Ethical Criteria for Allocating Health-care Resources - Authors' Reply

Publication Date


Document Type


Organizational Units

Sturm College of Law


Equitable healthcare, Rule of rescue


We agree with Tim Baker and Peter Baker that allocating scarce, lifesaving medical resources by ability to pay is presumptively “inequitable and even immoral”. First, our discussion focused on the allocation of resources such as organs and influenza vaccines in a pandemic that would be scarce even in a developed economy with adequate resources for health care. Second, our aim was to explore morally justified systems, not describe existing systems. We agree that allocation by ability to pay is “active and widespread”, especially in developing countries. However, since it is so clearly morally unjustifiable for absolutely scarce resources, we did not deem it worthy of discussion. Our criticism of allocation by first-come, first-served because it favours the wealthy applies even more forcefully to allocation by ability to pay.