Indlæg ved CM's (Centrum för Marxistiska Samhällsstudier) seminar i filosofi i Lund, april 1978.

The principle of need—the idea that resources should be allocated according to need—is often invoked in priority setting in the health care sector. In this article, I argue that a reasonable principle of need must be indeterminate, and examine three different ways that this can be dealt with: appendicizing the principle with further principles, imposing determinacy, or empowering decision makers. I argue that need must be conceptualized as a composite property composed of at least two factors: health shortfall and capacity (...) to benefit. When one examines how the different factors relate to each other, one discovers that this is sometimes indeterminate. I illustrate this indeterminacy in this article by applying the small improvement argument. If the relation between the factors are always determinate, the comparative relation changes by a small adjustment. Yet, if two needs are dissimilar but of seemingly equal magnitude, the comparative relation does not change by a small adjustment of one of the factors. I then outline arguments in favor of each of the three strategies for dealing with indeterminacy, but also point out that all strategies have significant shortcomings. More research is needed concerning how to deal with this indeterminacy, and the most promising path seems to be to scrutinize the position of the principle of need among a plurality of relevant principles for priority setting in the health care sector. (shrink)

Aggregating individuals’ consistent attitudes might produce inconsistent collective attitudes. Some groups therefore need the capacity to form attitudes that are irreducible to those of their members. Such groups, group-agent realists argue, are agents in control of their own attitude formation. In this paper, however, I show how group-agent realism overlooks the important fact that groups consist of strategically interacting agents. Only by eliminating group agency from our social explanations can we see how individuals vote strategically to gain control of their (...) groups and produce collective attitudes we cannot make sense of if we treat groups as agents. (shrink)

This article presents a fairness principle for evaluating decision-making based on predictions: a decision rule is unfair when the individuals directly impacted by the decisions who are equal with respect to the features that justify inequalities in outcomes do not have the same statistical prospects of being benefited or harmed by them, irrespective of their socially salient morally arbitrary traits. The principle can be used to evaluate prediction-based decision-making from the point of view of a wide range of antecedently specified (...) substantive views about justice in outcome distributions. (shrink)

Can groups really be agents or is group agency just a fiction? Christian List and Philip Pettit argue influentially for group-agent realism by showing how certain groups form and act on attitudes in ways they take to be unexplainable at the level of the individual agents constituting them. Group agency is therefore considered not a fiction or a metaphor but a reality we must account for in explanations of certain social phenomena. In this paper, I challenge this defence of group-agent (...) realism by showing how it is undermined by individual-level analysis of how individuals interact within groups. While group agency can be a useful fiction, real agents are at the individual level, not the collective level. (shrink)

Incommensurability is the impossibility to determine how two options relate to each other in terms of conventional comparative relations. This book features new research on incommensurability from philosophers who have shaped the field into what it is today, including John Broome, Ruth Chang and Wlodek Rabinowicz. The book covers four aspects relating to incommensurability. In the first part, the contributors synthesize research on the competing views of how to best explain incommensurability. Part II illustrates how incommensurability can help us deal (...) with seemingly insurmountable problems in ethical theory and population ethics. The contributors address the Repugnant Conclusion, the Mere Addition Paradox and so-called Spectrum Arguments. The chapters in Part III outline and summarize problems caused by incommensurability for decision theory. Finally, Part IV tackles topics related to risk, uncertainty and incommensurability. Value Incommensurability: Ethics, Risk, and Decision-Making will be of interest to researchers and advanced students working in ethical theory, decision theory, action theory, and philosophy of economics. (shrink)

Distributive theories evaluate distributions of goods based on candidate recipients’ characteristics, e.g. how well off candidates are, how deserving they are, and whether they fare below sufficiency. But such characteristics vary across possible worlds, so distributive theories may differ in terms of the world which for them settles candidates’ characteristics. This paper examines how distributive theories differ in terms of whether candidate recipients’ relevant characteristics are grounded in the possible world that would take place if the distributor does not intervene (...) (call it the “input” world) or if they are grounded in each possible world that the distributor can bring about through different decisions (call each an “output” world). We illustrate the importance of this distinction in relation to one distributive theory, prioritarianism. As we show, both input and output versions of prioritarianism are plausible interpretations of the literature, and there are good reasons to take input prioritarianism seriously. Ultimately, however, we argue that input prioritarianism should be rejected. (shrink)

