Bioethics 21 (8):426–438 (2007)

Application of egalitarian and prioritarian accounts of health resource allocation in low‐income countries have both been criticized for implying distribution outcomes that allow decreasing/undermining health gains and for tolerating unacceptable standards of health care and health status that result from such allocation schemes. Insufficient health care and severe deprivation of health resources are difficult to accept even when justified by aggregative efficiency or legitimized by fair deliberative process in pursuing equality and priority oriented outcomes. I affirm the sufficientarian argument that, given extreme scarcity of public health resources in low‐income countries, neither health status equality between populations nor priority for the worse off is normatively adequate. Nevertheless, the threshold norm alone need not be the sole consideration when a country's total health budget is extremely scarce. Threshold considerations are necessary in developing a theory of fair distribution of health resources that is sensitive to the lexically prior norm of sufficiency. Based on the intuition that shares must not be taken away from those who barely achieve a minimal level of health, I argue that assessments based on standards of minimal physical/mental health must be developed to evaluate the sufficiency of the total resources of health systems in low‐income countries prior to pursuing equality, priority, and efficiency based resource allocation. I also begin to examine how threshold sensitive health resource assessment could be used in the Philippines.
Keywords threshold norm  priority setting  extreme scarcity  sufficiency  health resource allocation  distributive justice
Categories (categorize this paper)
DOI 10.1111/j.1467-8519.2007.00580.x
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 65,593
Through your library

References found in this work BETA

Equality and Priority.Derek Parfit - 1997 - Ratio 10 (3):202–221.
Equality as a Moral Ideal.Harry Frankfurt - 1987 - Ethics 98 (1):21-43.
Equality, Priority, and Compassion.Roger Crisp - 2003 - Ethics 113 (4):745-763.
Equality, Priority or What?Larry S. Temkin - 2003 - Economics and Philosophy 19 (1):61-87.
Public Health or Clinical Ethics: Thinking Beyond Borders.Onora O'Neill - 2002 - Ethics and International Affairs 16 (2):35-45.

View all 10 references / Add more references

Citations of this work BETA

Profiting From Poverty.Ole Koksvik & Gerhard Øverland - 2019 - Canadian Journal of Philosophy 49 (3):341-367.

Add more citations

Similar books and articles


Added to PP index

Total views
79 ( #139,758 of 2,462,045 )

Recent downloads (6 months)
1 ( #448,768 of 2,462,045 )

How can I increase my downloads?


My notes