About this topic
Summary The allocation of medical 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. Resource allocations are typically driven by two competing factors: 'efficiency' (on the grounds that we should want resources in a social institution like medicine to bring about more benefit rather than less) and 'equality' (on the grounds people can suffer to differing degrees from ill health, and we should have some preference to help those who are worse off). Broadly speaking, many discussions of health care allocation are discussions of how to understand, and how to make commensurable, these two competing considerations. More recently, there has also been a turn towards the idea that since there may be no single, uniquely acceptable way of allocating medical resources, a theory of fair medical allocation must include some discussion of procedural principles, i.e. principles that relate to the process by which actual allocation decisions are made. 
Key works Bognar & Hirose 2014 Daniels 2007
Introductions Cookson & Dolan 2000 Buchanan 1984
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391 found
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  1. added 2019-01-17
    Personal Responsibility Within Health Policy: Unethical and Ineffective.P. Friesen - 2017 - Journal of Medical Ethics Recent Issues 44 (1):53-58.
    This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the (...)
  2. added 2019-01-11
    Priority to Organ Donors: Personal Responsibility, Equal Access and the Priority Rule in Organ Procurement.Andreas Brøgger Albertsen - 2017 - Diametros 51:137-152.
    In the effort to address the persistent organ shortage it is sometimes suggested that we should incentivize people to sign up as organ donors. One way of doing so is to give priority in the allocation of organs to those who are themselves registered as donors. Israel introduced such a scheme recently and the preliminary reports indicate increased donation rates. How should we evaluate such initiatives from an ethical perspective? Luck egalitarianism, a responsibility-sensitive approach to distributive justice, provides one possible (...)
  3. added 2019-01-11
    Pharmacogenomic Inequalities: Strategies for Justice in Biomedical Research and Healthcare.Giovanni De Grandis - 2017 - Diametros 51:153-172.
    The paper discusses the possibility that the benefits of pharmacogenomics will not be distributed equally and will create orphan populations. I argue that since these inequalities are not substantially different from those produced by ‘traditional’ drugs and are not generated with the intention to discriminate, their production needs not be unethical. Still, the final result is going against deep-seated moral feelings and intuitions, as well as broadly accepted principles of just distribution of health outcomes and healthcare. I thus propose two (...)
  4. added 2019-01-08
    The Ethics of Screening and Treating Persons with Hepatitis C.Ramseyer Apau Bediako - manuscript
    In this article, I argue that the government’s position against screening persons at increased risk of HCV and publicly funding HCV treatment is ethically unjustifiable. Cost of medication and likelihood of widening existing health inequality are the government’s argument for not funding HCV treatment and for also not having a screening program for at-risk populations. I object to this position and argue in favour of a screening program and public funding of HCV treatment. I argue that these barriers to screening (...)
  5. added 2019-01-08
    Pluralistyczna Teoria Alokacji Narządów.Piotr Grzegorz Nowak - 2017 - Diametros 51:65-89.
    Biomedical sciences cannot answer the question who should be saved from death if not everyone can be. This is an ethical issue. However, we face exactly this question when deliberating on the criteria for organ allocation. The main aim of this article is to formulate a pluralistic theory of just distribution of organs, which incorporates the tenets of utilitarianism, egalitarianism and sufficientarianism. Each constituent theory adopts a different value as a criterion for organ allocation. For utilitarianism it is a health (...)
  6. added 2018-12-10
    Just Solidarity: The Key to Fair Health Care Rationing.Leonard M. Fleck - 2015 - Diametros 43:44-54.
    I agree with Professor ter Meulen that there is no need to make a forced choice between “justice” and “solidarity” when it comes to determining what should count as fair access to needed health care. But he also asserts that solidarity is more fundamental than justice. That claim needs critical assessment. Ter Meulen recognizes that the concept of solidarity has been criticized for being excessively vague. He addresses this criticism by introducing the more precise notion of “humanitarian solidarity.” However, I (...)
  7. added 2018-12-10
    Jakiej sprawiedliwości wolno oczekiwać od lekarza? / What Kind of Justice Can We Expect from a Medical Doctor?Marek Olejniczak - 2015 - Diametros 44:78-88.
    The essential objective of the paper is to demonstrate the complexity of issues related to justice in the medical profession. The author claims that the virtue of justice as the foundation of a good doctor's moral attitude and the concept of justice in allocating medical goods are of primary importance. The most important thesis presented in the paper is that even if the so-called social justice needs to be complied with in the public healthcare system, it has nothing to do (...)