In this paper, I argue that sufficientarian principles are indispensable in the set of principles that have bearing on issues in distributive ethics. I provide two arguments in favor of this claim. First, I argue that sufficientarianism is the only framework that allows us to appropriately analyze what sort of obligations we have toward individuals who are badly off due to their own faults and choices. Second, I argue that sufficientarianism is the only theory that provides an adequate framework for (...) thinking about the desperately badly off. (shrink)

The main purpose of this book is to introduce a broader audience to emergence by illustrating how discoveries in the physical sciences have informed the ways we think about it. In a nutshell, emergence asserts that non-reductive behavior arises at higher levels of organization and complexity. As physicist Philip Anderson put it, "more is different." Along the text's conversational tour through the terrain of quantum physics, phase transitions, nonlinear and statistical physics, networks and complexity, the author highlights the various philosophical (...) nuances that arise in encounters with emergence. The final part of the book zooms out to reflect on some larger lessons that emergence affords us. One of those larger lessons is the realization that the great diversity of theories and models, and the great variety of independent explanatory frameworks, will always be with us in the sciences and beyond. There is no "Theory of Everything" just around the corner waiting to be discovered. One of the main benefits of this book is that it will make a number of exciting scientific concepts that are not normally covered at this level accessible to a broader audience. The overall presentation, including the use of examples, analogies, metaphors, and biographical interludes, is geared for the educated non-specialist. (shrink)

Verili bir durumu anlamayı, onu bir bütün olarak kurgulamak olarak düşünelim. Kurgu basit bir gösterge de olabilir, karmaşık bir yapı da olabilir; belli belirsiz bir iz veya izler toplamı da olabilir. Kurgunun işlevini yerine getirmesini sağlayan gerek ve yeter koşul verili olan durum ile kendi yapısı arasında bir karşılaştırma olanağını sağlamasıdır. Nitekim, en bilindik anlamda bir durumu kurgulamak onu bir başka durumla karşılaştırmaktır. Bu yüzden de karşılaştırma yapmayı anlama yetimiz için ön dayanak olan bir alt-yeti olarak tanımlayabiliriz. Bu alt-yetinin edimsel (...) doğasına ilişkin bazı sorulara yanıt aramak istersek, karşılaştırma dediğimiz edimin doğal koşullarını incelememiz gerekir. Bu bildiride karşılaştırma ediminin doğal koşullarını betimlemeyi amaçlayan bir çerçeve çizmeye ve böylelikle anlama yetimizin ön dayanaklarının edimsel doğasını uygun bir biçimde nasıl yorumlayabileceğimiz sorusuna yanıt vermeye çalışacağım. (shrink)

This article analyzes approaches to nondeterminacy that suggest that one can make justified choices when primary criteria fail to fully determine a best alternative by introducing a secondary criterion. It is shown that these approaches risk violating Basic Contraction Consistency. Some ways of adjusting two-step models in order to protect against this are addressed, and it is suggested that proponents of two-step models should adopt formal conditions which qualify what counts as a permissible secondary criterion that resemble supervaluationist conditions that (...) qualify what counts as admissible precisifications of vague terms. (shrink)

Introduction: What is evil and how can we understand it? -- The theology of evil -- Theodicies -- The privation theodicy -- The free will theodicy -- The Iraenean theodicy -- The totality theodicy -- History as secular theodicy -- Job's insight-the theodicy of the hereafter -- Anthropology of evil -- Are people good or evil? -- The typologies of evil -- Demonic evil -- Evil for evil's sake -- Evil's aesthetic seduction -- Sadism -- Schadenfreude -- Subjective and objective (...) evil -- Kant and instrumental evil -- The impossibility of a "devilish" will -- The paradox of evil -- Moral rebirth -- The evil is the other-idealistic evil -- "Us" vs. "them" -- Violent individuals -- Arendt and stupid evil -- The evil and the stupid -- Radical and banal evil -- Eichmann, Hoss, and Stangl -- Normal people and extreme evil -- Thinking as opposition -- Evil people -- The problem of evil -- Theory and praxis -- Ethics of conviction and ethics of responsibility -- Politics and violence -- Evil as a concrete problem. (shrink)

Introduction -- The history of written codes of ethics -- Contemporary codes -- Media councils in the Western Hemisphere -- Journalists' responsibility for the destiny of peace -- Towards an international code of ethics -- Journalistic ethics in Latin America -- The international ethics of journalists.

