Abstract

The problem of allocation of health care is a special case of the issue of the proper distribution of society's resources. Health care is often treated as a problem of social justice for society as a whole. In contrast, I argue that it rests on a moral argument about what is rightfully owed to individuals. This has wide implications because, by using health care as a model, "Moral Triage" establishes guidelines for the scope of societal duties. ;"Moral Triage" begins by providing a concise definition of "health." Then, based on the assumption that each of us has some reason to respect the freedom and rationality of others, it argues for providing certain health care services. A central claim is that the basic interests of rational persons are in preserving rational agency and living at a reasonable level. If we take seriously the view that we ought to respect others and recognize the empirical fact that the realization of our basic ends requires certain prerequisites, then we are drawn to the conclusion that we have an obligation to provide an equitable way to help others satisfy these needs. In developing this view I appeal to a Kantian argument showing we have certain "true needs" which are nonforegoable. Then I show that certain health needs fall within this class. Sometimes satisfaction of nonforegoable needs requires the help of others, generating a duty of mutal aid. Finally, "Moral Triage" argues that the logical extension of this obligation is a duty of nonsacrificial collective cooperation, or a duty to combine personal efforts to satisfy fundamental health needs. ;"Moral Triage," like medical triage, prioritizes health care demands into levels of urgency. Unlike the medical procedure however, "Moral Triage" argues that the duty of nonsacrificial collective cooperation generates some ethical obligation. In classifying demands into needs, desires, and preferences, "Moral Triage" develops criteria for determining which requests qualify as morally justified. "Moral Triage," unlike many other allocation systems, is able to provide non-utilitarian justification for the provision and prioritization of services crucial to well-being of members of society.