This essay serves as an introduction to this issue of the Journal of Medicine and Philosophy on commodification and health care. The essay attempts to sharpen the articulation of generally expressed worries about the commodification of health care. It does so by defining commodification, analyzing three components of the good of health care, and attempting to assess how commodification might distort the shape of each of those components. Next, it explores how the good of health care might be distorted by the market-based principle of distributive justice, "to each according to ability to pay." Finally, it identifies two basic questions about the relationship of medicine and the market that merit further exploration. (1) How does the market-based language of "incentives" so pervasive in the world of managed care distort the complex patterns of virtue and vice that motivate actors in the health care arena? (2) If we recognize that we cannot eliminate the influence of money from the health care system, how can we insure that the good of health care remains, in Radin's terms, "incompletely commodified"?

The author argues that the category of cooperation of evil needs to be supplemented by a new category of appropriation of evil. Cooperation focuses on agents who must decide whether to perform an act that contributes to the morally objectionable action of another. In contrast, appropriation concentrates on the "mirror image" problem faced by agents who must decide whether to make use of the fruits of another agent's morally objectionable action. She suggests that the new category better illuminates problems involved in research using fetal tissue obtained from elective abortions, the purchase of goods made in sweatshops, and some affiliations between Catholic health care facilities and those that perform procedures prohibited by the Ethical and Religious Directives.]

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The English courts in November 2000 authorized the surgical separation of conjoined twins known by the pseudonyms "Jodie" and "Mary." The operation resulted in the immediate death of Mary, while giving Jodie real hope of a normal life. Without the operation, both babies would have soon died. The author here considers how the morality of the operation would be assessed from the perspective of two different views of embodiment, the "Bodily Distinctness View" and the "Bodily Relatedness View." After showing how both views would support the operation (although on different grounds), she analyzes the statement opposing the operation that was submitted to the appellate court by Cormac Murphy-O'Connor, the Cardinal Archbishop of Westminister.]

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