This article analyses and presents a survey of ethical conflicts in prehospital emergency care. The results are based on six focus group interviews with 29 registered nurses and paramedics working in prehospital emergency care at three different locations: a small town, a part of a major city and a sparsely populated area. Ethical conflict was found to arise in 10 different nodes of conflict: the patient/carer relationship, the patient’s self-determination, the patient’s best interest, the carer’s professional ideals, the carer’s professional (...) role and self-identity, significant others and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. It is often argued that prehospital care is unique in comparison with other forms of care. However, in this article we do not find support for the idea that ethical conflicts occurring in prehospital care are unique, even if some may be more common in this context. (shrink)

A notorious problem that has recently received increased attention in axiology, normative theory and population ethics is the apparent ubiquity of what can be generally called nondeterminacy. This paper illustrates how nondeterminacy can spawn cyclical rankings. So, accepting that practical reasons can admit of nondeterminacy challenges the widely held idea that ‘better than’ is transitive. As a result, standard approaches to rational choice under nondeterminacy fail to be action-guiding, since in some situations all options are dominated, that is, impermissible according (...) to standard rational choice criteria. (shrink)

Despite the overuse of the word in movies, political speeches, and news reports, "evil" is generally seen as either flagrant rhetoric or else an outdated concept: a medieval holdover with no bearing on our complex everyday reality. In _A Philosophy of Evil_, however, acclaimed philosopher Lars Svendsen argues that evil remains a concrete moral problem: that we're all its victims, and all guilty of committing evil acts. "It's normal to be evil," he writes -- the problem is, we have (...) lost the vocabulary to talk about it. Taking up this problem -- how do we speak about evil? -- _A Philosophy of Evil_ treats evil as an ordinary aspect of contemporary life, with implications that are moral, practical, and above all, political. Because, as Svendsen says, "Evil should neither be justified nor explained away -- evil must be fought.". (shrink)

How should one understand comparisons in which neither of two alternatives is at least as good as the other? Much recent literature on comparability problems focuses on what the appropriate explanation of the phenomenon is. Is it due to vagueness or the possibility of non-conventional comparative relations such as parity? This paper argues that the discussions on how to best explain comparability problems has reached an impasse at which it is hard to make any progress. To advance the discussion we (...) suggest a new classification of comparability problems that focuses on the problems they cause for practical reasoning. (shrink)

Parker’s article is a welcome attempt to address the importance of environmental sustainability in the realm of clinical ethics.1 We support the recent movement to seriously consider the environmental impact of healthcare institutions in bioethics.2 3 Still, we find two partly linked weaknesses of Parker’s analysis and guideline suggestion. These relate to a need in ‘green’ bioethics to see beyond the normal healthcare ethical focus on health-related values related to individual patients, and to primarily adopt institutional ways of framing central (...) decision problems. Traditional bioethics applies a restricted scope of values to assess clinical decisions: primarily health-related patient well-being (including life) and patient autonomy. If a decision improves (or, as in Parker’s inhaler case, maintains) a patient’s health-related well-being, this supports it. However, if a decision improves a patient’s non health-related well-being, say, winning a beauty contest or securing a job by having cosmetic surgery, it is not supported. And so on. This idea of healthcare as, in Michael Walzer’s classic terminology, a separate ‘sphere of justice’ has two interrelated limitations: it reflects a bias towards individual patients over other people, and it restricts the scope of values allowed to influence healthcare ethical judgements. These limitations appear once we see that the issue addressed by Parker can be framed either as prescription decisions taken by individual doctors against the background of …. (shrink)

How should states and international organizations allocate global health resources? This paper examines proposals for distributing these resources in the literature. First, we look at the literature on the metrics for measuring what matters and consider how they might be modified to avoid some common objections—e.g., that these measures discriminate against the disabled or fail to give due weight to helping the young (or old) or those in present (or future) generations. Second, we canvas existing approaches to evaluating allocations of (...) health‐related resources utilizing such measures and advance a new way of doing so. We suggest that it is important to provide substantive arguments for directly evaluating alternative allocations, but there is also room for deliberation about fair procedures for selecting allocation criteria and securing just outcomes. (shrink)

