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Utilitarianism means choices to public benefit, utilitarianism guides to make choice that makes greatest benefit for most of people (Principles and Theories). Aims of utilitarianism can be criticized when person wants to make choices for own benefits. (Sajama 1993.) When arranging health care services I think that when thinking utilitarianism everyone can try to achieve own benefit but at same time think and respect public equity.
In my opinion utilitarianism is connected to responsibility and obligation. Policy-makers have responsibility of decisions for public benefit. Decision –makers have responsibility to get knowledge and hear specialists to underpin decisions. And In other hand people have responsibility to vote decision -makers and do other decisions as get medical care, pay taxes etc.
It´s difficult to make choices that are best for most of people concerning all groups affected at issue. All the groups have to be defended and speak of the problems that are according them particularly those parties who cant speak of them own.

2.2 Paternalism

Paternalism means that people´s rights are interfered because of action´s targets to cause good, benefits, welfare and according to people´s values. Some law or action of health care professional may be paternalism. (Launis 2010.) Some people think that it´s paternalism when society define our needs for example what health care services are arranged in spite of what we need or want.
As utilitarianism, paternalism is also connected to decision makers´ responsibility. It may feel that decisions are defined by the state but decision-makers are responsible for decisions according to fundamental law. These days when municipal services suffer from the recession new arrangements of munic...

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...have equal health care services. This challenge is with refugees in small cities for example when arranging interpreter service to minority languages in small cities. How it´s possible to arrange equal health and welfare services in client oriented way?
In my opinion health equality is linked up to several ethical principals. To achieve health equality human dignity, human rights, equality, the common good approach and fairness and justice approach are observed.
When pondering ethical principals in arranging health care services, many principals are connected with each other. Utilitarianism is connected to equality and human dignity and these principals are connected to responsibility and duty. Responsibility and duty is also connected to paternalism. Also to one topic is linked to many ethical issues that make these issues many-sided and challenging to discuss.