Justice and the allocation of healthcare resources: should indirect, non-health effects count?

Kasper Lippert-Rasmussen, Sigurd Lauridsen

    Research output: Contribution to journalJournal articleResearchpeer-review

    Abstract

    Alternative allocations of a fixed bundle of healthcare resources often involve significantly different indirect, non-health effects. The question arises whether these effects must figure in accounts of the conditions under which a distribution of healthcare resources is morally justifiable. In this article we defend a Scanlonian, affirmative answer to this question: healthcare resource managers should sometimes select an allocation which has worse direct, health-related effects but better indirect, nonhealth effects; they should do this when the interests served by such a policy are more urgent than the healthcare interests better served by an alternative allocation. We note that there is a prima facie case for the claim that such benefits (and costs) are relevant--i.e. they are real benefits, and in other contexts our decisions can permissibly be guided by them. We then proceed to rebut three lines of argument that might be thought to defeat this prima facie case: they appeal to fairness, the Kantian Formula of Humanity as an End in Itself, and the equal moral worth of persons, respectively.

    Original languageEnglish
    JournalMedicine, Health Care and Philosophy
    Volume13
    Issue number3
    Pages (from-to)237-46
    Number of pages10
    ISSN1386-7423
    DOIs
    Publication statusPublished - Aug 2010

    Keywords

    • Cost-Benefit Analysis/ethics
    • Health Care Rationing/economics
    • Health Priorities/economics
    • Humans
    • Social Justice/economics
    • Social Values/ethnology
    • Value of Life

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