- In Pursuit of Justice for Disability: Model Neutrality Revisited
- Theoretical Strategies to Define Disability
- Disability, Health, and Difference
- Habilitative Health and Disability
- Philosophy and the Apparatus of Disability
- Disability Liberation Theology
- Disabilities and Well-Being: The Bad and the Neutral
- Causing Disability, Causing Non-Disability: What’s the Moral Difference?
- Why Inflicting Disability is Wrong: The Mere-Difference View and the Causation-Based Objection
- Evaluative Diversity and the (Ir)Relevance of Well-Being
- Contractualism, Disability, and Inclusion
- Civic Republican Disability Justice
- Disability and Disadvantage in the Capabilities Approach
- Disability and Partial Compliance Theory
- Fair Difference of Opportunity
- The Disability Case Against Assisted Dying
- Epistemic Exclusion, Injustice, and Disability
- What’s Wrong with “You Say You’re Happy, but … ” Reasoning?
- Interactions with Delusional Others: Reflections on Epistemic Failures and Virtues
- Disability, Rationality, and Justice: Disambiguating Adaptive Preferences
- Ideals of Appreciation and Expressions of Respect
- The Limiting Role of Respect
- Respect, Identification, and Profound Cognitive Impairment
- Care and Disability: Friends or Foes
- A Dignitarian Approach to Disability: From Moral Status to Social Status
- Cognitive Disability and Moral Status
- Dignity, Respect, and Cognitive Disability
- On Moral Status and Intellectual Disability: Challenging and Expanding the Debates
- Neurodiversity, Autism, and Psychiatric Disability: The Harmful Dysfunction Perspective
- Educational Justice for Students with Intellectual Disabilities
- A Symmetrical View of Disability and Enhancement
- Cognitive Disability and Embodied, Extended Minds
- The Visible and the Invisible: Disability, Assistive Technology, and Stigma
- Neurotechnologies and Justice by, with, and for Disabled People
- Second Thoughts on Enhancement and Disability
- Cost-Effectiveness Analysis and Disability Discrimination
- Prioritization and Parity: Which Disabled Newborn Infants Should Be Candidates for Scarce Life-Saving Treatment?
- Why People with Cognitive Disabilities Are Justified in Feeling Disquieted by Prenatal Testing and Selective Termination
- Reproductive Choice in Context: Avoiding Excess and Deficiency?
- Bioethics, Disability, and Selective Reproductive Technology: Taking Intersectionality Seriously
- Procreation and Intellectual Disability: A Kantian Approach
- Parental Autonomy, Children with Disabilities, and Horizontal Identities
- Beyond Instrumental Value: Respecting The Will of Others and Deciding On Their Behalf
Abstract and Keywords
Public healthcare systems face challenging questions about how to allocate limited medical resources. Which patients should receive treatment? Could it be ethical to ration treatment on the basis of a preexisting disability? This chapter focuses on newborn infants and uses as an example one highly intensive and costly treatment—extracorporeal membrane oxygenation (ECMO). It distinguishes treatment-level from patient-level prioritization. Triage decisions (where two or more patients present simultaneously) are compared with threshold decisions (a determination for a single patient that treatment is worth providing). A central ethical question raised by patient-level prioritization is whether it is possible to balance fairness with benefit. The chapter describes one way of balancing principles through the concept of parity and explores ways to develop practically applicable parity thresholds. It is argued that disabled patients with a predicted benefit of treatment above the parity threshold should receive equal access to treatments like ECMO.
Dominic Wilkinson is Director of Medical Ethics and Professor of Medical Ethics at the Oxford Uehiro Centre for Practical Ethics, University of Oxford. He is also a consultant in newborn intensive care at the John Radcliffe Hospital, Oxford. Dominic is editor of the Journal of Medical Ethics, Journal of Practical Ethics, and is the author of ‘Death or Disability? The ‘Carmentis Machine’ and decision-making for critically ill children’ (OUP 2013).
Julian Savulescu is the Uehiro Chair in Practical Ethics and Director of the Oxford Uehiro Centre for Practical Ethics at Oxford University. Previously, he was Director of the Ethics of Genetics Unit at the Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia. Julian Savulescu is qualified in medicine, bioethics, and analytic philosophy. He has published many articles in journals such as the British Medical Journal, Lancet, Australasian Journal of Philosophy, Bioethics, the Journal of Medical Ethics, American Journal of Bioethics, Medical Journal of Australia and Philosophy, and Psychiatry and Psychology. Address is Oxford Uehiro Centre for Practical Ethics, Littlegate House, St Ebbes, Oxford, OX1 1PT, UK. Email: firstname.lastname@example.org
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