  8. added 2018-12-03
    Solidarity in the Legal Frames.Aleksandra Głos - 2015 - Diametros 44:204-222.
    The purpose of this paper is to explore the meaning of solidarity and its proper position in the legal frames, with particular focus on health care. Solidarity is often identified with welfare arrangements and social guarantees. In this institutional version, it tends to humiliate citizens and restrict their entrepreneurship. Moreover, administrative solidarity is unable to recognize the actual needs of the most vulnerable members of society, which should be one of its primary concerns. Solidarity, in its original meaning, understood as (...)
  9. added 2018-12-03
    The Moral Evaluation of Living Organ Donation and Trade in Human Organs in Light of Kant's Ethics.Piotr Grzegorz Nowak - 2015 - Diametros 46:30-54.
    In the article I justify the acceptability of ex vivo transplantation and I provide the ethical evaluation of trafficking in human organs from the Kantian perspective. Firstly, I refer to passages of Kant's works, where he explicitly states that depriving oneself of one’s body parts for other purposes than self-preservation is not permitted. I explain that the negative ethical evaluation of the disposal of the body parts was given various justifications by Kant. Subsequently, I provide partial criticism of this justification, (...)
  10. added 2018-12-03
    Finansowanie testów genetycznych ze źródeł publicznych.Olga Dryla - 2015 - Diametros 44:1-19.
    One of the signs of the rapid development of medical genetics is a gradual increase in the number of genetic tests available. Different aspects of this phenomenon have been addressed and debated in the source literature, but so far relatively little has been said about the obligation to provide equal access – in the social context – to selected kinds of tests. In this article, I attempt to reconstruct those few suggestions, dealing with the principles of funding genetic tests from (...)
  11. added 2018-11-20
    A Critique of Using Age to Ration Health Care.R. W. Hunt - 1993 - Journal of Medical Ethics 19 (1):19-27.
    Daniel Callahan has argued that economic and social benefits would result from a policy of withholding medical treatments which prolong life in persons over a certain age. He claims 'the real goal of medicine' is to conquer death and prolong life with the use of technology, regardless of the age and quality of life of the patient, and this has been responsible for the escalation of health care expenditure. Callahan's proposal is based on economic rationalism but there is little evidence (...)
  12. added 2018-10-08
    Bursting Bubbles? QALYs and Discrimination.Ben Davies - forthcoming - Utilitas:1-12.
    The use of Quality-Adjusted Life Years (QALYs) in healthcare allocation has been criticized as discriminatory against people with disabilities. This article considers a response to this criticism from Nick Beckstead and Toby Ord. They say that even if QALYs are discriminatory, attempting to avoid discrimination – when coupled with other central principles that an allocation system should favour – sometimes leads to irrationality in the form of cyclic preferences. I suggest that while Beckstead and Ord have identified a problem, it (...)
  13. added 2018-09-05
    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.
  14. added 2018-09-05
    Calculating Qalys: Liberalism and the Value of Health States.Douglas MacKay - 2017 - Economics and Philosophy 33 (2):259-285.
    The value of health states is often understood to depend on their impact on the goodness of people's lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification requirement – the requirement that public officials choose laws and policies that are justifiable to their citizens – should evaluate health states. Since the public justification requirement prohibits public officials from (...)
  15. added 2018-09-05
    Calibrating QALYs to Respect Equality of Persons.Franklin Donald - 2016 - Utilitas (1):1-23.
    Comparative valuation of different policy interventions often requires interpersonal comparability of benefit. In the field of health economics, the metric commonly used for such comparison, quality adjusted life years (QALYs) gained, has been criticized for failing to respect the equality of all persons’ intrinsic worth, including particularly those with disabilities. A methodology is proposed that interprets ‘full quality of life’ as the best health prospect that is achievable for the particular individual within the relevant budget constraint. This calibration is challenging (...)
  16. added 2018-09-05
    Individualised and Personalised QALYs in Exceptional Treatment Decisions.Warwick Heale - 2016 - Journal of Medical Ethics 42 (10):665-671.
    Quality-adjusted life years (QALYs) are used to determine how to allocate resources to health programmes or to treatments within those programmes in order to gain maximum utility from those limited, shared healthcare resources. However, if we use those same population- based QALYs when faced with individual treatment decisions we may act unjustly in relation to that individual or in relation to the wider population. A treatment with a population-based incremental cost-effectiveness ratio beyond our willingness to pay threshold may be denied (...)
