Rationing fairly: programmatic considerations

Bioethics. 1993 Apr;7(2-3):224-33. doi: 10.1111/j.1467-8519.1993.tb00288.x.


I conclude with a plea against provincialism. The four problems I illustrated have their analogues in the rationing of goods other than health care. To flesh out a principle that says "people are equal before the law" will involve decisions about how to allocate legal services among all people who can make plausible claims to need them by citing that principle. Similarly, to give content to a principle that assures equal educational opportunity will involve decisions about resource allocation very much like those involved in rationing health care. Being provincial about health care rationing will prevent us from seeing the relationships among these rationing problems. Conversely, a rationing theory will have greater force if it derives from consideration of common types of problems that are independent of the kinds of goods whose distribution is in question. I am suggesting that exploring a theory of rationing in this way is a prolegomenon to serious work in "applied ethics."

MeSH terms

  • Civil Rights
  • Cost-Benefit Analysis
  • Decision Making*
  • Delivery of Health Care
  • Democracy
  • Disabled Persons
  • Health Care Rationing*
  • Humans
  • Oregon
  • Patient Selection*
  • Prejudice
  • Prognosis
  • Public Policy*
  • Quality of Life
  • Quality-Adjusted Life Years
  • Resource Allocation*
  • Social Justice*
  • Social Values
  • State Government
  • Value of Life