Lifetime quality-adjusted life-year (QALY) prioritarianism has recently been defended as a reasonable specification of the prioritarian view that benefits to the worse off should be given priority in health-related priority setting. This paper argues against this view with reference to how it relies on implausible assumptions. By referring to lifetime QALY as the basis for judgments about who is worse off lifetime QALY prioritarianism relies on assumptions of strict additivity, atomism and intertemporal separability of sublifetime attributes. These assumptions entail that (...) a health state at some period in time contributes with the same amount to how well off someone is regardless of intrapersonal and interpersonal distributions of health states. The paper argues that this is implausible and that prioritarians should take both intrapersonal and interpersonal distributions of goods into account when they establish who is worse off. They should therefore not accept that lifetime QALY is a reasonable ground for ascribing priority and reject lifetime QALY prioritarianism. (shrink)

Much research aimed at developing measures for normative criteria to guide the assessment of healthcare resource allocation decisions has focused on health maximization, equity concerns and more recently approaches based on health capabilities. However, a widely embraced idea is that health resources should be allocated to meet health needs. Little attention has been given to the principle of need which is often mentioned as an alternative independent criteria that could be used to guide healthcare evaluations. This paper develops a model (...) and indicator of need satisfaction that aggregates the health needs of a population in a particular time period into a single measure that weights individual health needs by the severity of their ill health. The paper provides a first step towards formalizing the principle of need as a measurable objective for healthcare policy and we discuss some challenges for future research, including incorporating the duration of time into need-based health evaluations. (shrink)

A notorious debate in the ethics of healthcare rationing concerns whether to address rationing decisions with substantial principles or with a procedural approach. One major argument in favour of procedural approaches is that substantial principles are indeterminate so that we can reasonably disagree about how to apply them. To deal with indeterminacy, we need a just decision process. In this paper I argue that it is a mistake to abandon substantial principles just because they are indeterminate. It is true that (...) reasonable substantial principles designed to deal with healthcare rationing can be expected to be indeterminate. Yet, the indeterminacy is only partial. In some situations we can fully determine what to do in light of the principles, in some situations we cannot. The conclusion to draw from this fact is not that we need to develop procedural approaches to healthcare rationing, but rather that we need a more complex theory in which both substantial principles and procedural approaches are needed. (shrink)

This article presents an approach to how to make reasonable social choices when independent criteria (e.g., prioritarianism, religious freedom) fail to fully determine what to do. The article outlines different explanations of why independent criteria sometimes fail to fully determine what to do and illustrates how they can still be used to eliminate ineligible alternatives, but it is argued that the independent criteria cannot ground a reasonable social choice in these situations. To complement independent criteria when they fail to fully (...) determine what to do, it is suggested that society must engage in public deliberation by way of generating new reasons that can determine how to rank the alternatives. It is suggested that the approach to social choice presented here reveals a way of accepting the relevance of independent criteria for social choice without letting go of the idea that the attitudes of affected parties matter. (shrink)

This paper argues that decision problems and money-pump arguments should not be a deciding factor against accepting non-transitive better than relations. If the reasons to accept normative standpoints that entail a non-transitive better than relation are compelling enough, we ought to revise our decision method rather than the normative standpoints. The paper introduces the most common argument in favor of non-transitive better than relations. It then illustrates that there are different ways to reconceptualize rational choice so that rational choice is (...) possible also when the relevant better than relation is non-transitive. (shrink)

How should scarce health-related resources be allocated? This paper argues that values that apply to these decisions fail to always fully determine what we should do. Health maximization and allocation-according-to-need are suggested as two values that should be part of a general theory of how to allocate health-related resources. The “small improvement argument” is used to argue that it is implausible that one alternative is always better, worse, or equal to another alternative with respect to these values. Approaches that rely (...) on these values are thus incomplete. To deal with this, it is suggested that we ought to use incomplete theories in a two-step process. Such a process first discards ineligible alternatives, and, second, uses reasons grounded in collective commitments to identify a unique, best alternative in the remaining set. (shrink)

A moralised conception of freedom is based on a normative theory. Understanding it therefore requires an analysis of this theory. In this paper, I show how republican freedom as non-domination is moralised, and why analysing this concept therefore involves identifying the basic components of the republican theory of justice. One of these components is the non-moralised pure negative conception of freedom as non-interference. Republicans therefore cannot keep insisting that their freedom concept conflicts with, and is superior to, this more basic (...) concept. I demonstrate how we can use pure negative freedom to formulate the republican theory more precisely. This exercise is more fruitful than the common focus on the alleged conflict between the two freedom concepts. (shrink)

