Principles for Allocation of Scarce Medical Interventions
Publication Date
1-1-2009
Document Type
Article
Organizational Units
Sturm College of Law
Keywords
Complete lives system, Fair distribution, Allocation systems
Abstract
Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system-the complete lives system-which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.
Recommended Citation
Govind Persad, Alan Wertheimer & Ezekiel J. Emanuel, Principles for Allocation of Scarce Medical Interventions, 373 The Lancet 423 (2009).