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dc.creatorGoold, Susan D.en
dc.date.accessioned2015-05-05T18:57:18Zen
dc.date.available2015-05-05T18:57:18Zen
dc.date.created1996en
dc.date.issued1996en
dc.identifier10.1215/03616878-21-1-69en
dc.identifier.bibliographicCitationJournal of Health Politics, Policy and Law. 1996 Spring; 21(1): 69-98.en
dc.identifier.issn0361-6878en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=Allocating+Health+Care:+Cost-Utility+Analysis,+Informed+Democratic+decision+Making,+or+the+Veil+of+Ignorance?&title=Journal+of+Health+Politics,+Policy+and+Law.++&volume=21&issue=1&pages=69-98&date=1996&au=Goold,+Susan+D.en
dc.identifier.urihttp://dx.doi.org/10.1215/03616878-21-1-69en
dc.identifier.urihttp://hdl.handle.net/10822/748892en
dc.description.abstractAssuming that rationing health care is unavoidable, and that it requires moral reasoning, how should we allocate limited health care resources? This question is difficult because our pluralistic, liberal society has no consensus on a conception of distributive justice. In this article I focus on an alternative: Who shall decide how to ration health care, and how shall this be done to respect autonomy, pluralism, liberalism, and fairness? I explore three processes for making rationing decisions: cost-utility analysis, informed democratic decision making, and applications of the veil of ignorance. I evaluate these processes as examples of procedural justice, assuming that there is no outcome considered the most just. I use consent as a criterion to judge competing processes so that rationing decisions are, to some extent, self-imposed. I also examine the processes' feasibility in our current health care system. Cost-utility analysis does not meet criteria for actual or presumed consent, even if costs and health-related utility could be measured perfectly. Existing structures of government cannot creditably assimilate the information required for sound rationing decisions, and grassroots efforts are not representative. Applications of the veil of ignorance are more useful for identifying principles relevant to health care rationing than for making concrete rationing decisions. I outline a process of decision making, specifically for health care, that relies on substantive, selected representation, respects pluralism, liberalism, and deliberative democracy, and could be implemented at the community or organizational level.en
dc.formatArticleen
dc.languageenen
dc.sourceBRL:KIE/49923en
dc.subjectAccountabilityen
dc.subjectAdvisory Committeesen
dc.subjectAgeden
dc.subjectAutonomyen
dc.subjectCommittee Membershipen
dc.subjectConsensusen
dc.subjectCosts and Benefitsen
dc.subjectCultural Pluralismen
dc.subjectConsenten
dc.subjectDecision Makingen
dc.subjectDemocracyen
dc.subjectDue Processen
dc.subjectEvaluationen
dc.subjectFreedomen
dc.subjectGovernmenten
dc.subjectGuidelinesen
dc.subjectHealthen
dc.subjectHealth Careen
dc.subjectHealth Care Deliveryen
dc.subjectHealth Insuranceen
dc.subjectHealth Care Rationingen
dc.subjectInsuranceen
dc.subjectJusticeen
dc.subjectLifeen
dc.subjectMoral Policyen
dc.subjectPolicy Analysisen
dc.subjectPoliticsen
dc.subjectPresumed Consenten
dc.subjectPublic Participationen
dc.subjectPublic Policyen
dc.subjectQuality Adjusted Life Yearsen
dc.subjectResource Allocationen
dc.subjectRisks and Benefitsen
dc.subjectSelection for Treatmenten
dc.subjectStandardsen
dc.subjectTreatment Outcomeen
dc.subjectUtilitarianismen
dc.subjectValuesen
dc.titleAllocating Health Care: Cost-Utility Analysis, Informed Democratic Decision Making, or the Veil of Ignorance?en
dc.provenanceDigital citation created by the National Reference Center for Bioethics Literature at Georgetown University for the BIOETHICSLINE database, part of the Kennedy Institute of Ethics' Bioethics Information Retrieval Project funded by the United States National Library of Medicine.en
dc.provenanceDigital citation migrated from OpenText LiveLink Discovery Server database named NBIO hosted by the Bioethics Research Library to the DSpace collection BioethicsLine hosted by Georgetown University.en


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