Should organ transplants be given to patients who have waited the longest, or need it most urgently, or those whose survival prospects are the best? The rationing of health care is universal and inevitable, taking place in 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 and much-needed introduction to this increasingly important topic, considering and assessing the major ethical problems and dilemmas about the allocation, scarcity and rationing of health care. Beginning with a helpful overview of why rationing is an ethical problem, the authors examine the following key topics:
- What is the value of health? How can it be measured?
- What does it mean that a treatment is "good value for money"?
- What sort of distributive principles - utilitarian, egalitarian or prioritarian - should we rely on when thinking about health care rationing?
- Does rationing health care unfairly discriminate against the elderly and people with disabilities?
- 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 US, UK and other countries are used to illustrate the ethical issues at stake. Additional features such as chapter summaries, annotated further reading and discussion questions make 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.
Table of Contents
Introduction 1. Ethics and Health Care 2. The Value of Health 3. Ethics and Cost-Effectiveness 4. Problems of Discrimination 5. The Aggregation of Health Benefits 6. Responsibility for Health Conclusion. Index
Greg Bognar is a University Lecturer in the Department of Philosophy at Stockholm University, Sweden.
Iwao Hirose is Associate Professor at the Philosophy Department and the School of Environment, McGill University, Canada. He is the author of Egalitarianism (Routledge, 2014) and Moral Aggregation (2014), and a co-editor of The Oxford Handbook of Value Theory (2014) and Weighing and Reasoning (2014).
"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