Are clinical practice guidelines impartial?

Int J Technol Assess Health Care. 2004 Fall;20(4):415-20. doi: 10.1017/s0266462304001291.


In A Theory of Justice, John Rawls demands from citizens who decide upon principles of justice and the rules derived from such principles that they abstract from all particularities that constitute their identity as unique individuals. This demand is unrealistic in policy settings where actual policy-makers convene to provide guidance, establish rules regarding public good, and enact legislation. In practice, I argue, policy-makers, legislators, and others involved in developing social rules that pertain to distributive justice formulate such rules as reasonably partial spectators. To illustrate, I show how clinical practice guidelines are established and mediated by a reasonably partial expert panel whose partial action is publicly justifiable, yet whose claims to impartiality are not.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Costs and Cost Analysis
  • Ethics, Medical*
  • Health Care Rationing / economics
  • Health Care Rationing / ethics
  • Health Policy
  • Practice Guidelines as Topic*
  • Social Justice / economics
  • Social Justice / ethics