|Title / Titel||Towards an Integrative Model of Allocative Health Care Justice: Egalitarianism, Prioritarianism, Sufficientarianism|
|Abstract (PDF, 14 KB)|
|Summary / Zusammenfassung||The main purpose of the project is to identify and defend a model of justice which can be applied to health care resource allocation. A primary debate within the field of social justice concerns the value of equality. Is equality in itself valuable? Those who claim ‘yes’ can be said to support egalitarianism. Alternatively, some argue that the aim of social justice is to achieve the best possible level of advantage for the worst off (prioritarianism) or to achieve an ‘adequate’ level of advantage (sufficientarianism). This debate can also be applied specifically to health justice – are we aiming for equality, priority or sufficiency in health or health care, or a combination of these values? This project aims to define and assess egalitarianism, prioritarianism and sufficientarianism, and to apply this assessment to the development of an ethical framework for the fair distribution of health care resources. This ethical framework will be used to evaluate two specific problems of health care resource allocation and rationing:
(i) Which benefits should be included and excluded from basic health care packages as a matter of justice?
(ii) Is explicit age-based rationing fair (this form of rationing prioritises health care resources for younger over older people on the basis of age)?
Research proceeds from the hypothesis that the requisite model will not be monistic in form, but will instead incorporate elements of egalitarianism, sufficientarianism and prioritarianism. Part 1 of research will examine whether equality should indeed be considered to be an aim of social justice. A significant aspect of answering this question will be in specifying different forms of equality, and particularly in distinguishing distributive from social equality. Part 2 of research will analyse whether health justice is best represented by equality, priority or sufficiency of health, or which combination of these values need to be integrated into a model of health justice. While sufficiency of health seems to be the most convincing basis for a model of health justice, the significance of equality and priority are not ruled out. For example, while sufficiency in health is morally most urgent, equality or priority could be significant above the sufficiency threshold. Part 3 of research will apply the model that develops from Parts 1-2 to the normative justification of the benefits of health care packages and the fairness of explicit age-based rationing.
The following papers and book contributions have been published:
1. Fourie, C., 2012a. What is Social Equality? An Analysis of Status Equality as a Strongly Egalitarian Ideal. Res Publica, 18(2), pp.107–126.
2. Fourie, C., 2012b. What Do Theories of Social Justice Have to Say about Health Care Rationing? Well-Being, Sufficiency and Explicit Age-Rationing. In A. den Exter & M. Buijsen, eds. Rationing Health Care. Hard Choices and Unavoidable Trade-offs. Antwerpen: Maklu, pp. 65–86.
|Keywords / Suchbegriffe||Equality, priority, sufficiency, health care, justice|
|Project leadership and contacts /
Projektleitung und Kontakte
|Funding source(s) /
|SNF (Personen- und Projektförderung)
|Duration of Project / Projektdauer||Oct 2008 to Dec 2012|