Rationing, barbarity and the economist's perspective

Health Care Analysis

Volumn 4, Issue 2, 1996, Pages 146-156

  Loughlin, Michael ^b  

^a MANCHESTER METROPOLITAN UNIVERSITY   (United Kingdom)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

HEALTH CARE; HEALTH ECONOMICS; MEDICAL ETHICS; RESOURCE MANAGEMENT; SHORT SURVEY;

ANALYTICAL APPROACH; COSTS AND BENEFITS; HEALTH CARE; HEALTH CARE AND PUBLIC HEALTH; JUSTICE; RESOURCE ALLOCATION; SCARCITY; VALUES;

DECISION MAKING, ORGANIZATIONAL; ECONOMIC COMPETITION; HEALTH CARE RATIONING; HEALTH PRIORITIES; QUALITY-ADJUSTED LIFE YEARS; RESOURCE ALLOCATION; SOCIAL CHANGE; SOCIAL VALUES;

EID: 0029937215     PISSN: 10653058     EISSN: None     Source Type: Journal    
DOI: 10.1002/(SICI)1099-1042(199605)4:2<146::AID-HCA174>3.0.CO;2-U     Document Type: Short Survey

References (17)

1. Rawls, J. (1971). A Theory of Justice, Harvard University Press, Boston. Frequently authors incorporate Rawlsian assumptions into their work without an explicit statement either of the extent of the influence of Rawls, or of the highly controversial nature of his theory.
2. Loughlin, M. (1993). The strange quest for the health gain. Health Care Analysis 1(2), 165-169.
3. Zwart, M. (1993). Rationing in the Netherlands: The liberal and the communitarian perspective. Health Care Analysis 1(1), 53-56.
4. Williams, A. (1995). Economics, QALYs and medical ethics - a health economist's perspective. Health Care Analysis 3(3), 221-226.
5. Loughlin, M. (1995). The wall paper re-examined. Health Care Analysis 3(2), 127-134.
6. Loughlin, M. (1995). Bioethics and the mythology of liberalism. Health Care Analysis 3(4), 329-336.
7. Loughlin, M. (1993). The illusion of quality. Health Care Analysis 1(1), 69-73.
8. Wall, A. (1994). Behind the wallpaper a rejoinder. Health Care Analysis 2(4), 317-318.
9. Al-Assaf, A. and Schmele, J. (1993). The Textbook of Total Quality in Health Care, St Lucie Press, Delray Beach, Florida.
10. Klein, R. (1993). Dimensions of rationing: who should do what? In, Rationing in Action, BMJ Publishing Group, London. (Klein's realistic account is to be admired. It is revealing, and unfortunate, that he feels the need to make excuses for speaking the truth, and to attempt to find implications which are not so 'negative': as if his paper could not be deemed a success until he had found something positive to say.)
11. Loughlin, M. (1994). The silence of philosophy. Health Care Analysis 2(4), 310-316.
12. Loughlin, M. (1995). Dworkin, Rawls and Reality. Health Care Analysis 3(1), 37-44.
13. Williams, A. (1992). Cost-effectiveness analysis: is it ethical? Journal of Medical Ethics 18, 7-11.
14. Wall, A. (1989). Ethics and the Health Services Manager, King Edward's Hospital Fund, London.
15. Darbyshire, P. (1993). Guest editorial: Preserving nursing care in a destitute time. Journal of Advanced Nursing 18, 507-508.
16. Chadwick, R. (1993). Justice in priority setting. In, Rationing in Action, BMJ Publishing Group, London.
17. This question is far more complex than Williams' treatment of it implies. According to consequentialist moral theory it follows as a matter of logic (not 'commonsense') that what we ought to do is bring about the best consequences, however one determines what they are. Thus, Williams seems committed to some form of consequentialism, although as far as I know he offers no defence of this view. Philosophers who reject consequentialism often claim there is a logical distinction between what it is right to do and what it is 'best' (in consequential terms) to do, and that it is at least sometimes true that we ought to do what is right as opposed to what is best. Some authors who take this view appeal to arguments and illustrations which purport to show that 'commonsense' is in fact on their side.