Journal of Medical Ethics 47 (2):90-97 (2021)

Davide Fumagalli
University of Gothenburg
We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We demonstrate how this principle may take different forms, and show that a commitment to sustainability is supported by considerations internal to the ethical principles already guiding healthcare resource allocation. We also consider two objections. The first of these, we argue, is either based on implausible assumptions or begs the question, whereas the second can be adequately accommodated by the principle we propose.
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DOI 10.1136/medethics-2020-106644
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References found in this work BETA

Equality and Priority.Derek Parfit - 1997 - Ratio 10 (3):202–221.
Luck Egalitarianism.Carl Knight - 2013 - Philosophy Compass 8 (10):924-934.

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Citations of this work BETA

Sustainability, Equal Treatment, and Temporal Neutrality.Govind Persad - 2021 - Journal of Medical Ethics 47 (2):106-107.
Randomised Controlled Trials in Medical AI: Ethical Considerations.Thomas Grote - forthcoming - Journal of Medical Ethics:medethics-2020-107166.
Don’T Stop Thinking About Tomorrow.Alexander Guerrero - 2021 - Journal of Medical Ethics 47 (2):100-101.

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