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An Ethical Analysis of International Health Priority-Setting

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Abstract

Health care systems throughout the developed world face ‘crises’ of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Prioritisation of health care services for public funding has been one of the strategies used by decision makers to reconcile growing health care demands with limited resources. Priority setting at the macro level has yet to demonstrate real successes. This paper describes international approaches to explicit prioritisation at the macro-governmental level in the six experiences most published in the English literature; analyzes the ways in which values, principles and other normative concepts were presented in these international priority setting experiences; and identifies key elements of a more robust framework for ethical analysis which could promote meaningful and effective health priority setting.

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Acknowledgements

This 3 year study is funded by a research grant from the Canadian Health Services Research Foundation and the Canadian Institute of Health Research, with matching funds from the Nova Scotia Health Research Foundation, Newfoundland and Labrador Centre for Applied Health Research and Ontario Ministry of Health and Long Term Care (grant number RC2-0873-03). We would also like to acknowledge Raisa Deber, Lawrence Nestman, and Thomas Rathwell for their insightful feedback.

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Authors and Affiliations

  1. Department of Bioethics, Dalhousie University, 5848 University Avenue, Halifax, NS, Canada, B3H 4H7

    Nuala Kenny

  2. Faculty of Health Sciences, Simon Fraser University, West Mall Centre 2812, 8888 University Drive, Burnaby, BC, Canada, V5A 1S6

    Christine Joffres

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  1. Nuala Kenny
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Correspondence to Nuala Kenny.

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Kenny, N., Joffres, C. An Ethical Analysis of International Health Priority-Setting. Health Care Anal 16, 145–160 (2008). https://doi.org/10.1007/s10728-007-0065-5

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