Articles and Chapters

1. Sreenivasan, G, Why justice requires rationing in health care, in Medicine and Social Justice, edited by Rhodes, R; Silvers, A (2012), pp. 143-153, Oxford [doi].
   (last updated on 2024/04/19)

   Abstract:
   This chapter explains why justice requires rationing in health care, arguing that justice not only permits but in principle requires a national health scheme to deny some people some effective medical treatment they need. The basic moral structure of a national health care system is defined by its answers to two questions: whom to treat and which medical services to offer (to those whom the system treats). At first glance, the most compelling answers to these questions are the simplest ones, namely, "everyone" and "everything." Or, a little more precisely, "everyone, without regard to her ability to pay" and "every effective medical service that a sick person needs." This chapter contends that the second answer is actually mistaken. Not only does morality- or, more specifically, justice- permit a national health care system to deny some sick people some effective medical services that they need, but it positively requires as much. The chapter also compares the "rationing" approach to what it calls the "reverse-engineered" approach and describes premises that are required to reach the conclusion that justice requires health care rationing.