About this topic
Summary Health resource allocation concerns the allocation of resources that contribute to individual and public health. The recognition that health is subject to 'social determinants' that often have more influence than direct healthcare means that this category is much wider than the corresponding category of 'medical resource allocation' (to avoid duplication, papers concerning narrowly medical resources are not included in this category). Some issues are shared between the two categories: as with the allocation of medical resources, the allocation of health resources is a subfield within more general concerns about distributive justice. As such, much discussion of healthcare allocation uses familiar terms and theories from this broader area. However, it is also a subject that has been seen by many to have particular importance, due to the central importance that health plays in human lives. Broader questions include whether health care is 'special' compared with other ways of promoting health; whether allocations of health resources should be concerned with the health only of individuals, or also of groups; whether and how far the promotion of public health warrants compulsion or coercion; and how the demands of national health compete with global health. 
Key works Powers & Faden 2008 Venkatapuram 2011 Eyal et al 2013 
Introductions Hausman 2007 Wilson 2011
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172 found
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  1. Association of Race and Ethnicity With High Longevity Deceased Donor Kidney Transplantation Under the US Kidney Allocation System.Nour Asfour, Kevin C. Zhang, Jessica Lu, Peter P. Reese, Milda Saunders, Monica Peek, Molly White, Govind Persad & William F. Parker - forthcoming - American Journal of Kidney Diseases.
  2. Responsibility for addiction: risk, value, and reasonable foreseeability.Federico Burdman - forthcoming - In Rob Lovering (ed.), The Palgrave Handbook of Philosophy and Psychoactive Drug Use. New York: Palgrave Macmillan.
    It is often assumed that, except perhaps in a few rare cases, people with addiction can be aptly held responsible for having acquired the condition. In this chapter, I consider the argument that supports this view and draw attention to a number of challenges that can be raised against it. Assuming that early decisions to use drugs were made in possession of normal-range psychological capacities, I consider the key question of whether drug users who later became addicted should have known (...)
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  3. Fair Allocation of GLP-1 and Dual GLP-1-GIP Receptor Agonists.Ezekiel J. Emanuel, Johan L. Dellgren, Matthew S. McCoy & Govind Persad - forthcoming - New England Journal of Medicine.
    Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...)
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  4. How (Not) to Make Trade-Offs Between Health and Other Goods.Antti Kauppinen - forthcoming - Cambridge Quarterly of Healthcare Ethics.
    In the context of a global pandemic, there is good health-based reason for governments to impose various social distancing measures. However, such measures also cause economic and other harms to people at low risk from the virus. In this paper, I examine how to make such trade-offs in a way that is respectfully justifiable to their losers. I argue that existing proposals like using standard QALY (quality-adjusted life-year) valuations or WELLBYs (wellbeing-adjusted life-years) as the currency for trade-offs do not allow (...)
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  5. Special Supplement: What Do We Owe the Elderly? Allocating Social and Health Care Resources.Ruud ter Meulen, Eva Topinková & Daniel Callahan - forthcoming - Hastings Center Report.
  6. Rationing, Responsibility, and Vaccination During COVID-19: A Conceptual Map.Jin K. Park & Ben Davies - forthcoming - American Journal of Bioethics:1-14.
    Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about vaccine-sensitive resource (...)
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  7. Health Research Priority Setting: Do Grant Review Processes Reflect Ethical Principles?Leah Pierson & Joseph Millum - forthcoming - Global Public Health.
    Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. (...)
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  8. Predicting and Preferring.Nathaniel Sharadin - forthcoming - Inquiry: An Interdisciplinary Journal of Philosophy.
    The use of machine learning, or “artificial intelligence” (AI) in medicine is widespread and growing. In this paper, I focus on a specific proposed clinical application of AI: using models to predict incapacitated patients’ treatment preferences. Drawing on results from machine learning, I argue this proposal faces a special moral problem. Machine learning researchers owe us assurance on this front before experimental research can proceed. In my conclusion I connect this concern to broader issues in AI safety.
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  9. Ethical Consumerism, Human Rights, and Global Health Impact.Brian Berkey - 2024 - Developing World Bioethics 24 (1):31-36.