  17. added 2018-09-05
    Patients and Borders, Money and Mission: Responding to Medically Needy Persons From Other Countries Who Lack Financial Resources.Lauris Christopher Kaldjian - 2012 - Perspectives in Biology and Medicine 55 (2):186-200.
    When financially impoverished persons from resource-poor countries travel to resource-rich countries to seek medical treatment, health-care professionals and hospital administrators must decide how to respond. These financially impoverished "medical travelers" are medically no different from financially impoverished citizens or immigrants, but their national residence and purpose of travel may cause them to be seen as having a lower degree of standing within the communities that hospitals are expected to serve. In responding to such persons, health-care professionals and administrators encounter tension (...)
  18. added 2018-09-05
    Attending to Social Vulnerability When Rationing Pandemic Resources.Dorothy E. Vawter, J. Eline Garrett, Karen G. Gervais, Angela Witt Prehn & Debra A. DeBruin - 2011 - Journal of Clinical Ethics 22 (1):42.
    Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without (...)
  19. added 2018-09-05
    Dueling Ethical Frameworks for Allocating Health Resources.Dorothy E. Vawter, J. Eline Garrett, Karen G. Gervais, Angela Witt Prehn & Debra A. DeBruin - 2010 - American Journal of Bioethics 10 (4):54 – 56.
  20. added 2018-09-05
    Who Should We Treat? Rights, Rationing and Resources in the NHS. [REVIEW]R. E. Ashcroft - 2007 - Journal of Medical Ethics 33 (3):185-186.
  21. added 2018-09-05
    Resources and the Rule of Rescue.Mark Sheehan - 2007 - Journal of Applied Philosophy 24 (4):352–366.
    The central issue that I consider in this paper is the use of the so‐called ‘Rule of Rescue’ in the context of resource allocation. This ‘Rule’ has played an important role in resource allocation decisions in various parts of the world. It was invoked in Ontario to overturn a decision not to fund treatment for Gaucher's Disease and it has also been used to justify resource decisions in Israel concerning the same condition. -/- In the paper I consider the nature (...)
  22. added 2018-09-05
    Rights, Resources and Health Care.B. Dimond - 2006 - Nursing Ethics 13 (4):335-336.
  23. added 2018-09-05
    Parliament, Ethics and NHS Resources.Howard Stoate - 2006 - Clinical Ethics 1 (4):180-182.
  24. added 2018-09-05
    Maximizing Local Effect of HIV Prevention Resources.Shin-Yi Wu, Deborah Cohen, Lu Shi & Thomas Farley - 2005 - Contagion: Journal of Violence, Mimesis, and Culture 2 (3):127-132.
    Comparing estimates of the cost-effectiveness of human immunodeficiency virus (HIV) interventions can help communities select an HIV prevention portfolio to meet local needs efficiently. The authors developed a spreadsheet tool to estimate the relative cost-effectiveness of 26 HIV prevention interventions. HIV prevalence of the population at risk and the cost per person reached were the two most important factors determining cost-effectiveness. In low-prevalence populations, the most cost-effective interventions had a low per-person cost. Among the most cost-effective interventions overall were showing (...)
  25. added 2018-09-05
    Splitting the Difference—Patient Preference Vs Conservation of Resources.Robert Phillips - 2004 - AMA Journal of Ethics 6 (6):258-260.
  26. added 2018-09-05
    The Distribution of Biomedical Research Resources and International Justice.David B. Resnik - 2004 - Developing World Bioethics 4 (1):42–57.
    According to some estimates, less than 10% of the world's biomedical research funds are dedicated to addressing problems that are responsible for 90% of the world's burden of disease. This paper explains why this disparity exists and what should be done about it. It argues that the disparity exists because: 1) multinational pharmaceutical and biotechnology companies do not regard research and development investments on the health problems of developing nations to be economically lucrative; and 2) governmental agencies that sponsor biomedical (...)
  27. added 2018-09-05
    The Estonian Healthcare System and the Genetic Database Project: From Limited Resources to Big Hopes.Margit Sutrop & Kadri Simm - 2004 - Cambridge Quarterly of Healthcare Ethics 13 (3):254-262.
    This article focuses on healthcare ethics discussions in Estonia. We begin with an overview of the reform policies that the healthcare institutions have undergone since the region regained independence from the Soviet Union in 1991. The principles of distributing healthcare services and questions regarding just what ethical healthcare should look like have received abundant coverage in the national media. An example of this is the exceptionally public case of V—a woman with leukemia whose expensive drugs the national health insurance fund (...)
