2nd Edition

The Ethics of Health Care Rationing An Introduction

By Greg Bognar, Iwao Hirose Copyright 2022
    202 Pages 4 B/W Illustrations
    by Routledge

    202 Pages 4 B/W Illustrations
    by Routledge

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    The rationing of health care is universal and inevitable, taking place in both poor and affluent countries, in publicly funded and private health care systems. Someone must budget for as well as dispense health care whilst aging populations severely stretch the availability of resources.

    The Ethics of Health Care Rationing is a clear, timely, and much-needed introduction to this important topic. Substantially revised and updated, this second edition includes new chapters on disability discrimination and age discrimination, and on the price of drugs and medical therapies. Beginning with a helpful overview of why rationing is an ethical problem, the authors examine the following key topics:

    • What sort of distributive principles should we rely on when thinking about health care rationing?
    • What is the relation between ethics and cost-effectiveness in health care?
    • How should we think about controversies surrounding discrimination over disability and age?
    • How should we approach controversies surrounding rationing and the price of pharmaceutical drugs and medical therapies?
    • Should patients be held responsible for their health?
    • Why does the debate on responsibility for health lead to issues about socioeconomic status and social inequality?

    Throughout the book, examples from the United States, the United Kingdom, and other countries are used to illustrate the ethical issues at stake. Additional features such as chapter summaries, annotated further reading, and discussion questions have also been updated, making this an ideal starting point for students new to the subject, not only in philosophy but also in closely related fields such as politics, health economics, public health, medicine, nursing and social work.

    Preface to the second edition


    1. Ethics and health care

    2. The value of health

    3. Ethics and cost-effectiveness

    4. Disability discrimination

    5. The question of age

    6. The aggregation of health benefits

    7. Responsibility for health

    8. The price of drugs






    Greg Bognar is Senior Lecturer in Practical Philosophy at Stockholm University and Senior Researcher at the Stockholm Centre for Healthcare Ethics (CHE), Sweden. He is currently working on an edited volume with Axel Gosseries on the ethics of age limits and age discrimination.

    Iwao Hirose is Professor and Canada Research Chair in Value Theory and the Philosophy of Public Policy at McGill University, Canada. He is the author of Egalitarianism (Routledge, 2015) and Moral Aggregation (2015), and a coeditor of The Oxford Handbook of Value Theory (2015) and Weighing and Reasoning (2015).

    Praise for the First Edition

    'Most contemporary publications related to health care rationing are written for specialized, often academic, audiences, but this work is an introduction to the topic for general readers. It is accessible to those with no prior knowledge of philosophy, bioethics, or health policy. Suggested readings are available at the end of each chapter for both new and advanced readers to explore chapter topics in more depth. Summing Up: Recommended. All health sciences students, researchers/faculty, professionals/practitioners, and general readers.' - M. L. Charleroy, CHOICE

    'Against the background of ineluctable scarcity in healthcare resources, this important, accessible and provocative book introduces readers to pressing issues concerning how, morally speaking, we ought to determine who gets what. If we want an informed public debate on healthcare rationing, I don’t know of a better place to start.' - Samuel Kerstein, University of Maryland, USA

    'A great introduction to the field, combining philosophical sophistication with economic literacy to deliver profound insights into the resource allocation dilemmas facing health care decision makers. A valuable resource for students and health professionals alike.' - Richard Cookson, University of York, UK

    'Bognar and Hirose illuminate and make accessible the most pressing and entrenched controversies in health care rationing. This book spans political philosophy, health economics and bioethics, grounding arguments in vividly described cases. It delivers complex ideas in a relaxed style perfectly suited to drawing us all in to a long overdue common inquiry.' - Monique Jonas, University of Auckland, New Zealand 

    'The Ethics of Health Care Rationing is…a ‘must read’ for students of bioethics and other interested parties, as it sheds a light on issues that we often tend to avoid or ignore in our field. Moreover, it is an agreeable read and the mix of real-life and fictional examples works particularly well.' - Kristien Hens, Ethical Perspectives