    In this paper, I raise some doubts about Nicole Hassoun's account of the obligations of states, pharmaceutical firms, and consumers with regard to global health, presented in Global Health Impact. I argue that it is not necessarily the case, as Hassoun claims, that if states are just, and therefore satisfy all of their obligations, then consumers will not have strong moral reasons, and perhaps obligations, to make consumption choices that are informed by principles and requirements of justice. This is because (...)
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  10. Responsibility and Healthcare.Ben Davies, Gabriel De Marco, Neil Levy & Julian Savulescu (eds.) - 2024 - Oxford University Press USA.
    A volume with 14 chapters on various aspects of the relationship between responsibility and healthcare, plus a substantial introduction that offers a comprehensive overview of the relevant debates and how they relate to one another. -/- Questions of responsibility arise at all levels of health care. Most prominent has been the issue of patient responsibility. Some health conditions that risk death or serious harm are partly the result of lifestyle behaviours such as smoking, lack of exercise, or extreme sports. Are (...)
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  11. When Can Physicians Fire Patients with Opioid Use Disorder for Nonmedical Use of Prescription Medications?Levi Durham - 2024 - Journal of Clinical Ethics 35 (1):65-69.
    The opioid crisis has greatly increased the number of patients who are illegally injecting drugs while hospitalized for other conditions. Physicians face a difficult decision in these circumstances: when is it appropriate to involuntarily discharge or “fire” a patient with opioid use disorder for their continued nonmedical use of opioids? This commentary analyzes physicians’ responsibilities to their patients and argues that physicians should fire non-adherent patients only when every other option has been exhausted and the expected benefits of firing the (...)
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  12. Manufactured scarcity and the allocation of scarce resources–Authors' reply.Ezekiel J. Emanuel & Govind Persad - 2024 - The Lancet 403 (10426):532.
  13. Making Sense of Race-Based Affirmative Action in Allocating Scarce Medical Resources.Yuichiro Mori - 2024 - Res Philosophica 101.
    The aim of this article is to consider whether, when, and why it is morally right to treat members of socially disadvantaged racial or ethnic groups favorably when allocating scarce medical resources. Since the COVID 2019 pandemic has had different impacts on racial and ethnic groups, some U.S. states have given racial and ethnic minorities preferential access to COVID-19 vaccines, leading to controversy over the moral and legal permissibility of doing so. I examine three arguments for affirmative action—the compensation, equality-of-opportunity, (...)
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  14. Sistema sanitario neuquino: atención de las mujeres mapuce en Las Coloradas.C. Rodríguez Garat - 2024 - Nuestro Noa 18:1-28.
    El objetivo de este artículo es realizar una historización del sistema sanitario de Neuquén, concretamente atendiendo a los programas de salud aplicados en esta provincia desde su surgimiento hasta el año 2020. En este marco, en primer lugar, me enfocaré en los lineamientos políticos que definieron las bases ideológicas de las políticas públicas llevadas a cabo en la atención sanitaria neuquina, y, en segundo lugar, examinaré las variables estadísticas publicadas por el sistema de salud provincial referidas a las condiciones materiales (...)
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  15. Identified Person "Bias" as Decreasing Marginal Value of Chances.H. Orri Stefánsson - 2024 - Noûs 58 (2):536-561.
    Many philosophers think that we should use a lottery to decide who gets a good to which two persons have an equal claim but which only one person can get. Some philosophers think that we should save identified persons from harm even at the expense of saving a somewhat greater number of statistical persons from the same harm. I defend a principled way of justifying both judgements, namely, by appealing to the decreasing marginal moral value of survival chances. I identify (...)
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  16. NHS Underfunding and the Lopsided Socialized Model.Ognjen Arandjelović - 2023 - Ethics, Medicine and Public Health 28:Article 100902.
    Background: The funding of health care is a major challenge to governments all across the world; the UK presents a useful and illustrative case. -/- Methodology: In this article I explain why the manner in which the provision of health care in the UK is organized is fundamentally incoherent and continuing to ignore this incoherence is bound to lead to ever-greater problems. -/- Discussion: Our society must decide on its priorities; herein I do not wish to argue what these ought (...)
