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date: 23 October 2019

Abstract and Keywords

This chapter examines the ethics of healthcare rationing based on the definition of “rationing” as a policy or practice of consciously limiting access to medical interventions of known benefit. It first considers the different types of healthcare rationing and the factors that influence how the various policies and practices that involve rationing are sorted out. It then places the wide range of rationing policies and practices in a three-dimensional topographic space before turning to a discussion of the principal strategies for making such policies “ethical.” Four principles are explored—beneficence, nonmaleficence, respect for persons, and justice—along with the competition between the concepts of utilitarian distribution versus allocation. This chapter argues that rationing involves not a single but multiple realities and that we need to determine whether the benefits of rationing inherent in policies developed for other reasons justify the costs of that rationing.

Keywords: ethics, healthcare rationing, medical interventions, healthcare policies, beneficence, nonmaleficence, respect for persons, justice, utilitarian distribution, healthcare allocation

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