The Ethics of Health Care Rationing: an Introduction

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.

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).