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  17. Open and Inclusive: Fair processes for financing universal health coverage.Elina Dale, David B. Evans, Unni Gopinathan, Christoph Kurowski, Ole Frithjof Norheim, Trygve Ottersen & Alex Voorhoeve - 2023 - Washington, DC: World Bank.
    This World Bank Report offers a new conception of fair decision processes in health financing. It argues that such procedural fairness can contribute to fairer outcomes, strengthen the legitimacy of decision processes, build trust in authorities, and promote the sustainability of reforms on the path to health coverage for all.
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  18. Criteria For the Fairness of Health Financing Decisions: A Scoping Review.Elina Dale, Elizabeth Peacocke, Espen Movik, Alex Voorhoeve, Trygve Ottersen, Ole Frithjof Norheim, Christoph Kurowski, Unni Gopinathan & David B. Evans - 2023 - Health Policy and Planning 38 (1):i13–i35.
    Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which (...)
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  19. Medical need and health need.Ben Davies - 2023 - Clinical Ethics 18 (3):287-291.
    I introduce a distinction between health need and medical need, and raise several questions about their interaction. Health needs are needs that relate directly to our health condition. Medical needs are needs which bear some relation to medical institutions or processes. I suggest that the question of whether medical insurance or public care should cover medical needs, health needs, or only needs which fit both categories is a political question that cannot be resolved definitionally. I also argue against an overly (...)
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  20. The shared ethical framework to allocate scarce medical resources: a lesson from COVID-19.Ezekiel J. Emanuel & Govind Persad - 2023 - The Lancet 401 (10391):1892–1902.
    The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair (...)
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  21. Cost Sharing in Managed Care and the Ethical Question of Business Purpose.Robert C. Hughes - 2023 - Journal of Managed Care and Specialty Pharmacy 29 (8):965-69.
    For-profit managed care organizations face decisions about cost sharing that can involve a tradeoff between the interests of investors and the interests of patients. No successful business can ignore the interests of its investors, but moral philosophy points to ethical reasons for managed care organizations to make patients’ health, rather than investors’ profit, their primary goal. One reason is the ethical obligation of all businesses to avoid wrongful exploitation of vulnerable customers. An insurance company’s cost-sharing policy can exploit customers either (...)
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  22. Towards a new model of global health justice: the case of COVID-19 vaccines.Nancy S. Jecker, Caesar A. Atuire & Susan J. Bull - 2023 - Journal of Medical Ethics 49 (5):367-374.
    This paper questions an exclusively state-centred framing of global health justice and proposes a multilateral alternative. Using the distribution of COVID-19 vaccines to illustrate, we bring to light a broad range of global actors up and down the chain of vaccine development who contribute to global vaccine inequities. Section 1 (Background) presents an overview of moments in which diverse global actors, each with their own priorities and aims, shaped subsequent vaccine distribution. Section 2 (Collective action failures) characterises collective action failures (...)
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  23. How Do People Balance Death against Lesser Burdens?Veronika Luptakova & Alex Voorhoeve - 2023 - In Matthew Lindauer, James R. Beebe & Justin Sytsma (eds.), Advances in Experimental Political Philosophy. New York: Bloomsbury. pp. 123-158.
  24. Should health research funding be proportional to the burden of disease?Joseph Millum - 2023 - Politics, Philosophy and Economics 22 (1):76-99.
    Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/aids research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: Insofar as the scientific (...)
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  25. Fair domestic allocation of monkeypox virus countermeasures.Govind Persad, R. J. Leland, Trygve Ottersen, Henry S. Richardson, Carla Saenz, G. Owen Schaefer & Ezekiel J. Emanuel - 2023 - Lancet Public Health 8 (5):e378–e382.
    Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...)
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  26. Clarifying the Discussion on Prioritization and Discrimination in Healthcare.Joona Räsänen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):139-140.
    Discrimination is an important real-life issue that affects many individuals and groups. It is also a fruitful field of study that intersects several disciplines and methods. This Special Section brings together papers on discrimination and prioritization in healthcare from leading scholars in bioethics and closely related fields.
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  27. Equitable global allocation of monkeypox vaccines.G. Owen Schaefer, Ezekiel J. Emanuel, Caesar A. Atuire, R. J. Leland, Govind Persad, Henry S. Richardson & Carla Saenz - 2023 - Vaccine 41 (48):7084-7088.