  28. added 2018-09-05
    Book Review: Setting Limits Fairly: Can We Learn to Share Medical Resources? [REVIEW]Tom Meulenbergs - 2003 - Nursing Ethics 10 (2):224-225.
    Health care systems have four objectives: (1) the provision of the best possible care for all; while (2) guaranteeing equal access to health care; (3) maintaining freedom of choice for health care providers and patients; and (4) controlling the costs. In an ideal world with abundant resources the realization of these objectives would pose no significant problems. However, any actual health care system will need a trade-off between the different objectives because resources are limited. In Setting Limits Fairly, Norman Daniels (...)
  29. added 2018-09-05
    Utilitarianism and the Disabled: Distribution of Resources.Mark S. Stein - 2002 - Bioethics 16 (1):1–19.
    Utilitarianism is more convincing than resource egalitarianism or welfare egalitarianism as a theory of how resources should be distributed between disabled people and nondisabled people. Unlike resource egalitarianism, utilitarianism can redistribute resources to the disabled when they would benefit more from those resources than nondisabled people. Unlike welfare egalitarianism, utilitarianism can halt redistribution when the disabled would no longer benefit more than the nondisabled from additional resources. -/- The author considers one objection to this view: it has been argued, by (...)
  30. added 2018-09-05
    Ageing, Autonomy and Resources: Edited by A Harry Lesser, Aldershot, Ashgate, 1999, X + 245 Pages, Pound39.45 (Hb). [REVIEW]J. C. Hughes - 2001 - Journal of Medical Ethics 27 (1):69-69.
  31. added 2018-09-05
    Allocation of Resources and Personal Responsibility.Henk Amj ten Have - 2001 - In H. Ten Have & Bert Gordijn (eds.), Bioethics in a European Perspective. Kluwer Academic Publishers. pp. 271.
  32. added 2018-09-05
    The Distribution of Medical Resources, Withholding Medical Treatment, Drug Trials,Advance Directives, Euthanasia and Other Ethical Issues: The Thandi Case (II).Trefor Jenkins, Darrel Moellendorf & Udo Schüklenk - 2001 - Developing World Bioethics 1 (2):163–174.
    In the first part of this article, we considered how Thandi, a 15-year-old girl, was treated when taken by her mother to their GP, Dr Randera. Dr Randera notified them that Thandi was pregnant, HIV positive, and had syphilis and herpes. Dr Randera also informed them that there was a substantial risk that the baby would be born HIV positive. Both Thandi and her mother wanted an abortion. However, Dr Randera, who was morally opposed to abortions, refused to provide the (...)
  33. added 2018-09-05
    Ageing, Autonomy and Resources.Harry Lesser - 1999
  34. added 2018-09-05
    The Question of Resources and the Application of Disability Rights.R. Whittle - 1998 - Health Care Analysis 6 (3):227-233.
  35. added 2018-09-05
    Medication Event Monitoring Systems, Health Resources and Trust.Vanya Kovach - 1998 - Health Care Analysis 6 (4):321-323.
    Rivers et al. raise two ethical issues in relation to the use of medication event monitoring systems (MEMS). The first issue, identified as an 'economic' concern, centres on the waste of health resources caused by patient failure to adhere to medication programmes. The second is the danger that MEMS may pose to 'the trust that should exist between patient and prescriber'. In what follows I offer an analysis of these issues, and their relationship to each other.
  36. added 2018-09-05
    Paper Two: Allocation of Scarce Resources: The Need for Critical Analysis.Christopher Williams - 1996 - Health Care Analysis 4 (1):28-34.
  37. added 2018-09-05
    Allocating Health Care Resources. [REVIEW]John McKie - 1996 - Bioethics 10 (4):353-353.
  38. added 2018-09-05
    Some Equity-Efficiency Trade-Offs in the Provision of Scarce Goods: The Case of Lifesaving Medical Resources.Volker H. Schmidt - 1994 - Journal of Political Philosophy 2 (1):44–66.
  39. added 2018-09-05
    Will Resources for Elder Care Be Scarce?Anneke van den Berg Jeths & Mats Thorslund - 1994 - Hastings Center Report 24 (5):6-10.
    One of the major issues in the debate about the future of health care is how to keep costs under control while meeting growing demands for care. Addressing that, especially on an international scale, is far from easy. How are we to determine what the demands for care will most likely be? Even if it is not possible to estimate the future number of dependent elderly persons with any precision, it is hard to ignore the most probable scenario: a substantial (...)
