Principles of justice in health care rationing

Title: Principles of justice in health care rationing
Authors: Cookson, Richard and Dolan, Paul
Publisher: Journal of medical ethics, 26 (5). pp. 323-329
ISSN: 0306-6800
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Abstract: This paper compares and contrasts three different substantive (as opposed to procedural) principles of justice for making health care priority-setting or “rationing” decisions: need principles, maximising principles and egalitarian principles. The principles are compared by tracing out their implications for a hypothetical rationing decision involving four identified patients. This decision has been the subject of an empirical study of public opinion based on small-group discussions, which found that the public seem to support a pluralistic combination of all three kinds of rationing principle. In conclusion, it is suggested that there is room for further work by philosophers and others on the development of a coherent and pluralistic theory of health care rationing which accords with public opinions.