    With the world grappling with continued spread of monkeypox internationally, vaccines play a crucial role in mitigating the harms from infection and preventing spread. However, countries with the greatest need - particularly historically endemic countries with the highest monkeypox case-fatality rates - are not able to acquire scarce vaccines. This is unjust, and requires rectification through equitable allocation of vaccines globally. We propose applying the Fair Priority Model for such allocation, which emphasizes three key principles: 1) preventing harm; 2) prioritizing (...)
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  28. Involuntary Withdrawal: A Bridge Too Far?Joanna Smolenski - 2023 - Clinical Ethics Case Studies, Hastings Bioethics Forum.
    RD, a 32-year-old male, was admitted to the hospital with hypoxic COVID pneumonia–a potentially life-threatening condition characterized by dangerously low levels of oxygen in the body- during one of the pandemic’s surges. While RD’s age gave the clinical team hope for his prognosis, his ability to recover was complicated by his being unvaccinated and having multiple comorbidities, including diabetes and obesity. His condition worsened to the point that he required extracorporeal membrane oxygenation (ECMO), a machine that maintains the functioning of (...)
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  29. More Carrots, Less Sticks: Encouraging Good Stewardship in the Global Antimicrobial Commons.Cristian Timmermann - 2023 - Health Care Analysis 31 (1):53-57.
    Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.
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  30. Reproductive Embryo Editing: Attending to Justice.Inmaculada De Melo-Martín - 2022 - Hastings Center Report 52 (4):26-33.
    The use of genome embryo editing tools in reproduction is often touted as a way to ensure the birth of healthy and genetically related children. Many would agree that this is a worthy goal. The purpose of this paper is to argue that, if we are concerned with justice, accepting such goal as morally appropriate commits one to rejecting the development of embryo editing for reproductive purposes. This is so because safer and more effective means exist that can allow many (...)
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  31. Good Enough? The Minimally Good Life Account of the Basic Minimum.Nicole Hassoun - 2022 - Australasian Journal of Philosophy 100 (2):330-341.
    ABSTRACT What kind of basic minimum do we owe to others? This paper defends a new procedure for answering this question. It argues that its minimally good life account has some advantages over the main alternatives and that neither the first-, nor third-, person perspective can help us to arrive at an adequate account. Rather, it employs the second-person perspective of free, reasonable, care. There might be other conditions for distributive justice, and morality certainly requires more than helping everyone to (...)
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  32. Responding to the Tragedies of Our Time - The Human Right to Health and the Virtue of Creative Resolve.Nicole Hassoun - 2022 - Global Justice: Theory Practice Rhetoric 13 (2):41-59.
    We live in tragic times. Millions are sheltering in place to avoid exacerbating the Coronavirus (COVID-19) pandemic. How should we respond to such tragedies? This paper argues that the human right to health can help us do so because it inspires human rights advocates, claimants, and those with responsibility for fulfilling the right to try hard to satisfy its claims. That is, the right should, and often does, give rise to what I call_ the virtue of creative resolve_. This resolve (...)
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  33. Value assessment frameworks: who is valuing the care in healthcare?Jonathan Anthony Michaels - 2022 - Journal of Medical Ethics 48 (6):419-426.
    Many healthcare agencies are producing evidence-based guidance and policy that may determine the availability of particular healthcare products and procedures, effectively rationing aspects of healthcare. They claim legitimacy for their decisions through reference to evidence-based scientific method and the implementation of just decision-making procedures, often citing the criteria of ‘accountability for reasonableness’; publicity, relevance, challenge and revision, and regulation. Central to most decision methods are estimates of gains in quality-adjusted life-years, a measure that combines the length and quality of survival. (...)
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  34. Should health research funding be proportional to the burden of disease?Joseph Millum - 2022 - Politics, Philosophy and Economics 1 (1):1-24.
    Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/AIDS research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: Insofar as the scientific (...)
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  35. Sustainable healthcare resource allocation, grounding theories and operational principles: response to our commentators.Christian Munthe, Davide Fumagalli & Erik Malmqvist - 2022 - Journal of Medical Ethics 48 (1):38-38.
