Chapitre 4. Subventions discriminatoires de soins medicaux à l’épreuve du principe éthique de la justice : cas d’un service d’orl au burkina faso

Abstract

Introduction: A legal exception to the principle of equal health rights, discriminatory subsidies often pose an ethical dilemma in the field of application.

Aim: To analyze discriminatory subsidies for healthcare in the light of the ethical principle of justice and to propose alternatives to any inherent legal and ethical conflicts.

Method: This was a qualitative, descriptive and analytical study based on semi-structured interviews with caregivers.

Results: Participants felt that the application of discriminatory subsidies has a negative impact on substantial distributive justice. The infringements of the award conditions were exclusively for the benefit of the patients concerned. Their impact was considered positive on distributive justice and negative on formal justice.

Discussion: Discriminatory care subsidies generally stem from a legal requirement whose application should not be ambiguous. It is apparent that the infringements of the conditions for attribution were in favour of substantial distributive justice. This opposition is a potential source of decision-making difficulties for caregivers who often choose to violate conditions for the benefit of their indigent patients. There are therefore violations of ethically understandable standards, which must be admitted. This could be done through the provision of exceptions for the application of standards for ”noble causes” and conscientious objection clauses in health policy texts.

Conclusion: The legitimacy of health policy norms is essential for their effective application, hence the interest of taking distributive justice into account in the genesis of formal norms.