Hannah Arendt and Theodor W. Adorno, two of the most influential political philosophers and theorists of the twentieth century, were contemporaries with similar interests, backgrounds, and a shared experience of exile. Yet until now, no book has brought them together. In this first comparative study of their work, leading scholars discuss divergences, disclose surprising affinities, and find common ground between the two thinkers. This pioneering work recovers the relevance of Arendt and Adorno for contemporary political theory and philosophy and lays (...) the foundation for a critical understanding of political modernity: from universalistic claims for political freedom to the abyss of genocidal politics. (shrink)

Public reason liberals expect individuals to have justificatory reasons for their views of certain political issues. This paper considers how groups can, and whether they should, give collective public reasons for their political decisions. A problem is that aggregating individuals’ consistent judgments on reasons and a decision can produce inconsistent collective judgments. The group will then fail to give a reason for its decision. The paper considers various solutions to this problem and defends a deliberative procedure by showing how it (...) incentivizes information sharing and leads to outcomes most acceptable to the group members. (shrink)

The revival of republicanism was meant to challenge the hegemony of liberalism in contemporary political theory on the grounds that liberals show insufficient concern with institutional protection against political misrule. This article challenges this view by showing how neorepublicanism, particularly on Philip Pettit’s formulation, demands no greater institutional protection than does political liberalism. By identifying neutrality between conceptions of the good as the constraint on institutional requirements that forces neorepublicanism into the liberal framework, the article shows that neutrality is what (...) neorepublicans must jettison to offer a tenable critique of liberalism. Only then can neorepublicans ensure greater protection against misrule by demanding that citizens participate more actively in politics. They can then also criticize liberalism for failing to appreciate the importance of such protection. (shrink)

Institutions promoting republican freedom as non-domination are commonly believed to differ significantly from institutions promoting negative freedom as non-interference. Philip Pettit, the most prominent contemporary defender of this view, also maintains that these republican institutions are neutral between the different conceptions of the good that characterise a modern society. This paper shows why these two views are incompatible. By analysing the institutional requirements Pettit takes as constitutive of republican freedom, I show how they also promote negative freedom by reducing overall (...) interference. To avoid this result, republican institutions must be more restrictive and require that citizens conform to a life of political engagement. But then republican freedom will not be a neutral ideal. Rejecting negative freedom therefore means sacrificing neutrality. (shrink)

This article is a response to Thomas David Riisfeldt’s paper entitled ‘Weakening the ethical distinction between euthanasia, palliative opioid use and palliative sedation’. It is shown that as far as euthanasia and palliative sedation are concerned, Riisfeldt has not established that a common ground, or a similarity, between the two is the relief of suffering. Quite the contrary, this is not characteristic of euthanasia, neither by definition nor from a clinical point of view. Hence, the argument hinges on a conceptually (...) and empirically erroneous premise and is accordingly a non-starter. (shrink)

In 1997 John Broome presented the Collapsing Argument that was meant to establish that non-conventional comparative relations cannot exist. Broome's argument has faced a lot of scrutiny and a certain type of counterexample has been used to undermine it. Most of the counterexamples focus on the Collapsing Principle which plays a central role in Broome's argument. In this article we will take a closer look at the most common type of counterexample and propose how to adjust the Collapsing Principle in (...) order to avoid objections based on these counterexamples. We argue that a weaker version of the Collapsing Principle is not susceptible to the classical counterexamples. Furthermore, after an explorative discussion about the intuitions behind the original principle, we show that this weaker formulation is at least as intuitive as the principle suggested by Broome. (shrink)

This article argues that values that apply to health care allocation entail the possibility of “spectrum arguments,” and that it is plausible that they often fail to determine a best alternative. In order to deal with this problem, a two-step process is suggested. First, we should identify the Strongly Uncovered Set that excludes all alternatives that are worse than some alternatives and not better in any relevant dimension from the set of eligible alternatives. Because the remaining set of alternatives often (...) contain more than one element, we need some complementary method of selecting a unique alternative. In order to address this issue, I suggest that we must invoke caps on the values that are used to evaluate alternatives, and that these caps must be grounded in collective commitments. (shrink)