    We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions. All our commentators acknowledge our core message: healthcare needs to pay attention to the future. They also strengthen our proposal by offering support by luck egalitarian and Rawlsian arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.
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  36. Conflicting Aims and Values in the Application of Smart Sensors in Geriatric Rehabilitation: Ethical Analysis.Christopher Predel, Cristian Timmermann, Frank Ursin, Marcin Orzechowski, Timo Ropinski & Florian Steger - 2022 - JMIR mHealth and uHealth 10 (6):e32910.
    Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...)
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  37. Dose optimisation and scarce resource allocation: two sides of the same coin.Garth Strohbehn, Govind Persad, William F. Parker & Srinivas Murthy - 2022 - BMJ Open 12 (10):e063436.
    Objective: A deep understanding of the relationship between a scarce drug's dose and clinical response is necessary to appropriately distribute a supply-constrained drug along these lines. Summary of key data: The vast majority of drug development and repurposing during the COVID-19 pandemic – an event that has made clear the ever-present scarcity in healthcare systems –has been ignorant of scarcity and dose optimisation's ability to help address it. Conclusions: Future pandemic clinical trials systems should obtain dose optimisation data, as these (...)
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  38. Value choices in European COVID-19 vaccination schedules: how vaccination prioritization differs from other forms of priority setting.Karolina Wiśniowska, Tomasz Żuradzki & Wojciech Ciszewski - 2022 - Journal of Law and the Biosciences 9 (2):lsac026.
    With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision-makers had to determine the order in which different groups were prioritized. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared prioritization regulations in 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two types of priority categories: groups that have increased (...)
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  39. Crisis Nationalism: To What Degree Is National Partiality Justifiable during a Global Pandemic?Eilidh Beaton, Mike Gadomski, Dylan Manson & Kok-Chor Tan - 2021 - Ethical Theory and Moral Practice 24 (1):285-300.
    Are countries especially entitled, if not obliged, to prioritize the interests or well-being of their own citizens during a global crisis, such as a global pandemic? We call this partiality for compatriots in times of crisis “crisis nationalism”. Vaccine nationalism is one vivid example of crisis nationalism during the COVID-19 pandemic; so is the case of the US government’s purchasing a 3-month supply of the global stock of the antiviral Remdesivir for domestic use. Is crisis nationalism justifiable at all, and, (...)
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  40. Understanding Government Decisions to De-fund Medical Services Analyzing the Impact of Problem Frames on Resource Allocation Policies.Mark Embrett & Glen E. Randall - 2021 - Health Care Analysis 29 (1):78-98.
    Many medical services lack robust evidence of effectiveness and may therefore be considered “unnecessary” care. Proactively withdrawing resources from, or de-funding, such services and redirecting the savings to services that have proven effectiveness would enhance overall health system performance. Despite this, governments have been reluctant to discontinue funding of services once funding is in place. The focus of this study is to understand how the framing of an issue or problem influences government decision-making related to de-funding of medical services. To (...)
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  41. Ordeals, women and gender justice.Anca Gheaus - 2021 - Economics and Philosophy 37 (1):8-22.
    Rationing health care by ordeals is likely to have different effects on women and men, and on distinct groups of women. I show how such putative effects of ordeals are relevant to achieving gender justice. I explain why some ordeals may disproportionately set back women’s interest in discretionary time, health and access to health care, and may undermine equality of opportunity for positions of advantage. Some ordeals protect the interests of the worse-off women yet set back the interests of better-off (...)
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  42. Implementation of Tobacco Control Policies in Bangladesh: A Political Economy Analysis.Md Mahmudul Hoque & Riffat Ara Zannat Tama - 2021 - Public Administration Research 10 (2):36-51.
    After ratifying the Framework Convention for Tobacco Control in 2004, Bangladesh enacted anti-tobacco laws, policies, and administrative measures. Evidence suggests that the progress so far has not been significant, and Bangladesh will most likely fail to meet its target to become tobacco-free by 2040. This study undertakes a national-level political economy analysis to explore the dynamics that affect the processes of required tobacco policy reforms and implementation. Based on a desk review of pertinent pieces of literature and key informant interviews, (...)
