Mathias Barra, Mari Broqvist, Erik Gustavsson, Martin Henriksson, Niklas Juth, Lars Sandman & Carl Tollef Solberg
Health Care Analysis 1:1-20 (2019)
AbstractPriority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity criteria in Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda.
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Citations of this work
Should Rare Diseases Get Special Treatment?Monica Magalhaes - 2022 - Journal of Medical Ethics 48 (2):86-92.
Hope or Despair: A Response to ‘Do Not Despair About Severity—Yet’.Daniel Hausman - 2020 - Journal of Medical Ethics 46 (8):559-559.
Age and Illness Severity: A Case of Irrelevant Utilities?Borgar Jølstad & Niklas Juth - 2022 - Utilitas 34 (2):209-224.
Public Health Priority Setting: A Case for Priority to the Worse Off in Well-Being During the COVID-19 Pandemic.Sindre August Horn, Mathias Barra, Ole Frithjof Norheim & Carl Tollef Solberg - 2021 - Etikk I Praksis - Nordic Journal of Applied Ethics 2:5-15.
Bør vi diskontere fremtidige helsegevinster?Carl Tollef Solberg, Mathias Barra & Bjarne Robberstad - 2020 - Norsk Filosofisk Tidsskrift 55 (2-03):170-184.
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