Reflective disequilibrium: a critical evaluation of the complete lives framework for healthcare rationing.
J Med Ethics
; 47(2): 108-112, 2021 02.
Article
in English
| MEDLINE | ID: covidwho-985734
ABSTRACT
One prominent view in recent literature on resource allocation is Persad, Emanuel and Wertheimer's complete lives framework for the rationing of lifesaving healthcare interventions (CLF). CLF states that we should prioritise the needs of individuals who have had less opportunity to experience the events that characterise a complete life. Persad et al argue that their system is the product of a successful process of reflective equilibrium-a philosophical methodology whereby theories, principles and considered judgements are balanced with each other and revised until we achieve an acceptable coherence between our various beliefs. Yet I argue that many of the principles and intuitions underpinning CLF conflict with each other, and that Persad et al have failed to achieve an acceptable coherence between them. I focus on three tensions in particular the conflict between the youngest first principle and Persad et al's investment refinement; the conflict between current medical need and a concern for lifetime equality; and the tension between adopting an objective measure of complete lives and accommodating for differences in life narratives.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Social Justice
/
Health Care Rationing
/
Triage
/
Health Equity
/
Ethics, Clinical
/
Decision Making
Type of study:
Experimental Studies
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
J Med Ethics
Year:
2021
Document Type:
Article
Affiliation country:
Medethics-2020-106626
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