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Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 2000 Oct;26(5):323–329. doi: 10.1136/jme.26.5.323

Principles of justice in health care rationing

R Cookson 1, P Dolan 1
PMCID: PMC1733291  PMID: 11055033

Abstract

This paper compares and contrasts three different substantive (as opposed to procedural) principles of justice for making health care priority-setting or "rationing" decisions: need principles, maximising principles and egalitarian principles. The principles are compared by tracing out their implications for a hypothetical rationing decision involving four identified patients. This decision has been the subject of an empirical study of public opinion based on small-group discussions, which found that the public seem to support a pluralistic combination of all three kinds of rationing principle. In conclusion, it is suggested that there is room for further work by philosophers and others on the development of a coherent and pluralistic theory of health care rationing which accords with public opinions.

Key Words: Health care • rationing • medical ethics • justice • need

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Selected References

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