Medicine, Health Care and Philosophy

, Volume 13, Issue 3, pp 237–246 | Cite as

Justice and the allocation of healthcare resources: should indirect, non-health effects count?

  • Kasper Lippert-Rasmussen
  • Sigurd Lauridsen
Scientific Contribution


Alternative allocations of a fixed bundle of healthcare resources often involve significantly different indirect, non-health effects. The question arises whether these effects must figure in accounts of the conditions under which a distribution of healthcare resources is morally justifiable. In this article we defend a Scanlonian, affirmative answer to this question: healthcare resource managers should sometimes select an allocation which has worse direct, health-related effects but better indirect, nonhealth effects; they should do this when the interests served by such a policy are more urgent than the healthcare interests better served by an alternative allocation. We note that there is a prima facie case for the claim that such benefits (and costs) are relevant—i.e. they are real benefits, and in other contexts our decisions can permissibly be guided by them. We then proceed to rebut three lines of argument that might be thought to defeat this prima facie case: they appeal to fairness, the Kantian Formula of Humanity as an End in Itself, and the equal moral worth of persons, respectively.


Health care rationing Health priorities Social justice and resource allocation Fairness Kantian ethics Indirect benefits Equality Scanlon Equal worth 



We thanks two anonymous reviewers of this journal for some very helpful comments.


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Institut for StatskundskabAarhus UniversitetÅrhus CDenmark
  2. 2.University of CopenhagenCopenhagenDenmark

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