Closing the gap : exploring edentulism through Norman Daniels’ approach to health and healthcare

Valentine, Terence Albert (2015-12)

Thesis (MPhil)--Stellenbosch University, 2015.

Thesis

ENGLISH ABSTRACT: Statistics from the Western Cape Department of Oral and Dental Health Services show an alarming decrease in the construction of dentures by dentists working at state health facilities. In addition, statistical evidence shows that the most common treatment modality used by dentists in the public sector is extraction, the result of which is a growing sector of society presenting with partial or full edentulism. Edentulism is a condition characterised by partial or complete loss of natural teeth. The aim of this thesis is to explore edentulism as a healthcare need in the light of Norman Daniels’ approach to health and just healthcare provision. Daniels argues that healthcare is morally important because of the role that it plays in ensuring fair equality of opportunity. This thesis will argue that for individuals whose dependence is solely on the public healthcare system, edentulism can restrict opportunity. A requirement of justice would therefore require that denture or other appropriate prosthesis construction be incorporated into macro level healthcare design so that it would serve to protect and maintain opportunity in order for individuals to realise their life plans relative to others in their society. Where resource constraints make this difficult, Daniels’ “Accountability for Reasonableness” approach can be applied to ensure that procedural justice is maintained in making fair decisions around rationing.

AFRIKAANSE OPSOMMING: Statistieke van die Weskaapse Departement van Mond en Tandheelkundige Dienste toon ‘n kommerwekkende afname in die konstruksie van kunsgebitte deur tandartse verbonde aan die staat se gesondheidsfasiliteite. Daar is verdere bewyse wat aandui dat die mees algemene behandeling deur tandartse verbonde aan die openbare sektor die trek van tande is. Die laasgenoemde tandheelkundige behandeling veroorsaak ‘n groeiende sektor in die gemeenskap wat tandeloos is. Tandeloosheid is ‘n toestand gekenmerk deur gedeeltelike of algehele verlies van natuurlike tande. Die doel van hierdie tesis is om tandeloosheid te ondersoek deur middel van Norman Daniels se benadering tot gesondheid en regverdige gesondheidsorg voorsiening. Daniels beweer dat gesondheidsorg van morele belangrikheid is vanweë die rol wat dit in die versekering van billike gelykheid van geleenthede speel. Hierdie tesis argumenteer dat persone met tandeloosheid en wat uitsluitlik van die openbare gesonheidstelsel gebruik kan maak ‘n beperking van geleenthede sal hê. Die vereiste vir regverdigheid sal dan op makrovlak by die beplanning van gesonheidsdienste aandag moet geniet oor die beskikbaarheid van fasiliteite vir die rekonstruksie van die gebit asook die beskikbaarheid van die aangewese prostese. Dit sal dan aan die beskerming van geleenthede voorsien ten einde die lewens beplanning van individue met tandeloosheid relatief tot ander in hul gemeenskap. In gevalle van beperkinge op hulpbronne kan Daniels se “Aanspreeklikheid vir Redelikheid” benadering toegepas word sodat regverdigheid gehandhaaf kan word in besluite rondom billike rantsoenering.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/97960
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