad funcional, son intrínsecas a la existencia de toda comunidad y que la empatía, la solidaridad y el respeto, constituyen la base para una sociedad auténticamente libre.
The purpose of this thesis is to carry out a critical analysis of the main theories of justice in health care to identify their structural elements and the consequences of their application in public policy and normative production. Starting from a study on the emergence, development, and expansion of the right to health, it establishes the characteristics behinds its conceptualization and that have guided the rationale for the duty to contribute to the financing of a system of assistance for the mitigation, treatment or cure of diseases or health problems, as well as for the inclusion of people with varying degrees of functional diversity in society. Similarly, it aims to identify the reasoning proposed by some schools of thought concerning the duty of restriction of States to exercise a redistributive function of resources or to become an engine of social justice, in accordance with some neoclassical liberal and libertarian doctrines. In this way, it pretends and evaluates arguments for and against the recognition of a right to health care with universal coverage, whose purpose is to provide the conditions of health care and inclusion necessary for the development of basic human capabilities. On this basis, it formulates a theory of justice that establishes that health care is not a public service, but a right with specific obligations on the part of the State, which can be enforceable before national and supranational courts based on the norms of public international law. In addition, it sets the need to lay down differential budgetary approaches and the formulation of principles that serve as inputs for the normative production, for the resolution of controversies, antinomies, normative gaps, and collisions of principles, related to the right to health care. Finally, it establishes the need to create substantive and procedural agreements, which serve as a basis for the restructuring of existing normative hierarchies based on the idea of selfishness, in order to make way for an inclusive society, under the aegis of a practical reason oriented to the recognition of diversity as a human condition and adapted to the needs of a global society that must understand that life, death, illness and functional diversity are intrinsic to the existence of every community and that empathy, solidarity and respect constitute the basis for an authentically free society.
The purpose of this thesis is to carry out a critical analysis of the main theories of justice in health care to identify their structural elements and the consequences of their application in public policy and normative production. Starting from a study on the emergence, development, and expansion of the right to health, it establishes the characteristics behinds its conceptualization and that have guided the rationale for the duty to contribute to the financing of a system of assistance for the mitigation, treatment or cure of diseases or health problems, as well as for the inclusion of people with varying degrees of functional diversity in society. Similarly, it aims to identify the reasoning proposed by some schools of thought concerning the duty of restriction of States to exercise a redistributive function of resources or to become an engine of social justice, in accordance with some neoclassical liberal and libertarian doctrines. In this way, it pretends and evaluates arguments for and against the recognition of a right to health care with universal coverage, whose purpose is to provide the conditions of health care and inclusion necessary for the development of basic human capabilities. On this basis, it formulates a theory of justice that establishes that health care is not a public service, but a right with specific obligations on the part of the State, which can be enforceable before national and supranational courts based on the norms of public international law. In addition, it sets the need to lay down differential budgetary approaches and the formulation of principles that serve as inputs for the normative production, for the resolution of controversies, antinomies, normative gaps, and collisions of principles, related to the right to health care. Finally, it establishes the need to create substantive and procedural agreements, which serve as a basis for the restructuring of existing normative hierarchies based on the idea of selfishness, in order to make way for an inclusive society, under the aegis of a practical reason oriented to the recognition of diversity as a human condition and adapted to the needs of a global society that must understand that life, death, illness and functional diversity are intrinsic to the existence of every community and that empathy, solidarity and respect constitute the basis for an authentically free society.
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Keywords
Teorías de la justicia, Desarrollo, Libertad, Diversidad funcional, Redistribución, Utilitarismo, Liberalismo, Libertarismo, Capacidades humanas básicas, Derecho a la asistencia sanitaria, Razón práctica, Metaderecho, Condición humana, Theories of justice, Development, Freedom, Functional diversity, Redistribution, Utilitarianism, Liberalism, Libertarianism, Basic human capabilities, Right to health care, Practical reason, Metaright, Human condition