TY - JOUR
T1 - Can Rationing through Inconvenience Be Ethical?
AU - Eyal, Nir
AU - Romain, Paul L.
AU - Robertson, Christopher
N1 - Funding Information:
We also wish to thank Maryanne Chege, Michael Gill, Kasper Lippert-Rasmussen, Holly Fernandez-Lynch, Margaret McConnell, Ole Norheim, Thomas Søbirk Petersen, Leah Price, Jesper Ryberg, Richard Zeckhauser, and audiences at the American Society for Bioethics and the Humanities 2016 annual conference; the Clinical Bioethics Committee at University Medical Center, Tucson, Arizona; Harvard Law School’s Petrie-Flom Center; and the Edward J. Safra 30th Anniversary conference at Harvard University. Nir Eyal’s work was partly funded by the Rector’s award from Roskilde University, Denmark.
Publisher Copyright:
© 2018 The Hastings Center
PY - 2018/1/1
Y1 - 2018/1/1
N2 - In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.
AB - In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under certain conditions, rationing through inconvenience may turn out to serve as a legitimate and, compared to direct rationing, even a preferable tool for rationing; we propose a research agenda to identify more precisely when that might be the case and when, alternatively, rationing through inconvenience remains ethically undesirable. After defining and illustrating rationing through inconvenience, we turn to its moral advantages and disadvantages over other rationing methods. We take it as a starting assumption that rationing, understood as scarce-resource prioritization, is inevitable and, in a society that has goals beyond optimizing health care for individual patients—such as improving societal health care, education, or overall welfare—prudent and fair.
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U2 - 10.1002/hast.806
DO - 10.1002/hast.806
M3 - Article
C2 - 29457241
AN - SCOPUS:85042218793
VL - 48
SP - 10
EP - 22
JO - Hastings Center Report
JF - Hastings Center Report
SN - 0093-0334
IS - 1
ER -