by Cristina Fernandez-Garcia
Discussions on the prioritisation of healthcare are marred by disagreements on what should count as a fair distribution of resources. Ethical discourse is sometimes used in an attempt to solve disputes on the use of these scarce resources. However, principles of justice often conflict with each other when used in procedural (1) or deliberative approaches to prioritisation. Giving priority to the worst off (2) could clash with the sufficientarian ethos, which advocates enough resources for everyone, (3) and luck egalitarian concerns designed to counteract the distributive effects of luck (4), whilst utilitarian approaches (5), focusing on the maximising overall wellbeing, can lead to the exclusion of those in most need of medical care. It has been argued that one way to break the deadlock caused by these conflicting views on justice is to involve the public and introduce the values and opinions of those directly affected by rationing into the decision making process.
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