Il dibattito in Bioetica - From solidarity to speculation: how actuarial logic undermines the dignity of the patient
Year: 2025
Type: article
Abstract: This article examines how market-driven healthcare, guided by actuarial assessments, inverts medicine’s ethos by prioritizing financial risk over patient need. Through the case of “Bill”– a healthy individual denied long-term-care coverage due to a genetic predisposition to ALS – I reveal how utilitarian efficiency fosters exclusion rather than support. Drawing on critiques by Illich, Foucault, and MacIntyre, as well as Kantian and personalist ethics, I argue that healthcare must uphold the patient’s ontological dignity rather than reducing individuals to actuarial liabilities. While acknowledging the necessity of resource allocation, I contend that true moral legitimacy demands subordinating economic considerations to solidarity and justice. Moreover, emerging technologies like AI-driven diagnostics stand at a crossroads: they can either intensify selection based on genetic risk or be harnessed for preventive, person-centered care. Ultimately, I call for a reorientation of healthcare around the irreducible dignity of each patient rather than profit-driven imperatives.
Source: Medicina e Morale
Author: Diego Menniti
Institution: Loyola University Chicago
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415026491
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