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  43. Difficult Trade-Offs in Response to COVID-19: The Case for Open and Inclusive Decision-Making.Ole Frithjof Norheim, Joelle Abi-Rached, Liam Kofi Bright, Kristine Baeroe, Octavio Ferraz, Siri Gloppen & Alex Voorhoeve - 2021 - Nature Medicine 27:10-13.
    We argue that deliberative decision-making that is inclusive, transparent and accountable can contribute to more trustworthy and legitimate decisions on difficult ethical questions and political trade-offs during the pandemic and beyond.
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  44. Sustainability, equal treatment, and temporal neutrality.Govind Persad - 2021 - Journal of Medical Ethics 47 (2):106-107.
    Addressing distributive justice issues in health policy—ranging from the allocation of health system funding to the allocation of scarce COVID-19 interventions like intensive care unit beds and vaccines—involves the application of ethical principles. Should a principle of sustainability be among them? I suggest that while the value of temporal neutrality underlying such a principle is compelling, it is already implicit in the more basic principle of equal treatment. Munthe et al imagine sustainability accompanying four other principles: need, prognosis, equal treatment (...)
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  45. Allocating scarce life-saving resources: the proper role of age.Govind Persad & Steven Joffe - 2021 - Journal of Medical Ethics 47 (12):836-838.
    The COVID-19 pandemic has forced clinicians, policy-makers and the public to wrestle with stark choices about who should receive potentially life-saving interventions such as ventilators, ICU beds and dialysis machines if demand overwhelms capacity. Many allocation schemes face the question of whether to consider age. We offer two underdiscussed arguments for prioritising younger patients in allocation policies, which are grounded in prudence and fairness rather than purely in maximising benefits: prioritising one’s younger self for lifesaving treatments is prudent from an (...)
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  46. Pushing poverty off limits: quality improvement and the architecture of healthcare values.Guddi Singh, Vikki Entwistle, Alan Cribb & Polly Mitchell - 2021 - BMC Medical Ethics 22 (1):1-13.
    Background: Poverty and social deprivation have adverse effects on health outcomes and place a significant burden on healthcare systems. There are some actions that can be taken to tackle them from within healthcare institutions, but clinicians who seek to make frontline services more responsive to the social determinants of health and the social context of people’s lives can face a range of ethical challenges. We summarise and consider a case in which clinicians introduced a poverty screening initiative into paediatric practice (...)
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  47. Aggregation, Balancing, and Respect for the Claims of Individuals.Bastian Steuwer - 2021 - Utilitas 33 (1):17-34.
    Most non-consequentialists “let the numbers count” when one can save either a lesser or greater number from equal or similar harm. But they are wary of doing so when one can save either a small number from grave harm or instead a very large number from minor harm. Limited aggregation is an approach that reconciles these two commitments. It is motivated by a powerful idea: our decision whom to save should respect each person who has a claim to our help, (...)
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  48. Respect for persons and the allocation of lifesaving healthcare resources.Xavier Symons - 2021 - Bioethics 35 (5):392-399.
    Many ethicists argue that we should respect persons when we distribute resources. Yet it is unclear what this means in practice. For some, the idea of respect for persons is synonymous with the idea of respect for autonomy. Yet a principle of respect for autonomy provides limited guidance for how we should distribute scarce medical interventions. In this article, however, I sketch an alternative conception of respect for persons—one that is based on an ethic of mutual accountability. I draw in (...)
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  49. The Evolving Science of Disorders of Consciousness Calls for an Inclusive Framework for Healthcare Resource Allocation.Jasmine Walter - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):151-153.
    Commentary on "What Justifies the Allocation of Health Care Resources to Patients with Disorders of Consciousness?", Peterson, Aas and Wasserman.
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  50. The ethics of grandfather clauses in healthcare resource allocation.Gry Wester, Leah Zoe Gibson Rand, Christine Lu & Mark Sheehan - 2021 - Bioethics 35 (2):151-160.
    A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excellence (NICE) in the United Kingdom. NICE provides evidence‐based guidance on healthcare technologies and public health interventions that influence resource allocation decisions in the National Health Service (NHS) and the broader public (...)
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