Justice and the allocation of healthcare resources: should indirect, non-health effects count? [Book Review]

Medicine, Health Care and Philosophy 13 (3):237-246 (2010)
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Alternative allocations of a fixed bundle of healthcare resources often involve significantly different indirect, non-health effects. The question arises whether these effects must figure in accounts of the conditions under which a distribution of healthcare resources is morally justifiable. In this article we defend a Scanlonian, affirmative answer to this question: healthcare resource managers should sometimes select an allocation which has worse direct, health-related effects but better indirect, nonhealth effects; they should do this when the interests served by such a policy are more urgent than the healthcare interests better served by an alternative allocation. We note that there is a prima facie case for the claim that such benefits (and costs) are relevant—i.e. they are real benefits, and in other contexts our decisions can permissibly be guided by them. We then proceed to rebut three lines of argument that might be thought to defeat this prima facie case: they appeal to fairness, the Kantian Formula of Humanity as an End in Itself, and the equal moral worth of persons, respectively



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References found in this work

What we owe to each other.Thomas Scanlon - 1998 - Cambridge, Mass.: Belknap Press of Harvard University Press.
What We Owe to Each Other.Thomas Scanlon - 2002 - Mind 111 (442):323-354.
What is the point of equality.Elizabeth Anderson - 1999 - Ethics 109 (2):287-337.
Creating the Kingdom of Ends.Christine M. Korsgaard - 1996 - New York, NY, USA: Cambridge University Press.

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