Abstract
Two kinds of priority setting problems are discussed in this chapter: setting research priorities and setting priorities in health care. They are not unrelated, but the criteria are not the same. Focus is then, as the title suggests, on setting priorities in health care. The discussion is based in the assumption that in the future there will be stem cell based treatments of many current disorders, and we may have to choose within them or between them and other treatments, since resources are scarce. I argue that new standards are not needed for such problems; current criteria and standards can be used. Several problems in applying them are related to lack of clarity of distinctions, such as the one between vertical and horizontal priority setting, differences between different health care systems and the value premises used as starting point.
Taking a human rights-based approach as a point of departure, some relevant dimensions are outlined and incorporated into a model – to be used in the practical handling of priority setting problems. Problems of uncertainties and knowledge gaps are highlighted and their relevance to priority setting is explored. A take home message is that some of the problems in applying this model are not related to the value premises or dimensions of the model, but to the lack of knowledge of efficacy, costs, prevalence, patient needs etc. Cases of increasing difficulty are distinguished and illustrated. Fair access is not only a problem from a global point of view, it is also a problem in many countries, since wealth is unevenly distributed. Social justice aspects – discussed in the recent ISSCR guidelines – conclude this chapter.
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Hermerén, G. (2011). Looking at the Future of Translational Stem Cell Research and Stem Cell-based Therapeutic Applications: Priority Setting and Social Justice. In: Hug, K., Hermerén, G. (eds) Translational Stem Cell Research. Stem Cell Biology and Regenerative Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-959-8_31
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DOI: https://doi.org/10.1007/978-1-60761-959-8_31
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