  40. added 2018-09-05
    The Relevance of Suffering and Identifying with Others When Allocating Resources, and Clinical Implications of the Elasticity of the Law.E. G. Howe - 1993 - Journal of Clinical Ethics 4 (3):203.
  41. added 2018-09-05
    Accumulating Resources in Perinatal Intensive Care Centers.Barbara Bridgman Perkins - 1993 - Business and Professional Ethics Journal 12 (2):51-66.
  42. added 2018-09-05
    Health Care as a Right, Fairness and Medical Resources.Heta Hayry Matti Hayry - 1990 - Bioethics 4 (1):1-21.
  43. added 2018-09-05
    Health Care as a Right, Fairness and Medical Resources.Matti Hayry & Heta Hayry - 1990 - Bioethics 4 (1):1–21.
    There is a growing feeling in many Western countries that every human being has a right to health, or a right to health care. This feeling is reflected in a declaration of the World Health Organization (WHO) from 1976, which states: The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Our intention in the following is to use the WHO (...)
  44. added 2018-09-05
    The Medicare Prospective Payment System: Impact on the Frail Elderly and an Alternative Reimbursement Formula.Phoebe Sharkey & June Buckle - 1988 - Notre Dame Journal of Law, Ethics and Public Policy 3 (2):227-240.
    The U.S. health care system is in the midst of unprecedented change. New health care delivery systems and financing mechanisms are reshaping the health care arena. The thrust of these changes with respect to medical care for most Americans and their implications for the future are difficult issues to assess. In this article we discuss implementation of the Medicare Prospective Payment System (PPS) and the impact of its financial incentives. We specifically identify the ramifications of this cost containment effort on (...)
  45. added 2018-09-05
    Balancing Efficiency and Quality - Toward Market-Based Health Care.William Roper - 1988 - Notre Dame Journal of Law, Ethics and Public Policy 3 (2):169-186.
    This article describes the steps Medicare has taken and will continue to take to fulfill the Reagan Administration's mandate to control health care costs and maintain quality care by increasing reliance on market forces and on appropriate incentives.
  46. added 2018-09-05
    The Cost-Factor in Health Care.Richard Mccormick - 1988 - Notre Dame Journal of Law, Ethics and Public Policy 3 (2):161-168.
    Introduction to a special issue on medical cost containment.
  47. added 2018-09-05
    The Ethics of Cost-Containment: Bureaucratic Medicine and the Doctor as Patient-Advocate.Barry Furrow - 1988 - Notre Dame Journal of Law, Ethics and Public Policy 3 (2):187-226.
    Physicians are feeling the heat of cost containment. Pressures on doctors to contain costs have mounted - from hospital and Health Maintenance Organization (HMO) administrators, from state and national government, from medical staffs. Medicare payment reforms, corporate and insurer demands, and market pressures have all come together to pressure health care providers to cap escalating health care costs. This article posits that such pressures to control costs are not always counter to the patient's best interests and that the ethical debate (...)
  48. added 2018-09-05
    Misallocating Health Care and Societal Resources.Richard Lamm - 1988 - Notre Dame Journal of Law, Ethics and Public Policy 3 (2):241-248.
    The future will be controlled by those nations which most intelligently allocate their resources. Our nation's capital is the stored flexibility needed by our children to meet the future. How we allocate our nation's limited resources and capital will dictate the kind of lives our children will lead. We are not correctly or intelligently allocating our nation's health care resources. There are serious internal contradictions in a society that no longer produces the radios, televisions, or video recorders it invented, yet (...)
  49. added 2018-09-05
    DRGs and the Ethical Reallocation of Resources.Robert M. Veatch - 1986 - Hastings Center Report 16 (3):32-40.
    To allocate resources ethically under DRGs, we need an expanded medical ethics. Appealing to traditional patient-centred principles such as beneficence and autonomy will not be sufficient. We also need to take into account the social principles of full beneficence and justice. If marginal benefits must be eliminated, clinicians should not participate in deciding who should get less care but should remain committed to their patients' interests.
  50. added 2018-09-05
    Triage and Justice: The Ethics of Rationing Life-Saving Medical Resources Gerald R. Winslow Berkeley: University of California Press, 1982. Pp. 240. $19.95. [REVIEW]Abbyann Lynch - 1983 - Dialogue 22 (4):754-756.
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