In the debate on how we ought to define political freedom, some definitions are criticized for implying that no one can ever be free to perform any action. In this paper, I show how the possibility of freedom depends on a definition that finds an appropriate balance between absence of interference and protection against interference. To assess the possibility of different conceptions of freedom, I consider the trade-offs they make between these two dimensions. I find that pure negative freedom is (...) clearly possible. Republican freedom might also be possible, though its protection requirement is too vague for a definitive verdict. Finally, the recently proposed ‘freedom as independence’ is impossible since it is an attempt to avoid the unavoidable trade-off. (shrink)

According to Niklas Luhmann, causality is both an impossibility and a necessity in education. On the one hand, the task of the teacher is an impossible one, because teaching as communication is a closed system that cannot determine the learning of pupils' psychical system in any causal sense. On the other hand, one cannot practice as a teacher without a belief in causality, i.e., in a causal connection between teaching and learning. In his article “The Child as the Medium of (...) Education,” Luhmann focuses on the enablement of education, despite its impossibility. His answer is that one thing that makes education possible is the emergence of the symbolically generalized medium “the child.” In this article, Lars Qvortrup focuses on Luhmann's understanding of causality. According to Luhmann, causality is not a simple, ontological fact, but the result of the attribution of certain causes to certain effects. The conclusion is that causality as an attribution category — and not causality as an ontological fact — is another thing that makes education possible. Qvortrup also concludes, however, that Luhmann is not alone in criticizing the traditional, mechanical concept of causality. Other contemporary philosophers and sociologists have pointed out that in order to analyze causality in complex social systems, one has to select some causal factors and ignore others. While others do this based on seemingly pure scientific and statistical criteria, Luhmann focuses on attribution as a social construction of causality. (shrink)

This study examined the influence of two organizational context variables, codes of conduct and supervisor advice, on personnel decisions in an experimental simulation. Specifically, we studied personnel evaluations and decisions in a situation where codes of conduct conflict with supervisor advice. Past studies showed that supervisors’ advice to prefer ingroup over outgroup candidates leads to discriminatory personnel selection decisions. We extended this line of research by studying how codes of conduct and code enforcement may reduce this form of discrimination. Eighty (...) German managers evaluated and selected candidates from an applicant pool including Germans (ingroup members) and foreigners (outgroup members). Supervisor advice to prefer ingroup members lowered suitability ratings of outgroup members as well as their chances to be selected for an interview. Ethical codes of conduct referring to equal opportunities limited this form of discrimination, but only when codes were enforced by sanctions and integrated into organizational every-day practice. The implications of these findings for research and practice are discussed. (shrink)

This article addresses the prioritization questions that arise when people attempt to institutionalize reasonable ethical principles and create guidelines for microlevel decisions. I propose that this instantiates an incommensurability problem, and suggest two different kinds of practical solutions for dealing with this issue.

This article shows that introducing the positive comparative relation parity only helps one block so‐called “Spectrum Arguments” in order to avoid their unsavoury implications if one specifies parity in a specific way with respect to its persistence. The article illustrates how parity must both admit of persistency and be weakly non‐persistent for parity to block Spectrum Arguments, and identifies some consequences of that discovery for the general debate on Spectrum Arguments, value theory and comparability problems.

This paper shows that versions of prioritarianism that focus at least partially on well-being levels at certain times conflict with conventional views of prudential value and prudential rationality. So-called timeslice prioritarianism, and pluralist views that ascribe importance to timeslices, hold that a benefit matters more, the worse off the beneficiary is at the time of receiving it. We show that views that evaluate outcomes in accordance with this idea entail that an agent who delays gratification makes an outcome worse, even (...) if it is better for the agent and worse for no one else. We take this to show that timeslice prioritarianism and some pluralist views violate Weak Pareto, and we argue that these versions of prioritarianism are implausible. (shrink)

This paper argues that cost-effectiveness analysis in the healthcare sector introduces a discrimination risk that has thus far been underappreciated and outlines some approaches one can take toward this. It is argued that appropriate standards used in cost-effectiveness analysis in the healthcare sector fail to always fully determine an optimal option, which entails that cost-effectiveness analysis often leaves decision makers with large sets of permissible options. Larger sets of permissible options increase the role of decision makers’ biases, whims, and prejudices, (...) which means that the discrimination risk increases. Two ways of mitigating this are identified: tinkering with standards used in the cost-effectiveness analysis and outlining anti-discrimination guidelines for decision makers. (shrink)