BACKGROUND The principle of distributive justice applies to the allocation of goods and services that are in limited supply. Men are known to have a shorter life expectancy than women (men: 73.8 years; women: 79.5 years in 1998). This is partly explained by the fact that men use medical services less frequently than women (4.9 MD contacts/year vs. 6.5 contacts/year).
METHODS Review of the literature to identify descriptions of gender-specific health service delivery services.
FINDINGS A large number of health programs have been instituted that are female-specific: 1. National Committee for Quality Assurance (NCQA) recently instituted 12 new female-specific standards for HMO accreditation. 2. The DHHS Office of Women's Health funds 17 women's "Centers of Excellence." 3. Overall, the U.S. Department of Health and Human Services allocates about $5 billion for women's health. 4. Over 3,600 health service programs across the country identify themselves as women's health centers.
In contrast, the NCQA has no male-specific standards that would benefit the 25 million men enrolled in the 441 managed care plans that are accredited by NCQA. The DHHS has no "Centers of Excellence" for men. The DHHS spends only $963.6 million on men's health programs. There are few clinics that identify themselves as men's health centers.
CONCLUSIONS These gender-specific programs pose an ethical dilemma, because they will likely worsen the disparity in health status between men and women. If gender-specific standards are to be mounted, ethical considerations would compel the development of at least an equal number of services that are specific to men's health.
Learning Objectives: 1. List the 12 NCQA gender-specific standards. 2. Contrast female-specific health programs with male-specific programs. 3. Describe how the principle of distributive justice applies to these programs.
Keywords: Gender, Bioethics
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Organization/institution whose products or services will be discussed: None